How Ozempic Transformed the Way We Look at Obesity
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See store or sleepnumber.com for details. It's an industry that's slimming waistlines and creating huge profits. New drugs used to treat diabetes and obesity. There's Monjaro, there's Rigobi, there's Ozempic. Monjaro, that's what I use.

There has been a weight loss revolution. To lose 40, 60 pounds, your body feels better. It's been fueled and popularized lately by high-profile personalities. You've been working on your health. No, that's ozempic. I'm down 50 pounds. And social media influencers. I am 55.2 freaking pounds down.

You hear a lot of boasting of fast results and even calling these drugs a miracle. Thank you, Jesus, for these injections. What they are are a brand new class of medications that are fundamentally changing the way we think about weight and how to lose it. It's even changing the way we look at our own bodies and food itself. There has never been a more exciting time to work within the field of obesity.

Essentially, the more we make, the more gets used. But here are the questions. Are these blockbuster therapeutics the future or just another fad? I looked at all the side effects and I said no. You thought not for me. Not at all. Are they safe or are they dangerous? This is a full warehouse of problem drugs. It's more than full, Sanjay. And the question for a lot of you, should you take them or leave them?

Yep, we've talked about these medications on the podcast before, but we've decided to go deeper. We're going to weigh in after a year-long global investigation. And I'm going to begin by taking you to the place where this whole story started. I'm Dr. Sanjay Gupta. Here is part one. Is Ozempic right for you? Welcome to Denmark. This is Copenhagen.

Quiet canals, picturesque buildings, pretty laid-back lifestyle. It's also a culinary capital. So many talented chefs and acclaimed restaurants call this place home. Which may leave you wondering, why did we decide to start our story here? Well, that's because Copenhagen is also home to one of the scientists who helped identify a key ingredient that is now revolutionizing the entire weight loss industry.

So do you still get excited coming into the lab? I really do. Meet Dr. Jens-Johr Holtz. He's a scientist, professor, and... Am I interviewing a future Nobel Prize winner? That is not to be to decide. If it were to you to decide, please go on. Do something about it. How big a deal is his work in all of this?

I think it is a huge deal. Dr. Giles Yeo is one of the world's leading experts on obesity. There has never been a more exciting time to work within the field of obesity because of the tools that are now available to at least begin to tackle the problem.

In the 1970s and early 80s, Jens and a small group of researchers around the world stumbled upon a hormone called glucagon-like peptide. Yeah, yeah, yeah, yeah. It's now widely known as GLP-1. At that time, though, they were actually looking for a solution to a totally different problem. It had nothing to do with obesity or diabetes. We were really, really busy with the treating of the bleeding ulcers.

bleeding ulcers. That's right. The original thought was that GOP1 might protect the lining of the stomach and prevent the acid buildup that causes those ulcers. It was painstaking research. I mean, nowadays, drug companies can quickly synthesize these hormones or they can rapidly ferment them in bulk like yogurt. But back then, however, none of that technology existed. So Jens had to harvest these hormones directly from nature.

That's a little bit like the needle in the haystack. When you're trying to isolate these hormones, first you do it in pigs. They took these 10,000 of intestines from pigs and ended up with 10 milligram of substance, which was the pure peptide hormone.

It was a lot of work for a very small amount. And after all that, they didn't even work. The hormones did not help treat the ulcers. But in 1986, scientists did notice something else. It was something unexpected. The hormones Jens helped discover seemed to be increasing insulin production and also decreasing another hormone, glucagon. Collectively, they could help lower your blood sugar.

obviously critically important for those with diabetes, a disease that by then was already on the rise, affecting more than 100 million people around the world. So Jens knew this could be big. He's a gruff Rottweiler. Don't let him know I said that. Well, it is on tape. Oh, yeah, okay.

So the very persistent professor connected with researchers at a local pharmaceutical company. They had heard about his work. That company is now known as Novo Nordisk. They were curious about what we were doing. They didn't believe it. Was there reluctance initially? Yeah, yeah, yeah, yeah. The old chemists, they said, why on earth should we bother with these stupid peptides? But they couldn't know that they were so good at that time.

To better understand how that hormone was modified to make one of the most popular prescription drugs in the world, we traveled half an hour outside of Copenhagen to Novo Nordisk headquarters. Right away, we noticed something quite striking. The massive building itself is shaped like an insulin molecule. It reflects the fact that treating diabetes has been that company's primary mission.

For nearly 100 years, Novo Nordisk had most of their revenue come from insulin. So the question was,

Was there a reluctance to do something that would take away from the insulin business? Yeah, at the very beginning there was a lot of debate as to why we needed to do something more than insulin. Karen Conde-Canape is Senior VP of Global Drug Discovery at Novo Nordisk. But luckily for us we have some very stubborn scientists that really kept saying, you know, we can apply the same learnings that we have done in modulating the insulin molecule to another molecule.

