(St. Martin’s Press, 287 pages)
From Hollywood stars who microdose the drug to people who were once hundreds of pounds overweight, many people have found Ozempic and its imitators to be game-changers. Ozempic has also been a game-changer for Novo Nordisk, the Denmark-based company that brought the drug to market at a time when its fortunes were failing.
In the 1990s the company had what was internally described as “an innovation problem,” Aimee Donnellan explains in this deep dive into the history of Ozempic and similar drugs. But Novo Nordisk had a promising project, a drug to help people with diabetes. It was a synthetic version of a gut hormone called GLP-1 (glucagon-like peptide 1), discovered through research on anglerfish caught in Boston Harbor, and it proved a powerful means of lowering blood sugar in people with diabetes — and, fortuitously, of helping these same people lose weight.
The weight loss industry has long been profitable in America, and it was clear there was money to be made. Ozempic was used for weight loss off-label; word spread and so did its use.
Several researchers did the work that would lead to this breakthrough, among them Danish chemist Svetlana Mojsov, whose work preceded the approval of Ozempic by more than a decade. But science is as competitive as politics, especially when its result is lucrative, and Donnellan takes up the banner of Mojsov here, presenting her as a woman done wrong by men who attempted to take credit for her work (and might have succeeded had she not kept detailed notes).
The story of the behind-the-scenes infighting seems incongruent with other parts of Off the Scales, which can’t seem to decide what sort of book it wants to be.
Donnellan, a Reuters columnist who covers the pharmaceutical industry, begins with the story of a marketing specialist in Michigan who lost more than 100 pounds on Ozempic and saw her world change. At work Sarah started getting promotions, even though her performance was the same. “At her parents’ house, her father, previously loving but somewhat absent, seemed to take a newfound interest in her. She could visibly see how proud he was of her. Now 34, she had never before seen this look on his face.”
Through Sarah’s story and others, Donnellan offers a picture of lives changed. Formerly invisible people gain social status as their bodies shrink and gain peace as the “food noise” that had dominated their lives quiets.
She also shares disturbing stories, like that of a Los Angeles hairstylist who lost weight on Mounjaro, albeit while also taking an anti-nausea medication because she constantly felt sick. After four months a friend told her she looked gaunt; she started getting facial injections to restore volume to her face. (Donnellan notes that not everyone can afford dermal fillers.) Moreover, Donnellan writes, “for a small minority of GLP-1 users, the side effects are so severe that they may wish they never even heard of the medication.”
Donnellan presents these and other stories without judgment. Toward the end she touches on what may be the most underreported part of the story: how these drugs will affect the culture as people who use them change their eating habits (several writers have tried to tackle this, as Kari Jenson Gold did in a First Things essay titled “The Night Ozempic Came to Dinner”). Donnellan suggests that changed eating patterns may spell doom for fast food restaurants and the makers of ultra-processed food, and says weight-loss drugs may also affect alcohol consumption.
But we are new to the GLP-1 world and we don’t know the drugs’ effect decades out. Donnellan’s examination, while sometimes disjointed and uneven in its readability, raises interesting questions. B-
Featured Photo: Off the Scales, by Aimee Donnellan