Some call it a miracle drug, others warn of its potentially damaging long-term effects on people and society.
In this episode, we'll look at the history of this drug, how it works, why it's popular, and what it reveals about American food and healthcare systems.
[00:00:05] Hello, hello hello, and welcome to English Learning for Curious Minds, by Leonardo English.
[00:00:11] The show where you can listen to fascinating stories, and learn weird and wonderful things about the world at the same time as improving your English.
[00:00:20] I'm Alastair Budge, and today we are going to be talking about a drug called Ozempic.
[00:00:26] To its greatest proponents, it is a miracle drug that will save millions of lives; to its critics its true dangers will only be understood in years to come.
[00:00:37] So in this episode we’ll cover the history of the drug, how it works, why it is so popular, and what it tells us about the American food and healthcare systems.
[00:00:48] And, the final point before we start is to say, just in case it wasn’t obvious, that I am not a doctor, this is not medical advice, so please do not take it as such.
[00:00:59] OK then, with that little and I hope superfluous disclaimer out of the way, let’s get going and talk about Ozempic.
[00:01:08] It is August at the moment, and millions of Americans will come to Europe for their summer holiday.
[00:01:15] For many, it will be an eye-opening experience. Paris, Rome, Barcelona.
[00:01:22] Museums, art galleries, restaurants, small cobbled streets.
[00:01:27] For some, it might even be the first time that they have left the United States.
[00:01:33] And judging by posts on social media that tend to increase at this time of year, many will make a startling discovery.
[00:01:41] They travel through Europe for a week or so, they drink coffee and eat pain au chocolats or filled pastries for breakfast, they eat pizza, pasta, cheese and meat; they drink beer and wine, they don’t do any exercise for the duration of their trip.
[00:01:57] Yet when they get back home they step on the scales and are met by a surprising revelation.
[00:02:05] Despite having eaten and drunk to their heart’s content, and having made absolutely no effort to stay in shape, they have lost weight.
[00:02:16] They then rush to social media to complain that “American food is poison”, and list the reasons that American food is so unhealthy, and why the US has one of the highest obesity rates in the world.
[00:02:30] Now, to state the obvious, obesity is a global problem, Europeans, Asians, Africans, Australians and South Americans are getting fatter and fatter too, and obesity rates tend to increase as a country develops economically.
[00:02:46] But America is unfortunately unique in the size and scale of its obesity epidemic.
[00:02:54] As of the last CDC report, 41.9% of American adults are obese, and a further 31.7% are overweight.
[00:03:06] To put it another way, only 26% of American adults are not either overweight or obese.
[00:03:15] And perhaps even more frightening is the situation with children.
[00:03:20] 20%, or 1 in 5 American children aged between 10-17, are obese.
[00:03:28] Even in very young children, those between 2 and 5 years old, 13% are obese.
[00:03:36] As I’m sure you already know, children who are overweight and obese have difficulty losing this weight as adults, and are much more likely to be plagued by health problems during their lifetime.
[00:03:49] It is a big problem, and it’s no surprise that childhood obesity has been called one of the greatest public health challenges of the 21st century.
[00:04:00] It is a challenge, because decades of doctors and public health officials telling parents to make sure that their children eat healthy food and get enough exercise, or telling adults that this is what we need to do to lose weight, well it simply hasn’t worked.
[00:04:16] It requires a behaviour change, it requires people to change their habits.
[00:04:22] And people don’t like doing that unless they absolutely have to.
[00:04:28] But, and it is a big but, what if there were a way to get people to change their behaviour?
[00:04:36] What if there were a way to get people to eat less?
[00:04:40] What if you could make someone want to eat less?
[00:04:45] There is already one way: gastric band surgery, where an operation is performed and a sort of knot is tied around the stomach, which restricts the amount of food that someone can eat.
[00:04:58] This procedure is generally reserved for people with severe obesity. After all, it is an operation that literally cuts someone open and ties a band around their stomach.
[00:05:11] It is an extreme solution for a problem where there is also a theoretically simple solution: eat less and exercise more.
[00:05:21] But in December of 2017 a new drug was approved that claimed to be a simple solution for this extreme problem. It was produced by a Danish pharmaceutical company and was given the brand name Ozempic.
[00:05:40] It was first approved for use with people with Type 2 Diabetes, which is the type of diabetes linked to being overweight or not doing enough exercise.
