OBE07241_Novo_Obesity Core Story.lo1

The obesity

core story

Novo Nordisk is committed to changing how the world

sees people with obesity and making obesity a heathcare

priority, in addition to developing a leading portfolio of

treatment solutions.

PromoMatsID: XXXXXX

Approval date: XXX XXX

For internal use only – all content is subject to local legal review and any established approval procedures

1

SPREAD OPTION A

Guidance for use

What is the obesity core story?

The Novo Nordisk obesity core story is our ‘mission

statement’, ensuring that Novo Nordisk speaks with

one voice about obesity.

The core story builds on the Novo Nordisk Obesity

Business Plan with its dual mission to:

1. Change how the world sees people with obesity

and make obesity a healthcare priority;

2. Develop a leading portfolio of treatment solutions

Our guiding principles for obesity disease awareness

1. Losing weight has a positive impact on health

2. Maintaining weight loss is difficult because regaining it is easy

3. Long-lasting medical treatment options are available

4. Lasting weight loss is possible

The core story has four chapters:

The core story is based on scientific evidence that defines

obesity as a chronic, yet manageable disease, and illustrates

why obesity is a key commitment to Novo Nordisk. The

story is a living document and just as the story of obesity

continues to evolve, particularly in light of the COVID-19

pandemic, this core story will also be regularly updated.

For more information, see the Semaglutide 2.4 mg Core

Science Deck and the Liraglutide 3.0 mg Core Science Deck.

1 2 3 4

Obesity is a chronic

disease and it is not

going away:

We will act on our

purpose by showing

leadership in solving

the global obesity

challenge

People with obesity

should not fight

alone:

We will ensure that

healthcare systems

acknowledge and

treat obesity as a

chronic disease

The narrative around

obesity is changing:

We are partnering

with stakeholders

to make obesity a

healthcare priority

People with obesity

deserve care and

treatment:

Novo Nordisk offers

treatment solutions

and an industryleading

obesity

pipeline

2 For internal use only – all content is subject to local legal review and any established approval procedures 3

SPREAD OPTION B1

Guidance

for use

What is the obesity core story?

The Novo Nordisk obesity core story is our ‘mission

statement’, ensuring that Novo Nordisk speaks with

one voice about obesity.

The core story builds on the Novo Nordisk Obesity

Business Plan with its dual mission to:

1. Change how the world sees people with obesity and

make obesity a healthcare priority;

2. Develop a leading portfolio of treatment solutions

The core story is based on scientific evidence that defines

obesity as a chronic, yet manageable disease, and illustrates

why obesity is a key commitment to Novo Nordisk. The

story is a living document and just as the story of obesity

continues to evolve, particularly in light of the COVID-19

pandemic, this core story will also be regularly updated.

For more information, see the Semaglutide 2.4 mg Core

Science Deck and the Liraglutide 3.0 mg Core Science Deck.


SPREAD OPTION B2

Our guiding principles for obesity disease awareness

1. Losing weight has a positive impact on health

2. Maintaining weight loss is difficult because regaining it is easy

3. Long-lasting medical treatment options are available

4. Lasting weight loss is possible

The core story has four chapters:

1 2 3 4

Obesity is a chronic

disease and it is not

going away:

We will act on our

purpose by showing

leadership in solving

the global obesity

challenge

People with obesity

should not fight

alone:

We will ensure that

healthcare systems

acknowledge and

treat obesity as a

chronic disease

The narrative around

obesity is changing:

We are partnering

with stakeholders

to make obesity a

healthcare priority

People with obesity

deserve care and

treatment:

Novo Nordisk offers

treatment solutions

and an industryleading

obesity

pipeline


1

Chapter 1

Obesity is a chronic disease and it is not

going away

We will act on our purpose by showing leadership in

solving the global obesity challeng

Obesity impacts 650 million adults worldwide. That’s approximately

13% of the world’s population. Meanwhile, 124 million children and

650 million adults adolescents are currently living with obesity globally: a 10-fold increase

over the past four decades. 1,2

125 million children

Novo Nordisk is committed to tackling obesity and the complications

associated with it. In order to find solutons and address barriers to

obesity care, we advocate for a shift from individual to shared

societal responsibility.