And in this particular case, GLP-1 was chosen. So welcome to our peptide lab. All right, this is it. This is it. So the magic happens. It is. This is one of the labs where scientists now synthesize those GLP-1 molecules. There's no more pigs, like in Yen's lab, just a lot of high-tech lab equipment. How hard is it to make this medicine? Oh, wow. That's a difficult question, Sanjay. It's hard to...

manufacture it at a large scale, I would say. In fact, it took them decades. Their first GLP-1-like drug for diabetes, a daily injection called Victoza, wasn't approved until 2010. So what is the best part of living in Copenhagen? The ambience. Lien Sorup was one of the first people in the world to use this medication.

I tried what was called sort of the little sister of Ozempic called Victoza. For her, it didn't work. Her blood sugars did not budge. Lean did not respond at all to that first generation daily injection. But everything changed seven years later. Oh!

Novo Nordisk's second-generation GLP-1-like medication, a weekly injection called Ozempic, something almost everyone has now heard of. But at the time, it was just a dream, a prayer. What was your first thought? Pray that it works. Yeah. At first, those prayers went unanswered, and the side effects were horrible.

The first time I tried Osempec, I got really sick. It was like being seasick. I was actually panicking a little bit because I knew once you injected yourself, it would be in your body for a whole week. That sounds miserable. So I had to stop very quickly. And then I tried again, and the side effects were worse. But then I had another break, and then I tried again, and then, oh, finally, it worked for me.

For the first time in her life, Leen's diabetes stabilized. Her blood sugar normalized. LEEN KHAI: I was very relieved. Oh, finally, this miracle medicine is working on me. MILES O' And something else amazing happened. She lost weight, a lot of weight, 70 pounds in total. She called Ozempic the world's easiest diet. LEEN KHAI: It's easier than all the other failed diets I have been on.

a good drug to start a journey. - A good drug that helps diabetics pretty clearly. But what about all that weight loss? Was that some sort of fluke or could it help the obese as well who are not diabetic? Several pharmaceutical companies around the world got busy trying to answer that question.

We started working on this, it was for type 2 diabetes, and then what we started to learn is that these medicines could have a very dramatic decrease in body weight. Dr. Dan Skowronski is the chief scientific officer at Eli Lilly. Now during those early days, he, like so many others, was skeptical that a diabetes drug could be used to treat obesity.

These molecules are injectable drugs. And at the time, it was thought that most patients wouldn't want to undergo injections for treatment of disease. Everyone who knew anything about the pharmaceutical business said, "Don't work on obesity drugs." To create the market for obesity drugs, I would never advise them to do it. Thank you very much. But for the man who helped start it all, he's sure happy they finally did.

It started back in the 80s, but it has developed through the help of a lot of people. And it's been really great to be part of that. Part of a weight loss revolution. Ready? And the lives now being changed might surprise you when we come back. This podcast is supported by Sleep Number.

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I lost 50 pounds in six months. I was fat. And that's when I decided to go to Jenny Craig. It was the early 1990s and Rashida Bush was a teenager being bombarded by these kinds of messages to lose weight.

I think there was just something internal or hormonal that just was not clicking right. I was exercising and limiting my food intake. I was doing everything that they said that you should do. For her, the pounds came and stayed. It would not budge at all. And so it makes you feel like a failure. Rashida's story is sad and increasingly too familiar.

I just wanted to be invisible so it made me more quiet, more shy. As a teenage girl, I have three of them. It must have been really, really hard. Yeah, it was difficult. It was difficult. Even more difficult as she watched her then 15-year-old son, Brian, deal with these very same issues.

There was one time where he had just come home from school and had a rough day. He just started crying and just saying that they were like picking on him, talking about his weight. And I'm just telling him like, "You're beautiful, Brian. You're handsome." And he said, "I'm not handsome." And that just broke my heart. That broke my heart. Breaks my heart. Hear that? Sorry.

I was like 370 at 13 years old. - 370 pounds? - Yeah. - How did you feel when you weighed that much? - I actually felt bad for myself. Like I wouldn't wanna go outside, I didn't wanna play with people, and I just wanted to stay in the house. It was just like a little bit of depression really. I also have social anxiety too.

They make assumptions about what you're eating, how you're exercising, the choices that you make. It's an acceptable way to judge someone, and I think that's unfair. The stigma is something Dr. Giles Yeo has been fighting his whole career.

I was at a dinner and someone asked me, "What do you do? What do you do?" And I told him this. I said, "I study the genetics of obesity in children." And he said, "Do you know what your problem is?" And he went, "You give fat people an excuse." And that was, and actually still by and large is the response I get. They're fat shaming, essentially. Pretty much. The problem with body weight is that people think it's some kind of choice.

If I said, "I'm studying the genetics of cancer," no one is saying you're giving people with cancer an excuse, right? Never. Over the years, the evidence has become increasingly clear on this: for so many people, obesity is not a choice.

We now know of over a thousand genes that play a role in our body weight. It's sort of like a thermostat, where for some people, a thermostat is set at whatever temperature it is in a house, whereas for other people, that thermostat is set slightly higher, slightly lower. And so if it's set higher and you end up having to eat more, you're going to be larger than someone else. It's why obesity is now considered a disease, not of the intestines or your stomach, but of the brain.