[00:05:50] And in 2021 it was approved for use with people with obesity under the brand name Wegovy - Wegovy and Ozempic are the same drug, just sold in slightly different doses and under different names.
[00:06:05] To avoid confusion, going forward I’ll use the term Ozempic to refer to both of them.
[00:06:11] And, in simple terms, in layman’s terms we could say, the drug works by making you feel full for longer, and reducing the urge to eat.
[00:06:22] No expensive surgery required, just a simple injection into the thigh or arm or abdomen once a week.
[00:06:31] And, in all of the extensive clinical trials, the drug has shown that it works remarkably well.
[00:06:40] People who take Ozempic want to eat less, so they eat less.
[00:06:45] And unsurprisingly, they lose weight, 15% of their body weight on average.
[00:06:53] And because they lose weight, they reduce the probability of cardiovascular disease, heart failure, all of these nasty health conditions that you are more likely to suffer if you are overweight or obese.
[00:07:06] Hallelujah, some health commentators were saying.
[00:07:09] This was literally a miracle drug.
[00:07:13] As if by magic, it tricked overweight and obese patients into feeling like they were full so that they didn’t want to eat as much, so they lost weight.
[00:07:23] As word spread, more and more doctors started recommending it to overweight and obese patients.
[00:07:31] After all, it worked, and it was cheap.
[00:07:35] Well, sometimes it was cheap. For Americans with insurance, the cost could be as little as $25 a month, without insurance it can rise to over $1,000 a month.
[00:07:47] But it was a small price to pay to shed some pounds and return to a more healthy weight.
[00:07:55] And in 2023, just last year, the American Academy of Pediatrics recommended prescribing weight-loss medication such as Ozempic to all obese children over the age of 12.
[00:08:11] After all, why not?
[00:08:13] Childhood obesity is a massive problem, there are decades of evidence that a “simple” solution of recommending children get more exercise and eat more healthily is ineffective.
[00:08:25] And if there is a drug that can help obese children lose weight and therefore have fewer health problems later on in life, well that must surely be a good thing.
[00:08:37] And it wasn’t just for obese kids.
[00:08:40] Ozempic also became increasingly used by adults who were not obese, but who simply wanted to lose weight.
[00:08:49] Celebrities such as Elon Musk and Oprah Winfrey posted about how the drug had helped them lose weight, and the hashtag Ozempic quickly gained over half a billion views on social media.
[00:09:03] To the producers of Ozempic, the company behind the miracle drug, this was of course music to their ears.
[00:09:11] The share price increased by almost 60 times, the Danish company that makes it is now bigger than the entire Danish economy, and this company, the company that produces the drug, was responsible for the entire growth of the Danish economy in 2023.
[00:09:31] It made record profits, and paid a whopping $2.3 billion in income tax to the Danish state, equivalent to almost $400 for every Danish citizen. And this was driven primarily by the sales of its weight-loss drugs.
[00:09:50] Obviously this was good news for Novo Nordisk, the company behind the drug, it was good news for Denmark and its citizens, who were almost literally having dollars transferred from American waistlines to their pension pots and already generous healthcare systems.
[00:10:08] And it was good news for the American patients, who were shedding pounds in record numbers.
[00:10:15] Or was it?
[00:10:17] As you might imagine, there are many prominent voices that have questioned Americans’ appetite for Ozempic.
[00:10:24] Firstly, there are criticisms of the way the drug works, and what it does to people. To some, it reportedly alters the way that food tastes, and results in people losing all pleasure in eating.
[00:10:38] Secondly, there is the criticism that the long-term effects of Ozempic are not yet fully understood.
[00:10:45] It has approval from the FDA, the Food and Drug Administration, but it is new, and rushing to recommend putting children as young as 12 on the drug, well that is irresponsible.
[00:10:59] But the third category of criticism is perhaps the most important.
[00:11:04] And that’s that Ozempic is not a cure. It doesn’t go to the root of the problem.
[00:11:11] To lose weight with Ozempic, you need to take it continuously, it isn’t like a medicine where there is a treatment period of 1 or 2 months, or even a year and then its work is done. Many patients will need to remain on it forever, and many Ozempic users report gaining weight as soon as they stop taking the drug.
[00:11:32] If a 12-year-old starts taking Ozempic, it is unlikely that they will ever be able to stop taking it.
