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The obesity
core story
Novo Nordisk is committed to changing how the world sees
people with obesity to make obesity a heathcare priority,
and to developing a leading portfolio of treatment solutions.
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For internal use only – all content is subject to local legal review and any established approval procedures
1
Guidance
for use
What is the obesity core story?
The Novo Nordisk obesity core story is the cornerstone
of our obesity strategies, ensuring that Novo Nordisk
speaks with one voice about obesity.
The core story builds on the Novo Nordisk’s 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.
Susie 2 For internal use only – all content is subject to local legal review and any established approval procedures 3
Our guiding principles for obesity disease awareness
Losing weight has a positive impact on health
Maintaining weight loss is difficult because regaining it is easy
Long-lasting medical treatment options are available
Lasting weight loss is possible
The chapters of the core story:
Abigale Sarah Wynford Susie
1 2 3 4
Obesity is a chronic
disease and it is not
going away:
We are acting 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 industry-leading
obesity pipeline
Elroy 4 “Spoonface”
For internal use only – all content is subject to local legal review and any established approval procedures 5
1
Obesity is a chronic disease
and it is not going away
D’S
650 million adults
We are acting on our purpose by
showing leadership in solving the
global obesity challenge
125 million children
Worldwide, obesity impacts
650 million adults 1
124 million
children living with
obesity globally 2
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.
975
MILLION OVER
THE NEXT
DECADE 1
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% or more. 5-8
Society
The significant burden of obesity and
obesity-related conditions such as diabetes
and cardiovascular disease is welldocumented.
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
6 For internal use only – all content is subject to local legal review and any established approval procedures 7
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.
Losing weight has a positive
impact on health
Why is obesity undertreated?
Reducing the stigma people with obesity face is critical:
On the street In the media At work Even at the doctor’s office
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.
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
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
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
8 loss in the long term. 28-30
9
3
The narrative around obesity
is changing
We are partnering with stakeholders to make
obesity a healthcare priority
The obesity narrative is changing
Progress is being made to address these issues in key areas
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 weight loss benefits, see slides 22–31 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 evidence-based care.
We have established and curate several platforms to educate about
obesity prevention and treatment:
Cities Changing
Diabetes
Obesity Clinics
Programme
Obesity Policy
Engagement Network
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
Rethink Obesity ®
The Awareness, Care
and Treatment in Obesity
Management Study
Truth About Weight
For more information, please see the Changing Obesity portal.
10 For internal use only – all content is subject to local legal review and any established approval procedures 11
4.1
People with obesity deserve
care and treatment
Novo Nordisk offers treatment solutions and an
industry-leading obesity pipeline
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)
Saxenda ® is currently the only GLP-1 RA approved for chronic weight
management in people living with obesity. 44
92% 3
1 IN 3
LOST 10%
BODY
WEIGHT
In adults treated with Saxenda ® , alongside lifestyle modification, 92%
achieved weight loss over one year and 1 out of 3 (33%) lost more than
10% of their body weight. 45 Furthermore, people treated with Saxenda ®
over three years were able to sustain their weight loss. 45,46
YEARS
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.
The long-term safety profile of Saxenda ® has
been well established by the SCALE clinical
trial programme in more than 5,000 patients
for up to three years and no new safety
signals were observed compared to the
profile of the wider GLP-1 RA class. 42
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 available in the US, Europe and
other countries. 42,52
For more information, see the Liraglutide
3.0 mg Core Science Deck.
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
12 For internal use only – all content is subject to local legal review and any established approval procedures 13
4.2
People with obesity deserve
care and treatment
Novo Nordisk offers treatment solutions and an
industry-leading obesity pipeline
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
15%
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
For more information, visit the Obesity
Communication semaglutide 2.4 mg
SharePoint page.
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
For more information, see the Semaglutide
2.4 mg Core Science Deck
14 For internal use only – all content is subject to local legal review and any established approval procedures 15
4.3
People with obesity deserve
care and treatment
Novo Nordisk offers treatment solutions and an
industry-leading obesity 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.
Hormones 101
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
• PYY 1875 – Novel analogue of appetite-regulating hormone PYY tested as single
and combination therapy with semaglutide
• LA-GDF15 – Long acting GDF15 analogue intended for appetite regulation
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
Human amylin is a
physiological regulator
of appetite. 68-73
It has the capacity to
induce weight loss
by reducing appetite
and delaying gastric
emptying. 68-70,74-76
PYY:
Human PYY is a
hormone produced
in the gut.
It helps regulate
appetite by slowing
gastric emptying. 31,32
GDF–15:
GDF-15 stands for
growth differentiation
factor–15.
16 For internal use only – all content is subject to local legal review and any established approval procedures 17
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 Jakobsen (JAJK) or Tove Iren
Spissøy Gerhardsen (TOIG) for questions or further guidance.
E: JAJK@novonordisk.com
M: +45 3079 0781
E: TOIG@novonordisk.com
M: +45 3077 7872
For more information, see the Core Obesity Deck.
18 For internal use only – all content is subject to local legal review and any established approval procedures 19
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