With the help of patient input, Novo Nordisk is seeking ways to change the obesity conversation – one myth and one medicine at a time.

If there’s one thing most people with obesity have heard again and again, it’s the old saw about how easy it is to lose weight. It’s part of a conversation laced with prejudice and myth, and it takes place everywhere - including the doctor’s office.  

“When you visit your healthcare provider, this is the myth that is perpetuated,” says Pamela Davis, a certified bariatric nurse who has had gastric bypass surgery as part of a weight loss programme. “It’s so easy, they say - just bend your elbow less, make healthier choices, push away from the table.”

The myth is also familiar to Joseph Nadglowski, CEO of the US-based Obesity Action Coalition:

“This over-simplification is part of the problem,” he says. “For some people it is easy to lose a little weight. But it’s really hard to maintain that weight loss.”

Bringing patient perspectives into solutions

Patient perspectives like these are helping Novo Nordisk create the kind of solutions that can change the conversation between doctors and people with obesity. And the company is seeking this input at a very early stage in the R&D process.

“Novo Nordisk has always been very patient-centred, but we are now beginning to identify how patients can advise us throughout the entire R&D process - even very early on, raising questions that can affect Discovery,” says Novo Nordisk’s Chief Medical Officer, Alan Moses. 

Obesity recognised as a disease

One of the major goals of Novo Nordisk’s engagement in obesity is to have the condition recognised as a disease in its own right. This in itself could change the conversation that patients have with doctors, many of whom avoid talking about obesity at all until it begins to cause other diseases such as hypertension.

“Doctors who would never let a patient leave the office with a blood pressure of 200/100 don’t say a word to them about their weight,” notes Joseph Nadglowski.

If and when the weight loss conversation does happen, he adds, patients need to hear more than the standard ‘eat less, exercise more.’ As Joseph points out, lifestyle changes are a great way to prevent obesity, but they don’t work very well as a stand-alone treatment.

The strategy: a two-front attack

Novo Nordisk has recently introduced its first medical treatment of obesity to the market. But this product represents only the beginning of an overall strategy that involves new molecules, new treatment combinations and new compounds that have yet to be invented.

The Novo Nordisk strategy is to attack obesity on two fronts, explains Mads Tang-Christensen, vice president of incretin and obesity research. It’s all about energy intake – and energy expenditure.

On the one hand, he notes that the company pipeline is heavy with molecules that can help reduce energy intake. Novo Nordisk’s new obesity treatment is based on this type of molecule, and the company has “a large, rather rich pipeline” of others, Mads says.

The challenge: burning off energy

On the other hand, and in the much longer term, Novo Nordisk is searching for molecules that can help people to expend more energy.

This, says Mads, is a real challenge. Not only because the company has so far only seen a couple of molecules that seem to affect energy expenditure. But also because of a phenomenon that has frustrated millions of people who have tried to lose weight simply by eating less and exercising more:

“When you reduce food intake, your body also reduces how much energy you burn. There’s a reaction to every action; your body is trying to hold you at the exact same weight,” Mads explains.

The mission: obesity leadership

Finding molecules with the potential to turbocharge the energy-burning process is “a future area of interest” for Novo Nordisk’s research site in Seattle, says Mads. And in spite of the fact that he expects a lot of setbacks along the way, he stresses the company’s long-term commitment to changing the way obesity – and those who suffer from it – are treated:

“The mission we all have is to build a world-recognised, highly competitive, respected and state-of-the-art research organisation that can actually find new targets and treat obesity.”

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