[00:11:40] When you think about the way the drug works, this is kind of obvious; it doesn’t make permanent changes to your body, it simply reduces your appetite while you are taking it. And as soon as you stop taking it, your appetite returns to its normal levels, you eat more, and surprise surprise, you will probably end up gaining weight.
[00:12:03] The root of the problem, to the greatest critics of Ozempic, is both the unhealthy nature of American food and the sedentary lifestyle that most Americans lead.
[00:12:14] To go back to the start of the episode, you heard about the classic and perhaps even now cliche experience of the American tourist in Europe who finds that they lose weight after a couple of weeks in Europe eating pastries, pizza and pasta and drinking wine.
[00:12:31] And when they return to the US, and return to American food, they find that they put that weight right back on.
[00:12:39] As you may know, American food is somewhat unique in its ultra-processed nature. 73% of food in the American market is ultra-processed, with the average American getting 60% of their daily calories from ultra-processed foods.
[00:12:57] And as I’m sure you know, ultra-processed foods are really bad for you. They are linked with all sorts of health conditions, and have been expressly designed to be addictive.
[00:13:09] That’s exactly why doctors and public health professionals telling people to “eat better” or “eat less” has been so ineffective; the majority of American food is ultra-processed, and when you eat ultra-processed food, it is hard to eat it in moderation.
[00:13:28] The criticism therefore is that Americans are being “poisoned” and “fattened up” by unhealthy food AND they are then being sold the “cure” in the form of Ozempic.
[00:13:41] So, what’s the solution?
[00:13:43] Well, one proposed solution is to make American food healthier by increasing regulations on ultra-processed food producers.
[00:13:52] If we could just remove the most unhealthy elements from the average American diet, this would be a start. After all, lots of the most dangerous ingredients in American food are simply not allowed in large parts of the rest of the world.
[00:14:08] But, clearly, this is easier said than done.
[00:14:12] American food manufacturers wield vast power and spend huge amounts of money each year on lobbyists and consultants to influence government policy. Big food, as it is called, is simply too big and too powerful. There is too much money at stake, too many jobs, too many palms being greased for anything to be done about it.
[00:14:36] And talking of money at stake, pharmaceutical companies, such as the manufacturer of Ozempic, have a huge financial interest in making sure that they have an obese population to prescribe medicine to.
[00:14:50] A United States of salad-eating joggers with 32-inch waists would be a disaster for the pharmaceutical industry.
[00:14:57] Fortunately for Novo Nordisk, fortunately for American food manufacturers and fortunately for Danish pensioners, there are no signs that Americans have any intention of putting down the bag of Cheetos or extra large sodas.
[00:15:12] And for as long as that’s the case, Ozempic will continue to reign supreme.
[00:15:19] OK then, that is it for today's episode on Ozempic.
[00:15:23] I hope it's been an interesting one, and that you've learnt something new.
[00:15:27] We are actually going to be following up this episode with another episode on another, controversial new invention, e-cigarettes.
[00:15:35] So keep an eye out for that one coming out next week.
[00:15:39] You've been listening to English Learning for Curious Minds, by Leonardo English.
[00:15:43] I'm Alastair Budge, you stay safe, and I'll catch you in the next episode.
[00:00:05] Hello, hello hello, and welcome to English Learning for Curious Minds, by Leonardo English.
[00:00:11] The show where you can listen to fascinating stories, and learn weird and wonderful things about the world at the same time as improving your English.
[00:00:20] I'm Alastair Budge, and today we are going to be talking about a drug called Ozempic.
[00:00:26] To its greatest proponents, it is a miracle drug that will save millions of lives; to its critics its true dangers will only be understood in years to come.
[00:00:37] So in this episode we’ll cover the history of the drug, how it works, why it is so popular, and what it tells us about the American food and healthcare systems.
[00:00:48] And, the final point before we start is to say, just in case it wasn’t obvious, that I am not a doctor, this is not medical advice, so please do not take it as such.
[00:00:59] OK then, with that little and I hope superfluous disclaimer out of the way, let’s get going and talk about Ozempic.
[00:01:08] It is August at the moment, and millions of Americans will come to Europe for their summer holiday.
[00:01:15] For many, it will be an eye-opening experience. Paris, Rome, Barcelona.
[00:01:22] Museums, art galleries, restaurants, small cobbled streets.
[00:01:27] For some, it might even be the first time that they have left the United States.
[00:01:33] And judging by posts on social media that tend to increase at this time of year, many will make a startling discovery.
