Novo Nordisk’s annual results are out and they show the Danish pharmaceutical juggernaut earnt 290.4 billion Danish kroner last year (A$64 billion) — up 25%.
Novo Nordisk boasts 45 million customers using their drug Ozempic, which has caused a revolution in weight-loss treatment. Never before was there a drug that actually worked for weight loss. Now there is.
The Copenhagen-based company’s revenue was equal to 10% of Denmark’s GDP last year. They turned that DKK 290 billion in revenue into DKK 101 billion (A$22 billion) net profit, which was up 21% on 2023. Of course, pharmaceutical companies need to make profits on their hits because they also have a lot of misses.
And hot new drugs don’t remain hot and new forever. Every pharmaceutical company under the sun is rushing to develop its own drug that targets the glucagon-like peptide-1 (GLP-1). GLP-1 is a hormone that the body makes after eating.
The drugs are based on a hormone found in a lizard that eats only once every few months. Gila monster saliva contains a long-lasting GLP-1-like compound that was originally standardised and marketed for diabetes. However, that diabetes drug was shown to cause weight loss, which was when the market blew up.
Obesity is arguably the biggest health phenomenon worldwide. The global prevalence of obesity more than doubled between 1990 and 2022 to 16%.
The proximate cause of obesity is eating too much food. But that’s like saying the cause of the Titanic sinking was water getting into the hull. What causes people to eat too much? What has changed? What’s the iceberg in our analogy?
- Is it simply the low cost of food, making it more abundant than ever before in history? The problem with this analogy is some rich countries remain thin (France especially, Japan too).
- Is it the way new snack foods are engineered? Cheese corn chips are designed to be so palatable you don’t stop eating them until the packet is empty, whereas you don’t get that effect with a pack of almonds.
- Is it some new ingredient? Seed oils have exploded as a source of calories; fructose is also more abundant now.
- Or is it some environmental effect? The geographic spread of obesity shows patterns, for example, a relationship with altitude (people in the high mountains are thinner). Could an environmental contaminant that flows downstream be to blame?
Now we know that tackling GLP-1 can help reverse obesity, scientists are looking for causes that implicate GLP-1.
But while basic research continues slowly, a flood of Ozempic competitors are rushing to market. Some of them may work even better than Ozempic at causing weight loss. Mounjaro, from a company called Eli Lilly, is already on the market, but Pfizer has a drug under development too. It’s a pill, not an injection, which will likely make it more attractive. Novo Nordisk itself has a new and improved drug under development. Amycretin saw some participants lose 22% of their body weight in an early trial, though it is some years from being ready for the market.
Could Ozempic be overtaken? Novo Nordisk might do well to consider the fate of another Nordic firm: Nokia. The Finnish company dominated the early days of mobile telephony, but their early mover advantage did not help once big American and Korean firms entered the fray. Apple, Samsung and Google now dominate the market for mobile phones and Nokia has retreated to mostly providing back-end technology.
For Denmark that would be an economic problem, but for the world the prospect of better GLP-1 agonists is extremely enticing. The drugs’ side effects include a small list of negatives and a long list of surprising upsides.
A 2025 study published in Nature Medicine found “use was associated with a reduced risk of substance use and psychotic disorders, seizures, neurocognitive disorders (including Alzheimer’s disease and dementia), coagulation disorders, cardiometabolic disorders, infectious illnesses and several respiratory conditions”.
Evidence shows people on GLP-1 are less likely to overdose on opioids. Using GLP-1 drugs as a treatment for addiction might alone be reason to encourage them.
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