It's a huge shift in the way that we think, with huge implications for treatment. But these are still early days. And remember, at one time, even depression and addiction were seen as failures of willpower instead of a brain disease. Changing the perception of obesity, that's going to take time.

It's definitely true that there are people out there who've said time and again obesity is not really a disease. All you need to do is eat better and exercise more and you'll be okay. Rashida was one of them.

It has taken her years to see past the promise of those weight loss ads, to see her weight as a disease in and of itself, especially since she never had the serious health issues associated with a high body mass, like diabetes or high blood pressure, fatty liver disease, heart disease, stroke. I was 355.6 pounds. I didn't have like traditional health issues that you would have being overweight.

If somebody has a high BMI, but they have no other comorbidities, is it still a disease? Some of the scientists in the field like to call it the happy obese. I am not necessarily believing in that concept. When you're looking at the individual, all the other parameters seem to be in check.

That does not mean that this individual may not be in a progression towards developing this other comorbidities or other indications. It's that progression Rashida's doctor, John Venuti, started to see in her. So he recommended Ozempic. She was starting to get pre-diabetes and I thought it was a perfect opportunity to get her started.

I looked at all the side effects and I said no. You thought, not for me. No way. Not at all. But then in 2020, everything changed. If you were black, you were overweight, you had a greater risk to die from COVID. So you went back to your doctor and said, let's try this? Yes. I was like, I'm ready. Rashida started with a low dose of Ozempic. She had no side effects, but no positive effects either.

So her doctor increased the dose. I couldn't keep anything down. I was throwing up water. I went to the hospital and got some fluids in me because I was dehydrated. That sounds kind of scary. It was pretty scary. But I had a different mindset at that point because I said, I want to try it one more time and see if I'm still having the same side effect. And this time, something very different happened, something she had never experienced before in all those years of dieting.

What it did help me was not have a whole lot of thoughts about food. My cravings went away. Those voices in her head that had made her crave food, experts call it food chatter, they were silenced. And that is part of the magic of these new medications. GLP-1 seems to act in a way that no other known hormone can. Here's how it seems to work.

Every time you eat, all sorts of hormones are released, like GLP-1. They are called post-nutrient hormones. They travel here to the hypothalamus and the brain to tell you that you are full or satiated. They also travel over here to the pancreas to kick out more insulin to help absorb the energy you just consumed. And also over here to your gut to slow down the emptying, allowing you to better digest your food.

In so many ways, it seems like the perfect hormone to help you stop eating as much. Seemed perfect for Rashida. In that first year, she lost 100 pounds. It changed her life. And then in December of 2022, the FDA approved the weight loss medication called Wegovi for adolescents. Brian's doctor, a pediatric obesity specialist, recommended it. Now to be clear, it did not come without concerns.

I have family members that don't think it's a wise choice. They just don't feel like it's a good thing. Do you have any concerns about this medication? The only concern I'll say is there any other side effects besides stomach cramps? How has your lifestyle changed on these medications? Your diet, your activity? I used to get seconds and thirds, so I don't get that no more. My mom, she tried to take away the processed foods and all that.

Do you miss those foods? Not really. It was a reset, as Dr. Yeo would say, a reset of Brian's body and his mind, a reset of that thermostat. And this probably won't surprise you. As more young people have struggled with obesity and diabetes, the number of prescriptions in this age group for these new weight loss and diabetes drugs has skyrocketed nearly 600% since 2020.

It's like a new start for me, basically. I feel like I can just do anything now. Brian and his mother have together lost more than 200 pounds. It was something they never thought possible. And I wish we could end the story there. But mother and son were about to embark on another fight. It's true, for many people, these medications do seem to transform their lives. But at the same time, they can come with significant complications.

So next week, part two, is Ozempic right for you? We're going to talk about the challenges of staying on these weight loss drugs and also the perils of a growing counterfeit market. If this one saves one more person or stops one more person from doing it, that's got to be a winner. That's got to be good. Thanks for listening.

There's a reason the Sleep Number smart bed is the number one best bed for couples. It's because you can each choose what's right for you whenever you like. Firmer or softer on either side, Sleep Number does that. One side cooler and the other side warmer, Sleep Number does that too. You have to feel it to believe it. Sleep better together. And now save 50% on the new Sleep Number limited edition smart bed. Limited time. Exclusively at a Sleep Number store near you.

See store or sleepnumber.com for details.

This week on The Assignment with me, Adi Cornish. The truth is that many of us warned about this. Reverend Gabriel Salguero, pastor of The Gathering Place in Orlando, Florida. What are the kinds of messages you have been getting? I got a call from somebody saying that they're not going to go to church because they're afraid. Many pastors are concerned that it will impinge on our religious liberty to serve immigrant communities and mixed status communities. What does it feel like to be on the front lines of the immigration debate?

Listen to The Assignment with me, Audie Cornish, streaming now on your favorite podcast app.