[00:01:41] They travel through Europe for a week or so, they drink coffee and eat pain au chocolats or filled pastries for breakfast, they eat pizza, pasta, cheese and meat; they drink beer and wine, they don’t do any exercise for the duration of their trip.
[00:01:57] Yet when they get back home they step on the scales and are met by a surprising revelation.
[00:02:05] Despite having eaten and drunk to their heart’s content, and having made absolutely no effort to stay in shape, they have lost weight.
[00:02:16] They then rush to social media to complain that “American food is poison”, and list the reasons that American food is so unhealthy, and why the US has one of the highest obesity rates in the world.
[00:02:30] Now, to state the obvious, obesity is a global problem, Europeans, Asians, Africans, Australians and South Americans are getting fatter and fatter too, and obesity rates tend to increase as a country develops economically.
[00:02:46] But America is unfortunately unique in the size and scale of its obesity epidemic.
[00:02:54] As of the last CDC report, 41.9% of American adults are obese, and a further 31.7% are overweight.
[00:03:06] To put it another way, only 26% of American adults are not either overweight or obese.
[00:03:15] And perhaps even more frightening is the situation with children.
[00:03:20] 20%, or 1 in 5 American children aged between 10-17, are obese.
[00:03:28] Even in very young children, those between 2 and 5 years old, 13% are obese.
[00:03:36] As I’m sure you already know, children who are overweight and obese have difficulty losing this weight as adults, and are much more likely to be plagued by health problems during their lifetime.
[00:03:49] It is a big problem, and it’s no surprise that childhood obesity has been called one of the greatest public health challenges of the 21st century.
[00:04:00] It is a challenge, because decades of doctors and public health officials telling parents to make sure that their children eat healthy food and get enough exercise, or telling adults that this is what we need to do to lose weight, well it simply hasn’t worked.
[00:04:16] It requires a behaviour change, it requires people to change their habits.
[00:04:22] And people don’t like doing that unless they absolutely have to.
[00:04:28] But, and it is a big but, what if there were a way to get people to change their behaviour?
[00:04:36] What if there were a way to get people to eat less?
[00:04:40] What if you could make someone want to eat less?
[00:04:45] There is already one way: gastric band surgery, where an operation is performed and a sort of knot is tied around the stomach, which restricts the amount of food that someone can eat.
[00:04:58] This procedure is generally reserved for people with severe obesity. After all, it is an operation that literally cuts someone open and ties a band around their stomach.
[00:05:11] It is an extreme solution for a problem where there is also a theoretically simple solution: eat less and exercise more.
[00:05:21] But in December of 2017 a new drug was approved that claimed to be a simple solution for this extreme problem. It was produced by a Danish pharmaceutical company and was given the brand name Ozempic.
[00:05:40] It was first approved for use with people with Type 2 Diabetes, which is the type of diabetes linked to being overweight or not doing enough exercise.
[00:05:50] And in 2021 it was approved for use with people with obesity under the brand name Wegovy - Wegovy and Ozempic are the same drug, just sold in slightly different doses and under different names.
[00:06:05] To avoid confusion, going forward I’ll use the term Ozempic to refer to both of them.
[00:06:11] And, in simple terms, in layman’s terms we could say, the drug works by making you feel full for longer, and reducing the urge to eat.
[00:06:22] No expensive surgery required, just a simple injection into the thigh or arm or abdomen once a week.
[00:06:31] And, in all of the extensive clinical trials, the drug has shown that it works remarkably well.
[00:06:40] People who take Ozempic want to eat less, so they eat less.
[00:06:45] And unsurprisingly, they lose weight, 15% of their body weight on average.
[00:06:53] And because they lose weight, they reduce the probability of cardiovascular disease, heart failure, all of these nasty health conditions that you are more likely to suffer if you are overweight or obese.
[00:07:06] Hallelujah, some health commentators were saying.
[00:07:09] This was literally a miracle drug.
[00:07:13] As if by magic, it tricked overweight and obese patients into feeling like they were full so that they didn’t want to eat as much, so they lost weight.
[00:07:23] As word spread, more and more doctors started recommending it to overweight and obese patients.
[00:07:31] After all, it worked, and it was cheap.
[00:07:35] Well, sometimes it was cheap. For Americans with insurance, the cost could be as little as $25 a month, without insurance it can rise to over $1,000 a month.
[00:07:47] But it was a small price to pay to shed some pounds and return to a more healthy weight.
