Stephen Fry thought things were too good to be true.
Having spoken to his US-based doctor in 2019 about a new drug that promised to help him lose weight by reducing his appetite, the nation’s favourite public intellectual thought he’d give it a go.
“The first week or so, I was thinking, ‘This is astonishing,’” he told the podcast Ruthie’s Table 4 earlier this year. “‘Not only do I not want to eat, I don’t want any alcohol of any kind. This is going to be brilliant.’”
However, within a week of trying the injection-based drug, Fry started to feel some unpleasant side effects. “I started feeling sick, and I started getting sicker and sicker and sicker,” he said. “I was literally throwing up four, five times a day and I thought, ‘I can’t do this.’ So that’s it.”
Fry soon came to the conclusion that even a miraculous loss of weight was not worth the constant nausea that the drug in question, called Ozempic – generic name ‘Semaglutide’ – was leaving him feeling, and he soon stopped taking it.
Five years on, however, and Fry’s prompt abandonment and vicious bouts of vomiting has not stopped the Novo Nordisk-made drug from becoming a sensation. Along with Wegovy – which is also made by Novo and also uses Semaglutide as the active drug – they are being heralded as a solution to mushrooming levels of obesity and type 2 diabetes across the world, attracting plaudits from the diverse worlds of healthcare, politics, finance, and even Hollywood.
This latter camp of white smiles and immobile face muscles is – perhaps unsurprisingly – also partly responsible for its spiralling popularity, after high profile endorsements from A list celebrities like Oprah Winfrey and Elon Musk inserted the drug into the cultural zeitgeist.
The alacrity with which much of image-conscious Hollywood have taken to the appetite suppressant even opened up a whole new line of work for California’s cosmetic surgeons, who are increasingly being called upon to fix the ‘saggyness’ that the drug leaves behind.
This celebrity fuelled fascination and its potential to do clinically what concerning fads have claimed to do through homeopathy (or worse), has also prompted mania on social media, earned it the status of the world’s first “viral drug”.
What are Ozempic and Wegovy how effective are they?
Ozempic and Wegovy both use the same active ingredient – semaglutide – but they have different use-approved use cases in the UK. Whereas Ozempic is NICE-approved for lowering blood sugar and regulating insulin in Type 2 diabetes, Wegovy is approved for more general use as a weight loss-aiding drug.
Both have been clinical successes, not just for weight loss but also for associated conditions like heart disease.
“The clinical trial data shows that Wegovy can be an effective options for people living with obesity, with data demonstrating benefits beyond weight management including reduced risk of cardiovascular events amongst people living with obesity,” says Dr Stuart Flint, Associate Professor at the University of Leeds.
Having been approved for use in the NHS on 5 January, it works by sending signals to the area of the brain that is responsible for regulating your appetite, essentially tricking your body into thinking it’s full and doesn’t and reducing your preference for high-fat foods.
For now, it is only available to people who have been clinically diagnosed as living with obesity and who have tried other non-medicinal interventions. As Dr Flint also points out, “Other behavioural changes including physical activity are [also] key components of pharmacotherapy [the treatment of an illness with drugs] for optimal outcomes.”
There is, Dr Flint adds, a clear rationale for the strict preconditions on whom the drug is available to because”Wegovy and Tirzepatide [another weight loss drug] are clinically tested for people living with obesity only”.
But with over a quarter of the UK population currently living with obesity, even with those tight guardrails over who can take it, it is available to a significant proportion of British adults, prompting well-documented shortages across Britain.
The investment case for Novo Nordisk
These supply issues have been felt on a global level. Still, they haven’t prevented maker Novo Nordisk, the Danish pharmaceutical giant responsible for making the first-ever insulin pen device, from a blistering financial performance.
An earlier launch in the US, where the drug was first made available for clinicians to prescribe in 2021, means Novo Nordisk has already benefited from a major rally and now claims to have an 85 per cent share of the global obesity care market.
Profit at the company jumped a neck-breaking 51 per cent in its most recent annual results reported in January. And, since the start of 2021, when semaglutide first started to enter investors’ consciousness, the firm’s share price is up over 300 per cent.
These blistering numbers have cemented its status as Europe’s most valuable company and given it a market capitalisation that is larger than the entire Danish economy.
According to Susannah Streeter, head of money and markets at Hargreaves Lansdown, the latest data shows few signs that this ascent will hit a ceiling in the near future.
“Sales of Wegovy nearly doubled in the US in the first quarter. The market opportunity for this new generation of obesity treatment has the potential to support strong growth for many years,” she says. “Novo can boast of attractive end markets, particularly given the obesity epidemics in many countries. Also, the way it runs a tight ship operationally should be admired as it has enabled operating profit margins to stay consistently above 40 per cent.”
As ever, though, there are hurdles and potential bear traps on the horizon for the firm.
“Potential restrictions on usage and marketing, as well as emerging competition are risks to watch out for,” says Bartlett. “There are smaller rivals, developing similar weight loss products, which could eat into market share further ahead.”
Shareholders who have benefited from a huge surge in the company’s valuations could also be victims of their own success, she adds, as “the likelihood of ups and downs [is] elevated given its current valuation”.
The dangers of a viral drug
A further area for concern for the Novo Nordisk top brass is its status as one of the world’s first “viral drugs”.
Its capacity to rapidly reduce weight and its celebrity endorsements have given it a huge amount of cultural relevance, prompting Tiktok trends about the remedy and social media users to document its ability to help them lose weight.
This, Dr Flint warns, is particularly dangerous given Wegovy has only been tested clinically on people with obesity. “There is no clinically proven data that the products are safe for use amongst people who have not been clinically diagnosed with obesity.
“People who are not living with obesity should not be using these products,” he says, reserving particular scorn for lay social media users promoting it online. “Addressing the messages and apparent belief, caused in some part by influencers and celebrities using these products when there are not living with obesity, is very important.”
The drug’s viral success has further aggravated the aforementioned supply shortages, resulting in type 2 diabetes patients losing out on their prescribed medicine and forcing charities to issue guidance to concerned patients.
The supply squeeze is an issue Novo is working to remedy, but it has warned that patients and healthcare professionals should expect intermittent supply shortages running into 2025.
For now, demand might only be tampered by Stephen Fry taking to another podcast to complain about his side effects in more gory details.