It’s not just obesity. Drugs like Ozempic will change the world

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Every day seems to bring more exciting news. First the drugs tackled diabetes. Then, with just an injection a week, they took on obesity. Now they are being found to treat cardiovascular and kidney disease, and are being tested for Alzheimer’s and addiction. It is early days yet, but glp-1 receptor agonists have all the makings of one of the most successful classes of drugs in history. As they become cheaper and easier to use, they promise to dramatically improve the lives of more than a billion people—with profound consequences for industry, the economy and society.

In the three years since semaglutide was approved for treating obesity, it has taken America by storm. After decades of disappointing “miracle cures”, these drugs work. Image-conscious influencers and well-heeled financiers are not their only users. Already one in eight American adults has been on glp-1 drugs. Novo Nordisk, maker of semaglutide, branded Ozempic for diabetes and Wegovy for weight loss, and Eli Lilly, which makes tirzepatide, a more effective alternative, have together added around $1trn in market value since 2021.

The action is now moving beyond America. With over two-fifths of the world overweight or obese, demand for glp-1 drugs is voracious. Pharma companies are racing to make them work as pills, which would be cheaper to produce than jabs, and to reduce their side-effects. Generic versions for older GLP-1 agonists are entering the market. Semaglutide is to come off patent in Brazil, China and India in 2026; eight such drugs are in the works in China. That is just as well. As incomes in the developing world have risen and life has become more sedentary, people’s waistlines are catching up with those in the West.

Curbing obesity would be consequential. Yet glp-1 drugs promise to do much more. Overweight patients on semaglutide have been found to suffer fewer heart attacks and strokes; the benefits, astonishingly, seem to be largely independent of how much weight is lost. Tirzepatide improves sleep apnoea. Trials show that glp-1 agonists reduce chronic kidney disease in diabetics; and there are signs they may lessen brain shrinkage and cognitive decline in Alzheimer’s. Studies of health records suggest that they may help with addictions, too; people already on glp-1 drugs in America were less likely to overdose on opioids or abuse cannabis or alcohol. Researchers are even talking, in hushed tones, of their anti-ageing effects.

For patients, the new uses of glp-1 drugs would mean not just longer, healthier and more productive lives, but happier ones, too. In a world of abundance people succumb to their impulses even if they know their behaviour is harmful in the long term. Although GLP-1 agonists may limit the pleasure of instant gratification, they promise to end intrusive cravings and improve long-term health.

Rather as the contraceptive pill encouraged women to stay in education and work, so GLP-1 drugs could lead to profound economic and social change by enhancing productivity and freedom. Some business models could be upended.  The GLP-1 revolution is just beginning. Its promise is tantalising.

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