125 million children

650 million adults

13%

OF THE WORLD’S

POPULATION

The individual

The majority of people with obesity

believe weight management is their

own responsibility and that only lifestyle

interventions work. Yet, studies show

this approach is not enough to have a

lasting effect. 3

This has consequences, as obesity is

linked to a large number of complications

and disorders – some of which may impact

life-expectancy and health-related quality

of life. 4 However, with increasing weight

loss the improvements in complications

increase, and additional improvements

to overall health are seen with a weight

loss of 10%. 5-8

Society

The significant burden of obesity and obesityrelated

conditions such as diabetes and

cardiovascular disease is well-documented. 9

However, as the COVID-19 pandemic has

highlighted, obesity not only increases the

likelihood of long-term complications, it

also puts individuals at increased risk of

acute complications and severe outcomes

from infectious diseases. This has brought

obesity into the public agenda and further

underscored the need for obesity to be

treated as an urgent healthcare priority. 10-13

Annually, obesity accounts for USD 2 trillion

(DKK 12 trillion) in global healthcare costs. 14

Outside of healthcare, obesity is also costly

in the form of lost productivity including

sick days, reduced efficiency at work and

permanent disability. 15


2

Chapter 2

People with obesity should not

fight alone

We will ensure that healthcare systems acknowledge

and treat obesity as a chronic disease

To tackle obesity, people with obesity should have access to appropriate

treatment and care.

Reducing the stigma people with obesity face on the street, in the

media, at work and even at the doctor’s office is critical. Stigma can

impact their mental health and health-related quality of life, 16-19 and it

can stop them from seeking medical help.

There is a significant potential to educate about the physiological

causes of obesity, as well as the variety of treatment options available.

A strong-willed biology

Obesity is a multifactorial disease. 20

Psychological, social and environmental factors contribute to obesity.

Genetics also play a part with studies showing that up to 70% of the

causes of obesity can be linked to genetics, family history

and ethnicity. 21-23

For more information on the science behind obesity, see slides 17–21

of the Semaglutide 2.4 mg Simplified Core Science Deck.

Losing weight has a positive

impact on health

The benefits of losing weight and keeping it

off can be substantial:

• 5% weight loss has significant health benefits,

including reducing the risk of type 2 diabetes. 24

• Further improvements are seen with weight loss

of 10–15% in cardiovascular disease and related

risk factors, 5 osteoarthritis, 6 and health-related

quality of life. 7,8

• An improvement in overall health can be achieved

with weight loss greater than 15%, including the

remission of type 2 diabetes, and a reduced risk

of cardiovascular mortality and certain types of

heart failure. 25-27

For more information on weight loss benefits, see slides 22–31 of the

Semaglutide 2.4 mg Simplified Core Science Deck

Maintaining weight loss is difficult

because regaining it is easy

When weight loss is achieved, a process

called ‘metabolic adaptation’ kicks in. It

increases levels of hunger and the desire to

eat, while also reducing energy expenditure,

collectively driving weight regain. 28 This

process can persist for many years, which

goes some way to explain why two out of

three people are unable to maintain weight

What drives hunger?

Hormones like GLP-1, amylin, ghrelin and

peptide YY (PYY) play an important role in

regulating appetite and the food we eat. 31,32

In the brain, they regulate feelings of satiety

or hunger and so affect food intake. 31

People with obesity may have different levels

of these hormones, which can impact their

hunger levels and desire to eat. 33

Why is obesity undertreated?

