Weighing up Ozempic

ABC Listen, podcasts, radio, news, music, and more.

What do Rasputin, Tupac, and Pharaoh Ramses III have in common?

No, it's not the weirdest boy band ever.

They all met their end at the hand of an assassin.

From seizing power to silencing dissidents, Assassins unpacks the moments in which someone decides that murder is the move.

Search Assassins with Aslan Bahari on the ABC Listen app or wherever you get your podcasts.

This episode of If You're Listening first aired in September 2023.

This podcast was produced on the lands of the Wabakal and Gadigal people.

What do you think the biggest company in Denmark is?

Given the ubiquity of their outrageously overpriced plastic bricks, I would have guessed Lego.

But I'd be wrong.

No, this company's market cap is 10 times larger than Lego's.

Its market cap is now actually larger than Denmark's annual GDP.

It's a pharmaceutical company called Novo Nordisk.

After a century plugging away making insulin and other drugs to treat diabetes, it suddenly rocketed up to become the most valuable company in Europe.

And its unbelievable success is thanks to one drug, semaglutide, more commonly known as Ozempic or Wegovi.

It's a drug used to treat type 2 diabetes, but it's not just diabetes patients who want it.

Talk about Ozempic.

Finally.

Girl!

The way I feel free.

People who want to lose weight are clamoring for it too.

You're the reason I'm on Ozempic.

Right, I kind of like peer-pressured you into doing it.

Celebrities like Elon Musk and Amy Schumer have confirmed the drugs are part of their weight loss regimes.

And the reason it's driven Novonodisc to such stratospheric heights is, as opposed to weight loss drugs of the past, this one seems to actually

work.

I literally lost 10 pounds in the first week and I've lost 90 pounds.

The world is in the grips of a fairly sudden obesity epidemic.

Half of the global population is expected to be overweight or clinically obese by 2035.

On today's episode, is semaglutide the light at the end of the tunnel after a century of dangerous and expensive weight loss experimentation?

Or is it just going to create a whole new set of problems?

I'm Matt Bevan

and this is If You're Listening.

The Marmo Entertainers with music to charm you.

If you listen to a lot of radio in America in the early 1930s, there's a reasonable chance that you would have heard this.

There's an important war going on.

The war against ugly, energy-sapping, excess fat.

This was a syndicated radio show broadcast across the country to tell women they were getting too fat.

But how would you feel if you were 40 and weighed 175 with a husband who couldn't stand fat women?

When I was slender, he used to rave about every new outfit I got.

and insist on taking me out to dance somewhere.

Now he doesn't even notice when I get a new dress.

In between jaunty tunes, little radio plays were broadcast about women who were embarrassing the men in their life.

Well, you can't deny you were ashamed of having a hefty sister.

But the solution wasn't a diet.

Modern women don't go on diets.

Not if they have any sense.

Besides, it never did me much good.

I'll say it didn't.

So, what is the solution?

Marmola prescription tablets.

Pop it in water with some sugar and licorice and take three spoonfuls a day to help you lose weight.

A miracle drug.

Marmola ran ads in newspapers for decades that were, quite frankly, some of the most misogynistic things I've ever seen.

She was too fat.

Her husband was ashamed of her.

Nobody loves a fat girl.

But America had a brand new broadcast regulator, and it was trying to shut this radio show down.

The modern, right way to treat excess fat, the way doctors do it.

They weren't trying to shut it down because the ads were cruel, they were trying to shut it down because marmolar wasn't actually recommended by doctors or based on modern science.

The company kept its recipe secret, but scientists managed to reverse-engineer the formula by testing the tablets.

It was made of seaweed, salt, ground-up pig thyroid, and a powerful and dangerous laxative.

The modern science was evacuation of your food before your body got a chance to digest it.

The regulator took Marmola all the way to the U.S.

Supreme Court.

It took years, but eventually the Marmola entertainers were taken off the air.