[00:07:55] And in 2023, just last year, the American Academy of Pediatrics recommended prescribing weight-loss medication such as Ozempic to all obese children over the age of 12.
[00:08:11] After all, why not?
[00:08:13] Childhood obesity is a massive problem, there are decades of evidence that a “simple” solution of recommending children get more exercise and eat more healthily is ineffective.
[00:08:25] And if there is a drug that can help obese children lose weight and therefore have fewer health problems later on in life, well that must surely be a good thing.
[00:08:37] And it wasn’t just for obese kids.
[00:08:40] Ozempic also became increasingly used by adults who were not obese, but who simply wanted to lose weight.
[00:08:49] Celebrities such as Elon Musk and Oprah Winfrey posted about how the drug had helped them lose weight, and the hashtag Ozempic quickly gained over half a billion views on social media.
[00:09:03] To the producers of Ozempic, the company behind the miracle drug, this was of course music to their ears.
[00:09:11] The share price increased by almost 60 times, the Danish company that makes it is now bigger than the entire Danish economy, and this company, the company that produces the drug, was responsible for the entire growth of the Danish economy in 2023.
[00:09:31] It made record profits, and paid a whopping $2.3 billion in income tax to the Danish state, equivalent to almost $400 for every Danish citizen. And this was driven primarily by the sales of its weight-loss drugs.
[00:09:50] Obviously this was good news for Novo Nordisk, the company behind the drug, it was good news for Denmark and its citizens, who were almost literally having dollars transferred from American waistlines to their pension pots and already generous healthcare systems.
[00:10:08] And it was good news for the American patients, who were shedding pounds in record numbers.
[00:10:15] Or was it?
[00:10:17] As you might imagine, there are many prominent voices that have questioned Americans’ appetite for Ozempic.
[00:10:24] Firstly, there are criticisms of the way the drug works, and what it does to people. To some, it reportedly alters the way that food tastes, and results in people losing all pleasure in eating.
[00:10:38] Secondly, there is the criticism that the long-term effects of Ozempic are not yet fully understood.
[00:10:45] It has approval from the FDA, the Food and Drug Administration, but it is new, and rushing to recommend putting children as young as 12 on the drug, well that is irresponsible.
[00:10:59] But the third category of criticism is perhaps the most important.
[00:11:04] And that’s that Ozempic is not a cure. It doesn’t go to the root of the problem.
[00:11:11] To lose weight with Ozempic, you need to take it continuously, it isn’t like a medicine where there is a treatment period of 1 or 2 months, or even a year and then its work is done. Many patients will need to remain on it forever, and many Ozempic users report gaining weight as soon as they stop taking the drug.
[00:11:32] If a 12-year-old starts taking Ozempic, it is unlikely that they will ever be able to stop taking it.
[00:11:40] When you think about the way the drug works, this is kind of obvious; it doesn’t make permanent changes to your body, it simply reduces your appetite while you are taking it. And as soon as you stop taking it, your appetite returns to its normal levels, you eat more, and surprise surprise, you will probably end up gaining weight.
[00:12:03] The root of the problem, to the greatest critics of Ozempic, is both the unhealthy nature of American food and the sedentary lifestyle that most Americans lead.
[00:12:14] To go back to the start of the episode, you heard about the classic and perhaps even now cliche experience of the American tourist in Europe who finds that they lose weight after a couple of weeks in Europe eating pastries, pizza and pasta and drinking wine.
[00:12:31] And when they return to the US, and return to American food, they find that they put that weight right back on.
[00:12:39] As you may know, American food is somewhat unique in its ultra-processed nature. 73% of food in the American market is ultra-processed, with the average American getting 60% of their daily calories from ultra-processed foods.
[00:12:57] And as I’m sure you know, ultra-processed foods are really bad for you. They are linked with all sorts of health conditions, and have been expressly designed to be addictive.
[00:13:09] That’s exactly why doctors and public health professionals telling people to “eat better” or “eat less” has been so ineffective; the majority of American food is ultra-processed, and when you eat ultra-processed food, it is hard to eat it in moderation.
[00:13:28] The criticism therefore is that Americans are being “poisoned” and “fattened up” by unhealthy food AND they are then being sold the “cure” in the form of Ozempic.
[00:13:41] So, what’s the solution?
[00:13:43] Well, one proposed solution is to make American food healthier by increasing regulations on ultra-processed food producers.