Obesity remains underdiagnosed and

undertreated, with significant barriers

to weight management including

miscommunication, stigmatisation and lack of

a formal medical diagnosis. 3

For more information on the barriers to

weight management among people with

obesity and healthcare professionals, see

the Awareness, Care, & Treatment In Obesity

maNagemet – an International Observation

(ACTION IO) study. 3

10 loss in the long term. 28-30

11

3

Chapter 3

The narrative around obesity is changing

We are partnering with stakeholders to make obesity

a healthcare priority

Progress is being made to address these issues in two key areas:

The obesity narrative is changing

Media:

The media has played a significant role in perpetuating weight bias due

to a combination of its overt negative sentiment, inaccurate reporting,

and the use of stigmatising photos and language. This is gradually

shifting to a more neutral and in some cases even positive narrative.

Healthcare professionals:

There is increasing recognition amongst professional associations and

health organisations of the need to recognise obesity as a chronic

disease in order to treat and prevent it, and a focus on how to address

the growing prevalence of childhood obesity. 34-37

Policymakers:

Following major national efforts, many governments including those

of Portugal, Italy and Germany have now officially defined obesity as a

disease or disease process. 38-40

Look for long-lasting medical treatment options

Obesity is a manageable disease, and today’s options for tackling obesity are increasingly

growing. A holistic solution to treating obesity includes early diagnosis, lifestyle and

behavioural interventions, pharmacotherapy and bariatric surgery. 42,43

For more information on obesity management, see slides 32–39 of the Semaglutide 2.4 mg Simplified Core Science Deck.

How is Novo Nordisk helping?

Changing Obesity is our long-term commitment to improve the lives of people with obesity

and change how the world sees, prevents and treats obesity. As part of this, we work to build

healthier environments; foster empathy for people with obesity and champion for obesity to

become a healthcare priority; and ensure people living with obesity have access to evidencebased

care.

We have established and curate several platforms to educate about obesity prevention

and treatment:

People with obesity:

Patient organisations, key influencers and obesity advocates are

contributing positively in the media and online by challenging weight

stigma and common perceptions of obesity. 41

Cities Changing

Diabetes

Obesity Clinics

Programme

Obesity Policy

Engagement

Network (OPEN)

Rethink Obesity ®

The Awareness,

Care and

Treatment

in Obesity

Management

Study

Truth About

Weight


4

Chapter 4.1

People with obesity deserve care

and treatment

Novo Nordisk offers treatment solutions and an

industry-leading obesity pipeline

1

Lasting weight loss is possible

In Novo Nordisk, we are aiming to expand our ‘palette’ of treatment

options for people with obesity. We know that sustaining weight loss

can be challenging, so our aim is to bridge the gap in treating obesity

long-term.

Saxenda ® (liraglutide 3.0 mg)

Adolescents (aged 12–<18) living with

obesity who were treated with Saxenda ®

and underwent lifestyle therapy

demonstrated a significant reduction in

Body Mass Index (BMI) Standard Deviation

Score (BMI-SDS) and other weight-related

outcomes. 49 Saxenda ® is currently under

review with the regulatory authorities for

weight management in adolescents.

What is Saxenda ® ?

Saxenda ® is a once-daily GLP-1 analogue

with 97% similarity to naturally occurring

human GLP-1, the hormone that is released

in response to food intake. 42,50,51

Like natural GLP-1, Saxenda ® acts on specific

parts of the brain to reduce appetite and food

intake by increasing fullness and reducing

hunger, resulting in clinically relevant and

30, 37

maintained weight loss.