This was just one in a long line of harmful medications being marketed for weight loss.

After World War II, companies started selling amphetamines to help people lose weight.

You can still lose ugly fat fast.

Get calometric reducing formula at your drugstore.

While promising that the pills contained no dangerous drugs, no hormones.

By 1970, it was pretty well understood that the side effects of weight loss drugs weren't worth the benefits.

But even if the drugs weren't working, the shaming continued.

Many people thought that bullying overweight and obese people was in their best interests, as it would convince them to lose weight.

People were pummeled with humiliating, degrading, and cruel messaging about weight loss without much in the way of actual help.

TV stories, including on the ABC, included endless montages of the disemheaded bodies of overweight people, often accompanied by tuba music.

The ABC used this tuba music at a weight loss meeting in Sydney where housewives were competing to lose weight.

The women who had gained weight that week stood up the front to sing an unbelievably humiliating song.

Unsurprisingly, humiliating people didn't help them lose weight, it just made them feel worse.

People continued gaining weight, and in the 1980s, the rate of obesity accelerated until experts started calling it an epidemic.

By 2009 a quarter of Australian adults were obese according to the World Health Organization's definition of the term.

By 2016, a quarter of adults across all high-income countries fit that definition too.

It's essentially caught the medical world by surprise.

But defining obesity is a tricky thing.

The WHO uses the body mass index or BMI which is based on on weight and height.

But that means that Arnold Schwarzenegger, at the height of his bodybuilding career, was obese.

So are most NRL and NFL players.

We do know that being obese can put you at higher risk of serious health problems like heart disease, diabetes, and stroke.

About half of adults in developed countries say they are trying to lose weight, both for health reasons and because of the insane scrutiny and humiliation that we subject overweight people to.

But it's hard.

And the prevailing theory on why it's so hard is the set weight theory.

Basically, this theory says that mostly thanks to your genetics, you have a set weight that your body thinks you should be.

British physiologist Dr.

Simon Cork says when you try and reduce your weight below that point, your body will actively work against you.

But he thinks that the person is in a starvation mode, so it works to bring your body weight back up to what it thinks is normal.

We have evolution to thank for this.

Humans spent 300,000 years as hunter-gatherers at serious risk of being wiped out by famine.

We also need more energy than our monkey ancestors, thanks to our very, very large

brain.

So our bodies store energy.

When we start to diet, our body thinks the famine has hit and does everything it can to try and make us regain weight.

Your metabolism slows down, so weight loss, the burning up of stored fat, is slowed down also.

That basically means it can be incredibly hard to lose weight.

As the weight comes off, you start to get hungry again, your motivation starts to go down, you start to feel tired and lethargic.

That is your body bringing your working to bring your body weight back up.

Thanks evolution.

Clearly, for 100 years, people have seen that there is a demand for an effective product to help people people lose weight.

And a lot of money has been made scamming people who are looking for a solution.

That's why when a product came along that actually seems to work, it's led to stratospheric stock market speculation.

Semaglutide drugs like Azempic are something the market has been waiting for for more than a century.

Danish pharmaceutical company Novonordisk got their start in 1923 producing insulin.

Their only interest in obesity was in how it related to diabetes.

In 1982, they began to experiment with a hormone called GLP-1.

They took it from the pancreas of pigs and then gave it to pigs with diabetes.

This seemed to be working.

They then started testing it on humans.

They gave the humans a dose of the hormone and then asked them to eat a meal so they could measure what happened to their blood glucose levels.

But there was a problem.

The test subjects couldn't finish the meal.

They weren't hungry.

The drug was working to treat diabetes.

It slowly releases insulin from the pancreas.

But incredibly, they'd also stumbled upon an interesting side effect.

The drug made people not want to eat.

It took three decades to get the drug to market, but in 2017, Novonordisc semaglutide was approved for use in diabetes patients under the name Ozempic.

In the United States, where advertising prescription drugs is totally cool, it sold with this jingle.