[00:13:52] If we could just remove the most unhealthy elements from the average American diet, this would be a start. After all, lots of the most dangerous ingredients in American food are simply not allowed in large parts of the rest of the world.
[00:14:08] But, clearly, this is easier said than done.
[00:14:12] American food manufacturers wield vast power and spend huge amounts of money each year on lobbyists and consultants to influence government policy. Big food, as it is called, is simply too big and too powerful. There is too much money at stake, too many jobs, too many palms being greased for anything to be done about it.
[00:14:36] And talking of money at stake, pharmaceutical companies, such as the manufacturer of Ozempic, have a huge financial interest in making sure that they have an obese population to prescribe medicine to.
[00:14:50] A United States of salad-eating joggers with 32-inch waists would be a disaster for the pharmaceutical industry.
[00:14:57] Fortunately for Novo Nordisk, fortunately for American food manufacturers and fortunately for Danish pensioners, there are no signs that Americans have any intention of putting down the bag of Cheetos or extra large sodas.
[00:15:12] And for as long as that’s the case, Ozempic will continue to reign supreme.
[00:15:19] OK then, that is it for today's episode on Ozempic.
[00:15:23] I hope it's been an interesting one, and that you've learnt something new.
[00:15:27] We are actually going to be following up this episode with another episode on another, controversial new invention, e-cigarettes.
[00:15:35] So keep an eye out for that one coming out next week.
[00:15:39] You've been listening to English Learning for Curious Minds, by Leonardo English.
[00:15:43] I'm Alastair Budge, you stay safe, and I'll catch you in the next episode.
[00:00:05] Hello, hello hello, and welcome to English Learning for Curious Minds, by Leonardo English.
[00:00:11] The show where you can listen to fascinating stories, and learn weird and wonderful things about the world at the same time as improving your English.
[00:00:20] I'm Alastair Budge, and today we are going to be talking about a drug called Ozempic.
[00:00:26] To its greatest proponents, it is a miracle drug that will save millions of lives; to its critics its true dangers will only be understood in years to come.
[00:00:37] So in this episode we’ll cover the history of the drug, how it works, why it is so popular, and what it tells us about the American food and healthcare systems.
[00:00:48] And, the final point before we start is to say, just in case it wasn’t obvious, that I am not a doctor, this is not medical advice, so please do not take it as such.
[00:00:59] OK then, with that little and I hope superfluous disclaimer out of the way, let’s get going and talk about Ozempic.
[00:01:08] It is August at the moment, and millions of Americans will come to Europe for their summer holiday.
[00:01:15] For many, it will be an eye-opening experience. Paris, Rome, Barcelona.
[00:01:22] Museums, art galleries, restaurants, small cobbled streets.
[00:01:27] For some, it might even be the first time that they have left the United States.
[00:01:33] And judging by posts on social media that tend to increase at this time of year, many will make a startling discovery.
[00:01:41] They travel through Europe for a week or so, they drink coffee and eat pain au chocolats or filled pastries for breakfast, they eat pizza, pasta, cheese and meat; they drink beer and wine, they don’t do any exercise for the duration of their trip.
[00:01:57] Yet when they get back home they step on the scales and are met by a surprising revelation.
[00:02:05] Despite having eaten and drunk to their heart’s content, and having made absolutely no effort to stay in shape, they have lost weight.
[00:02:16] They then rush to social media to complain that “American food is poison”, and list the reasons that American food is so unhealthy, and why the US has one of the highest obesity rates in the world.
[00:02:30] Now, to state the obvious, obesity is a global problem, Europeans, Asians, Africans, Australians and South Americans are getting fatter and fatter too, and obesity rates tend to increase as a country develops economically.
[00:02:46] But America is unfortunately unique in the size and scale of its obesity epidemic.
[00:02:54] As of the last CDC report, 41.9% of American adults are obese, and a further 31.7% are overweight.
[00:03:06] To put it another way, only 26% of American adults are not either overweight or obese.
[00:03:15] And perhaps even more frightening is the situation with children.
[00:03:20] 20%, or 1 in 5 American children aged between 10-17, are obese.
[00:03:28] Even in very young children, those between 2 and 5 years old, 13% are obese.
[00:03:36] As I’m sure you already know, children who are overweight and obese have difficulty losing this weight as adults, and are much more likely to be plagued by health problems during their lifetime.
[00:03:49] It is a big problem, and it’s no surprise that childhood obesity has been called one of the greatest public health challenges of the 21st century.
