Eka’s Weekly Roundup (31 March 2022)

Issue 26 l Looking into Ozempic

Mar 31, 2023

In 1993, the prevalence of obesity in the US was 13%. Today, it’s 42% and expected to get to 50% by 2030. This week, we listened to Zoe’s podcast on Ozempic, a new drug tackling obesity which has gone viral on social media. Obesity and nutrition more broadly is an area that we are looking at as a whole through various solutions such as: inclusive exercise software promoting behaviour change, junk-food substitution products, and broader initiatives in improving the social determinants of health. We are still forming a view about how best to tackle obesity as a chronic condition, prioritising preventative interventions over reactive healthcare.

Developments in obesity management 🗞️

Breaking down the podcast into five parts, and adding in our own views.

1. What is in Ozempic?

Podcast: Ozempic consists of semaglutide, which mimics a naturally occurring hormone in our body that helps to regulate our weight. When this naturally occurring hormone is released into the bloodstream after you eat, it helps you start feeling full.

Our view: There are many ways to tackle obesity beyond reactive-based approaches. While the literature is suggesting that some determinants of obesity are genetic, we are also looking at broader determinants of health which have a direct link with obesity including: nutrition, physical exercise, mental health. This also includes indirect links such as access to housing, community support, and inclusive financial services.

2. What’s the difference between various weight loss drugs?

Podcast: The drug semaglutide is actually in both of the main obesity drugs (Ozempic and Wegovy), the difference is a trading name and what they're approved for.

Ozempic. Ozempic is a semaglutide that's approved for individuals with type two diabetes.
Wegovy. Wegovy is also semaglutide, but this is approved for individuals with obesity and it's approved at a higher dose.

This leads to some confusion in the marketplace, but they are essentially the same drugs under two different trade names.

Our view: While we are encouraged by drug developments, we are also cautious about the viral impact that influencer media has had around Ozempic. Regulators have been looking into the promotion of the drug on social media and its impact on non-clinical populations who are looking to use the drug as a looser weight management tool.

3. What does the early trial data suggest?

Podcast: The STEP trial study was published in the New England Journal of Medicine fairly recently. This was a global trial of about 2,000 individuals in the step one trial in which individuals, all of them who were overweight or had obesity, many with a medical problem, were randomized blindly to take this new drug. They also had a placebo, which is just an inactive, comparator.

The trial participants all saw either a registered dietician or a healthcare professional who's trained in nutrition and received guidance on diet. They were asked to track their diet, increase their physical activity, and be aware of their surrounding social surroundings, and so forth. They also had a mandated calorie deficit of about 500 kilocalories per day.

After 68 weeks, when the trial came to an end, they saw positive significant impacts on body weight.

Individuals who took a placebo and just received lifestyle counseling lost about 3% of their body weight after one year. Those on the medication on average lost 15% of their body weight in the same amount of time. One in three lost 20 or more percent of their body weight. This hasn’t been seen in obesity management before.

Our view: We would like to see longer-term studies looking at the effects of the drug. The podcast mentions some side effects which do diminish the patient experience such as nausea and heartburn. The study could also be extended to look at non-obese populations using this in unhealthy eating habits linked to mental health disorders such as anorexia and body dysmorphia.

4. How short-term vs. long-term is the solution?

Podcast: The first priority was to double down on lifestyle, eating a healthy diet, balanced diet, calorie deficit, and reducing ultra-processed foods.

The medication works only as long as patients take it. The medication is supposed to be a long-term solution rather than a jump start.

Obesity is like a chronic disease. If you stop taking the medication, there's a high likelihood the obesity re-emerges in a few months or years time.

The academics followed the patients following the study. After the end of one year, individuals on average regained two-thirds of the weight that they lost over that first year. The article suggests that if they followed them long enough, they would probably get back to baseline.

Our view: The podcast clearly cites targeting a larger set of interventions including exercise, nutrition, and healthy habits. We believe these drugs will be a ‘last resort’ solution rather than a mass market cure for obesity in the long run.

There should be longer studies on the impact of the drug on a 10+ year time frame, which will likely come as the product matures.

5. What could the future of obesity management look like?

Podcast: In future, obesity management will be much more personalised because of these biological set points. Patients will be treated in a more targeted manner, depending on how responsive they are to semaglutide-based medication. We're not there yet, but that's the direction this whole field is going.

Our view: We agree that personalised medicine is the future, especially in chronic conditions where biogenetics are influencing disease development. We are still forming a view on the best ways to tackle obesity management, consistent with our thesis around prioritising prevention over reactive solutions (but resolving to reactive when the impact on quality of life is incredibly severe).

Flagging early-stage addressing obesity

Runna: world-class training, coaching and community for everyone, whether you're improving your 5k time or training for your first marathon.
Believe in Science: healthier donuts without compromising on the consumer experience.
Oxford Medical Products: revolution in non-invasive, meaningful, sustainable and affordable weight loss.

3 Key Charts 📊

1. Overview of clean energy supply chains: China dominates

2. Motivations behind meat purchases

3. Consumers struggle to know how to eat healthily across the West

Deal Capture 💰

Deals in the impact space across the UK and Europe

Getting in Touch 👋.

If you’re looking for funding, you can get in touch here.

Don’t be shy, get in touch on LinkedIn or on our Website 🎉.

We are open to feedback: let us know what more you’d like to hear about 💪.

Eka Ventures Newsletter

Discussion about this post