Book traces Ozempic's path from GLP-1 research to Novo Nordisk's rise

Aimee Donnellan's "Off the Scales: The Inside Story of Ozempic and the Race to Cure Obesity" went on sale Nov. 18, 2025, from St. Martin's Press ^[1]. The 320-page book sells for $30 and is available in hardcover, e-book, digital audio and trade paperback ^[1]. Donnellan is a Reuters journalist, and the book is her first, according to the Guardian's review ^[2].

The Guardian called it "a fascinating deep dive into the discovery, use and implications of a revolutionary new treatment" ^[2]. The Wall Street Journal described it as "a nuanced view of the transformational promise — for better and worse — of these unsettling medical marvels" ^[1]. Kirkus called it "a tangled plot stuffed with big money, towering egos, and innovative science, capably told and without an ounce of flab" ^[1].

The science the book reconstructs

The Guardian's review says the story starts with Svetlana Mojsov, a Macedonian immigrant who arrived at New York's Rockefeller University in 1972 to do post-graduate chemistry and engineered a synthetic version of GLP-1, a natural hormone that helps control blood sugar ^[2]. Scientists at Novo Nordisk picked up GLP-1 as a possible diabetes treatment, and decades of work produced semaglutide, which people with diabetes could take once a week instead of injecting insulin several times a day ^[2]. In trials, the drug controlled blood sugar and caused participants to lose up to 20 percent of their body weight, the review says ^[2].

The publisher's description says Ozempic works by activating GLP-1, making people feel fuller for longer ^[1]. The review says Mojsov is tipped to win a future Nobel Prize, and the publisher says Donnellan profiles a scientist whose contributions to the GLP-1 discovery were overlooked ^[1][2].

The review notes that Novo Nordisk's market value is now larger than the entire gross domestic product of Norway ^[2]. The publisher says the drug has already disrupted industries from health care to fast food to fashion, and that a true long-term cure for obesity could save 40 percent of American adults from dangerous, preventable illnesses ^[1].

Patients and culture

The review says the book opens with "Sarah," a 34-year-old marketing executive from Michigan who lost five stone (32 kilograms) in six months on Ozempic and found her standing at work transformed — invited into important meetings, given new management responsibilities and a raise — even though nothing about her behavior at work had changed ^[2]. The publisher says the book also includes firsthand accounts of several early Ozempic users and examines what the drugs' popularity says about beauty ideals ^[1]. The review notes that Oprah Winfrey told podcast listeners she took the drug, saying it "felt like relief, like redemption, like a gift" ^[2].

The review says Donnellan is careful not to treat the GLP-1 drugs as an unalloyed good: she covers side effects such as severe nausea, and use by people who are neither obese nor diabetic, a practice some commentators have likened to "an eating disorder in a pen" ^[2]. The review's main criticism is that the book does not dig into why the drugs work so well against obesity, beyond the fact that GLP-1 receptors are present in the brain ^[2].

Why it matters for patients

The book is a reported history and a business narrative, not clinical guidance, and it does not tell readers what to take or how much. What it does offer is context for decisions patients and their doctors are already making: the once-weekly semaglutide injection that came out of diabetes research ^[2], the up-to-20-percent weight loss reported in trials ^[2], and the side effects, including severe nausea, that the review says the book addresses ^[2].

It also documents a split the review highlights — people with diabetes or obesity using the drugs for health, and people who are neither using them for appearance ^[2]. The publisher frames the broader stakes as a question about inequality as much as medicine, asking whether the drugs could widen the gap between rich and poor ^[1]. Whether they can make the country healthier rather than just thinner is the question the Washington Examiner's review says the book leaves open ^[1].

What the book does not resolve, and what has not been reported in these accounts, is why the drugs work as well as they do; the review says scientists simply do not know beyond the presence of GLP-1 receptors in the brain ^[2]. The Times of London's review calls the book "the first draft of history" and says the story of Ozempic has only just begun ^[1].