[00:04:00] It is a challenge, because decades of doctors and public health officials telling parents to make sure that their children eat healthy food and get enough exercise, or telling adults that this is what we need to do to lose weight, well it simply hasn’t worked.
[00:04:16] It requires a behaviour change, it requires people to change their habits.
[00:04:22] And people don’t like doing that unless they absolutely have to.
[00:04:28] But, and it is a big but, what if there were a way to get people to change their behaviour?
[00:04:36] What if there were a way to get people to eat less?
[00:04:40] What if you could make someone want to eat less?
[00:04:45] There is already one way: gastric band surgery, where an operation is performed and a sort of knot is tied around the stomach, which restricts the amount of food that someone can eat.
[00:04:58] This procedure is generally reserved for people with severe obesity. After all, it is an operation that literally cuts someone open and ties a band around their stomach.
[00:05:11] It is an extreme solution for a problem where there is also a theoretically simple solution: eat less and exercise more.
[00:05:21] But in December of 2017 a new drug was approved that claimed to be a simple solution for this extreme problem. It was produced by a Danish pharmaceutical company and was given the brand name Ozempic.
[00:05:40] It was first approved for use with people with Type 2 Diabetes, which is the type of diabetes linked to being overweight or not doing enough exercise.
[00:05:50] And in 2021 it was approved for use with people with obesity under the brand name Wegovy - Wegovy and Ozempic are the same drug, just sold in slightly different doses and under different names.
[00:06:05] To avoid confusion, going forward I’ll use the term Ozempic to refer to both of them.
[00:06:11] And, in simple terms, in layman’s terms we could say, the drug works by making you feel full for longer, and reducing the urge to eat.
[00:06:22] No expensive surgery required, just a simple injection into the thigh or arm or abdomen once a week.
[00:06:31] And, in all of the extensive clinical trials, the drug has shown that it works remarkably well.
[00:06:40] People who take Ozempic want to eat less, so they eat less.
[00:06:45] And unsurprisingly, they lose weight, 15% of their body weight on average.
[00:06:53] And because they lose weight, they reduce the probability of cardiovascular disease, heart failure, all of these nasty health conditions that you are more likely to suffer if you are overweight or obese.
[00:07:06] Hallelujah, some health commentators were saying.
[00:07:09] This was literally a miracle drug.
[00:07:13] As if by magic, it tricked overweight and obese patients into feeling like they were full so that they didn’t want to eat as much, so they lost weight.
[00:07:23] As word spread, more and more doctors started recommending it to overweight and obese patients.
[00:07:31] After all, it worked, and it was cheap.
[00:07:35] Well, sometimes it was cheap. For Americans with insurance, the cost could be as little as $25 a month, without insurance it can rise to over $1,000 a month.
[00:07:47] But it was a small price to pay to shed some pounds and return to a more healthy weight.
[00:07:55] And in 2023, just last year, the American Academy of Pediatrics recommended prescribing weight-loss medication such as Ozempic to all obese children over the age of 12.
[00:08:11] After all, why not?
[00:08:13] Childhood obesity is a massive problem, there are decades of evidence that a “simple” solution of recommending children get more exercise and eat more healthily is ineffective.
[00:08:25] And if there is a drug that can help obese children lose weight and therefore have fewer health problems later on in life, well that must surely be a good thing.
[00:08:37] And it wasn’t just for obese kids.
[00:08:40] Ozempic also became increasingly used by adults who were not obese, but who simply wanted to lose weight.
[00:08:49] Celebrities such as Elon Musk and Oprah Winfrey posted about how the drug had helped them lose weight, and the hashtag Ozempic quickly gained over half a billion views on social media.
[00:09:03] To the producers of Ozempic, the company behind the miracle drug, this was of course music to their ears.
[00:09:11] The share price increased by almost 60 times, the Danish company that makes it is now bigger than the entire Danish economy, and this company, the company that produces the drug, was responsible for the entire growth of the Danish economy in 2023.
[00:09:31] It made record profits, and paid a whopping $2.3 billion in income tax to the Danish state, equivalent to almost $400 for every Danish citizen. And this was driven primarily by the sales of its weight-loss drugs.
[00:09:50] Obviously this was good news for Novo Nordisk, the company behind the drug, it was good news for Denmark and its citizens, who were almost literally having dollars transferred from American waistlines to their pension pots and already generous healthcare systems.