Saxenda ® is currently the only GLP-1 RA approved for chronic weight

management in people living with obesity. 44

The long-term safety profile of Saxenda ® has

been well established by the SCALE clinical

trial programme in more than 5,000 patients

Saxenda ® is available in the US, Europe and

other countries. 42,52

In adults treated with Saxenda ® , alongside lifestyle modification, 92%

for up to three years and no new safety

achieved weight loss over one year and 1 out of 3 (33%) lost more than

signals were observed compared to the

10% of their body weight. 45 Furthermore, people treated with Saxenda ®

profile of the wider GLP-1 RA class. 42

over three years were able to sustain their weight loss. 45,46

Clinically relevant and maintained weight loss over three years had

additional health benefits including delayed time to onset of type

2 diabetes, 46 improvements in cardio-metabolic risk factors and

inflammatory biomarkers, 46,47 sleep apnoea, 48 and health-related quality

of life. 46


4

Chapter 4.2


and treatment



2

Semaglutide 2.4 mg

Semaglutide 2.4 mg is a new once-weekly GLP-1 analogue currently

under review with the regulatory authorities for chronic weight

management. If approved, semaglutide 2.4 mg has the potential to

transform obesity management. 53-56

Semaglutide provides significant and maintained weight loss in people

with obesity predominately through loss of fat and improved body

composition, 57 as shown in the STEP (Semaglutide Treatment Effect in

People with obesity) phase 3a clinical development programme. 58

People with obesity treated with semaglutide 2.4 mg lost an average

of 15% in body weight sustained for more than one year, compared to

2.4% with placebo. 53

• Continued treatment with semaglutide 2.4 mg supports people with obesity to

maintain weight loss and avoid weight regain. 54

Semaglutide has an established safety profile,

and the most commonly reported side effects

were gastrointestinal, as seen previously with

GLP-1 RAs. 53-56

In addition to weight loss, semaglutide

has been shown to provide consistent

improvements in cardio-metabolic risk factors

beyond weight loss, including glycaemic

parameters and lipid profile, blood pressure

and anti-inflammatory biomarkers. 56,59-61

• The SELECT trial is designed to show if

semaglutide 2.4 mg may reduce risk of

cardiovascular events in people with overweight

or obesity with prior cardiovascular disease. 62

What is semaglutide?

Semaglutide is similar in structure (94%

homology) to the human GLP-1 hormone, 50,63

but it has been modified so that it is suitable

for once-weekly dosing. 64,65

Semaglutide induces weight loss by reducing

appetite and energy intake, improving control

of eating and reducing food cravings, and

lowering preference for fatty, energy-dense

foods .63,65-67


4

Chapter 4.3


and treatment



3

Pipeline

As part of Novo Nordisk’s ambition to drive scientific progress and

understanding in obesity, we continue to invest in research and

development projects to identify and cultivate new and existing obesity

drug targets.

Phase 2:

• AM833 – A long-acting amylin analogue intended as treatment for obesity

Phase 1:

• AM833-sema 2.4 mg – Combination of the amylin analogue and GLP-1

analogue semaglutide

Hormones 101

GLP-1:

GLP-1 stands for glucagon-like peptide-1.

It is released in response to food intake and

helps physiologically regulate appetite. 50,63

GLP-1 medications can be effective in weight

loss as they delay gastric emptying, induce

satiety, and decrease food intake. 50,63

Amylin:

Human amylin is a pancreatic hormone

made and released into the body alongside

insulin. 68-73

How to use the obesity core story

Communication using the core story must

be according to local regulatory and legal

guidelines.

Likewise, all external communication should

be coordinated with key internal stakeholders

and made subject to local legal review and

any established approval procedures.

Please contact Jakob Peter Jakobsen (JAJK) or

Tove Iren Spissøy Gerhardsen

• PYY 1875 – Novel analogue of appetite-regulating hormone PYY tested as single

and combination therapy with semaglutide

Human amylin is a physiological regulator

of appetite. 68-73

(TOIG) for questions or further guidance.

• LA-GDF15 – Long acting GDF15 analogue intended for appetite regulation

It has the capacity to induce weight loss

by reducing appetite and delaying gastric

emptying. 68-70,74-76

E: JAJK@novonordisk.com

M: +45 3079 0781

PYY:

Human PYY is a hormone produced in the gut.

It helps regulate appetite by slowing gastric

emptying. 31,32

E: TOIG@novonordisk.com

M: +45 3077 7872

GDF–15:

GDF-15 stands for growth differentiation

factor–15.


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