Oh!

Oh!

Ozempic!

But Ozempic did not become a household name until a little article was published in the New England Journal of Medicine in March 2021.

The journal article said that people who were given a higher dose of the drug lost 15% of their body weight in a year and a half compared with 2% on a placebo.

The research was conducted on patients who also changed their diet and exercised more.

So the diet and exercise are what are causing the weight loss.

But Dr.

Simon Cork says the drug stopped their bodies from making them feel starving and trying to bring their body weight back up.

It stops the hunger that is associated with weight loss.

And this brings about a really rapid reduction in weight.

I think what's hoped is that when patients go on this drug and they lose the weight for the two years that they're on it, it will be enough of a motivation to maintain the lifestyle changes that have occurred.

The media caught on that there was a new drug to treat obesity.

Azempic, alongside its weight loss equivalent, Wagovi, became the most in-demand drug in the world.

When something like this happens, there's always winners winners and losers.

The winners are the pharma companies.

Azempic is in such demand, it started a global pharmaceutical arms race bigger than anything seen since the COVID vaccine rollouts.

Now you can with once weekly Manjaro.

Rival company Eli Lilly has released a similar drug.

Plus, people taking Manjaro lost up to 25 pounds.

And now it and Novonodisk are the biggest pharma companies in the world.

The high demand from people hoping to lose weight has led to shortages for people with diabetes, causing a bit of Biffo over who deserves the drug more.

There is now a shortage.

Apparently all the celebrities are using them to lose weight.

First pharmacy I went to, they only give it to their type 2 diabetics.

Miss Kardashian or whoever, please, I need my meds.

And then there's the side effects.

Nearly half of people taking this drug get nausea.

About a quarter experience diarrhea, vomiting, and or constipation.

Do I feel like crap?

Even though I look gorge, I do not feel good on the inside.

Even the inventors say that most people stop taking it after a couple of years because the lack of interest in food makes them miserable.

And a study found that a year after going off the drug, people regain, on average, two-thirds of the weight they lost.

And just wait till you see the price tag.

Taking the drug for a year will cost some people $20,000.

In the last century, people have spent literally billions of dollars on methods of weight loss that do not work.

Now,

even though there's one that seems to work,

it's still not going to be cheap.

When Alexander Fleming was trying to cure the flu, he stumbled upon penicillin.

When Pfizer scientists were trying to cure heart disease, they stumbled upon Viagra.

And when Danish scientists were trying to cure diabetes, they stumbled upon a trillion dollars.

Sorry, a weight loss drug.

But that may not be all that it can do.

Some people using semaglutide have found that their other addictive impulses have begun to subside.

In addition to losing weight, they say they've lost their addiction to smoking, drinking, shopping, and nail biting.

Proper clinical trials haven't been done on humans yet, but this has been backed up with research on monkeys, although I don't think that the monkeys are shopaholics.

If it turns out to be true, it would make Azempic and drugs like it one of the biggest medical breakthroughs of the century.

A treatment for three of the most serious modern health dilemmas: diabetes, obesity, and addiction.

There's got to be a catch, right?

So, this episode first aired in September 2023.

The price of Ozempic has come down a fair bit since then, but it can still cost upwards of $2,000 a year.

While there hadn't been any trials in humans about using semiglutide to treat addiction at the time, there now have been a few, and the results are promising.

Novo Nordisc, by the way, has had some pretty dramatic ups and downs since this episode first aired, but it's still the biggest company in Denmark by market capitalisation.

This episode was written by me, the series producer at the time was Yasmin Parry.

Next Tuesday's episode is a new chat with my colleague Mark Finnell.

It's about the time that the US Navy teamed up with a very unlikely ally, the Mafia.

And keep your questions coming for our QA episode.

We've already had some fantastic ones come in.

If you want us to answer your question, record it as an audio message and email it to us at ifyourelistening at abc.net.au.

I'll catch you on Tuesday.