The world needs more than drugs to fight obesity, writes Novo Nordisk's ex-boss

Business Times

21 hours ago

OVER the next decade, obesity and associated chronic diseases will have a profound impact on economies and global health. Yet for all the publicity around weight-loss treatments, it is clear that pharmaceuticals alone cannot solve a crisis that already affects over a billion people worldwide. The challenge lies not just in developing medicines and other interventions, but also in finding ways to prevent obesity and other chronic diseases before they start.
As chief executive of Novo Nordisk from 2017 until earlier this month, I had a front-row seat to the promise and limitations of pharmaceutical interventions. These interventions have shown potential in weight management, but they cannot on their own address the economic and environmental factors that contributed to the obesity epidemic in the first place.
The latest forecasts in the Lancet are stark: more than half of adults and one in three children and adolescents are set to be obese or overweight by 2050. This represents not just a health catastrophe but an economic one. The annual global cost of obesity alone is forecast to reach US$4.3 trillion by 2035. The economic burden posed by other chronic conditions linked to obesity, including diabetes and cardiovascular disease, will be measured in the trillions too. Such eye-popping numbers underline the futility of any notion that treatment alone can be a silver bullet.
Radical rethink needed
If we are to reverse a curve trending in the wrong direction since the 1990s, a radical rethink is needed. The next five years are crucial: In parts of the population, notably children and adolescents, the number of people living with obesity is set to overtake the number who are overweight but not obese. Shirking from the urgent policy intervention that's needed would be a monumental societal failing.
A shift in focus is needed on many fronts. Obesity must be universally recognised and addressed as a multi-faceted societal responsibility rather than an individual one. This means restrictions on junk-food marketing to children and continued work to reduce the stigma associated with the disease. It also calls for urban planning that supports people's health, for instance by emphasising physical exercise over travelling by car. In short, the world must prioritise prevention.
This may sound counterintuitive coming from a pharmaceutical executive. But the reality is that even if every person living with obesity took medicines, we couldn't treat our way out of this crisis.
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Obesity science has come a long way. It is now widely accepted that socioeconomic, genetic and environmental factors play an important role in the development of the disease. Appetite regulation and the body's resistance to weight loss are also much better understood. We know it is not just a matter of calories in and calories out.
Moreover, our improved understanding of the hormones regulating glucose levels and appetite reinforces the argument for a holistic approach to interconnected cardiometabolic diseases. The evidence is clear: Obesity is associated with numerous comorbidities. Cancer, type-2 diabetes, sleep apnoea, liver disease, chronic kidney disease, Alzheimer's and cardiovascular disease – the biggest cause of death globally – often overlap in people living with obesity. Earlier interventions to prevent obesity are not simply about limiting weight gain; they are about enabling good long-term health.
This emerging area of science also offers clues as to how health care might be redesigned to be more patient-centred. The norm is for cardiologists to focus solely on cardiovascular disease while endocrine consultants treat patients with diabetes. A holistic approach built around the patient, rather than clinical specialisms, is the way forward.
As data collection and analysis methods improve, so does the ability to gain new insights into why people develop obesity and which interventions work. This is an area in which the private sector can step up to help governments with limited resources, competing demands and a burning need to effect change now to invest in the most effective measures.
Novo Nordisk is working with policymakers and academics as part of the Childhood Obesity Prevention Initiative: a controlled study across six cities in Brazil, Canada, France, Japan, South Africa and Spain, which is evaluating interventions to improve diets and boost physical activity among 6,000 children from disadvantaged communities. At the end of the programme, the plan is to produce a framework to guide regional and global policy decisions. More public-private action in this area must follow with pooled investment and, where appropriate, data-sharing.
Obesity interventions of this kind could mark a milestone in human healthcare. However, if managing a single disease in isolation remains the sole legacy of this era of scientific progress, the world will have missed an opportunity to fundamentally change how society views and deals with chronic disease.
Having recently stepped down after eight years at the top of Novo Nordisk, I am filled with hope rather than despair. Yes, the obesity epidemic is a huge challenge. But I have witnessed what is possible when science, policy and human determination align. I have seen patients improve their health and confidence. I have watched governments begin to act, from healthcare reforms to urban-planning reforms. Most importantly, I have observed a fundamental shift in the understanding of obesity: from an issue of individual responsibility to a condition requiring comprehensive and holistic care.
The tools exist. The science is clear. Now we need to act on our knowledge. My generation may have created this crisis, but the next generation, armed with a deeper understanding and hopefully wiser policies, can solve it.
©2025 The Economist Newspaper Limited. All rights reserved The writer was chief executive of Novo Nordisk from January 2017 to August 2025