[00:10:08] And it was good news for the American patients, who were shedding pounds in record numbers.
[00:10:15] Or was it?
[00:10:17] As you might imagine, there are many prominent voices that have questioned Americans’ appetite for Ozempic.
[00:10:24] Firstly, there are criticisms of the way the drug works, and what it does to people. To some, it reportedly alters the way that food tastes, and results in people losing all pleasure in eating.
[00:10:38] Secondly, there is the criticism that the long-term effects of Ozempic are not yet fully understood.
[00:10:45] It has approval from the FDA, the Food and Drug Administration, but it is new, and rushing to recommend putting children as young as 12 on the drug, well that is irresponsible.
[00:10:59] But the third category of criticism is perhaps the most important.
[00:11:04] And that’s that Ozempic is not a cure. It doesn’t go to the root of the problem.
[00:11:11] To lose weight with Ozempic, you need to take it continuously, it isn’t like a medicine where there is a treatment period of 1 or 2 months, or even a year and then its work is done. Many patients will need to remain on it forever, and many Ozempic users report gaining weight as soon as they stop taking the drug.
[00:11:32] If a 12-year-old starts taking Ozempic, it is unlikely that they will ever be able to stop taking it.
[00:11:40] When you think about the way the drug works, this is kind of obvious; it doesn’t make permanent changes to your body, it simply reduces your appetite while you are taking it. And as soon as you stop taking it, your appetite returns to its normal levels, you eat more, and surprise surprise, you will probably end up gaining weight.
[00:12:03] The root of the problem, to the greatest critics of Ozempic, is both the unhealthy nature of American food and the sedentary lifestyle that most Americans lead.
[00:12:14] To go back to the start of the episode, you heard about the classic and perhaps even now cliche experience of the American tourist in Europe who finds that they lose weight after a couple of weeks in Europe eating pastries, pizza and pasta and drinking wine.
[00:12:31] And when they return to the US, and return to American food, they find that they put that weight right back on.
[00:12:39] As you may know, American food is somewhat unique in its ultra-processed nature. 73% of food in the American market is ultra-processed, with the average American getting 60% of their daily calories from ultra-processed foods.
[00:12:57] And as I’m sure you know, ultra-processed foods are really bad for you. They are linked with all sorts of health conditions, and have been expressly designed to be addictive.
[00:13:09] That’s exactly why doctors and public health professionals telling people to “eat better” or “eat less” has been so ineffective; the majority of American food is ultra-processed, and when you eat ultra-processed food, it is hard to eat it in moderation.
[00:13:28] The criticism therefore is that Americans are being “poisoned” and “fattened up” by unhealthy food AND they are then being sold the “cure” in the form of Ozempic.
[00:13:41] So, what’s the solution?
[00:13:43] Well, one proposed solution is to make American food healthier by increasing regulations on ultra-processed food producers.
[00:13:52] If we could just remove the most unhealthy elements from the average American diet, this would be a start. After all, lots of the most dangerous ingredients in American food are simply not allowed in large parts of the rest of the world.
[00:14:08] But, clearly, this is easier said than done.
[00:14:12] American food manufacturers wield vast power and spend huge amounts of money each year on lobbyists and consultants to influence government policy. Big food, as it is called, is simply too big and too powerful. There is too much money at stake, too many jobs, too many palms being greased for anything to be done about it.
[00:14:36] And talking of money at stake, pharmaceutical companies, such as the manufacturer of Ozempic, have a huge financial interest in making sure that they have an obese population to prescribe medicine to.
[00:14:50] A United States of salad-eating joggers with 32-inch waists would be a disaster for the pharmaceutical industry.
[00:14:57] Fortunately for Novo Nordisk, fortunately for American food manufacturers and fortunately for Danish pensioners, there are no signs that Americans have any intention of putting down the bag of Cheetos or extra large sodas.
[00:15:12] And for as long as that’s the case, Ozempic will continue to reign supreme.
[00:15:19] OK then, that is it for today's episode on Ozempic.
[00:15:23] I hope it's been an interesting one, and that you've learnt something new.
[00:15:27] We are actually going to be following up this episode with another episode on another, controversial new invention, e-cigarettes.
[00:15:35] So keep an eye out for that one coming out next week.
[00:15:39] You've been listening to English Learning for Curious Minds, by Leonardo English.
[00:15:43] I'm Alastair Budge, you stay safe, and I'll catch you in the next episode.
