By Matt Bevan and Yasmin Parry for the ABC
Ozempic was originally formulated as a treatment for diabetes before its impact on people's appetites was discovered. Photo: AFP
What do you think the biggest company in Denmark is? It's a pharmaceutical company called Novo Nordisk.
This company's market cap is 10 times larger than Lego's. Its market cap is now sitting at $US427.4 billion ($NZ726 billion), a figure larger than Denmark's annual GDP.
After a century plugging away making insulin and other drugs to treat diabetes, it has suddenly rocketed to become not just the most-valuable company in Denmark, but in all of Europe.
It has unseated luxury goods retailer LVMH, home of Dior and Louis Vuitton, which held the spot for two and a half years.
And its unbelievable success is all thanks to one drug - semaglutide, more commonly known as Ozempic, or Wegovy.
The drug started life as a treatment for type 2 diabetes, but now it's being hailed as a miracle treatment for weight loss.
The drug is causing weight loss and having an impact on Denmark's economy. Photo: 123RF
Celebrities are using it and countries are running out of it.
Novo Nordisk has become so big it's starting to do weird things to Denmark's economy - like an elephant in the backyard pool.
Economists say Denmark's central bank has had to keep interest rates lower.
They're even debating whether Novo Nordisk should be taken out of the country's economic statistics because of how much it's disturbing the figures.
So how did a Danish pharmaceutical company become the proprietors of one of the most in-demand products in the world?
Novo Nordisk's humble beginnings
Novo Nordisk got its start in 1923 producing insulin. Its only interest in obesity was how it related to diabetes.
In 1982, staff began to experiment with a hormone called GLP-1. They took it from the pancreas of pigs and then gave it to pigs with diabetes.
It seemed to be working, so they started testing it on humans.
They gave the humans a dose of the hormone, then asked them to eat a meal so they could measure what happened to their blood glucose levels.
But there was a problem. The test subjects couldn't finish the meal. They weren't hungry.
The drug was working to treat diabetes by slowly releasing insulin from the pancreas, but they had also stumbled upon an interesting side effect - the drug made people not want to eat.
It took three decades to get the drug to market, but in 2017, Novo Nordisk's semaglutide was approved for use in diabetes patients under the name Ozempic.
For a few years Ozempic flew under the radar, until a little article was published in the New England Journal of Medicine in March 2021.
It said people who were given a higher dose of the drug lost 15 percent of their body weight in a year and a half, compared with 2 percent on a placebo.
The media caught on that the drug caused weight loss, and semaglutide became the most in-demand drug in the world.
Debilitating side effects
Actress and comedienne Amy Schumer is among those who have tried the drug but she was badly hit by side-effects. Photo: AFP
Ozempic is in such demand it's started a global pharmaceutical arms race bigger than anything seen since the Covid vaccine rollouts.
Rival company Eli Lilly has released a similar drug called Mounjaro; now it and Novo Nordisk are the biggest pharma companies in the world.
The high demand from people hoping to lose weight has led to shortages for people with diabetes, causing a debate over who deserves this drug more.
In Australia, only diabetes patients can access Ozempic until the end of the year. Wegovy is not available in Australia yet.
Those who have got their hands on the drug are not always happy with the experience.
Nearly half of people taking it get nausea. About a quarter experience diarrhoea, vomiting and/or constipation.
Actress Amy Schumer has talked publicly about her experience with Ozempic, saying she had to stop taking it for weight loss because of the debilitating side effects.
One of the inventors, Jens Juul Holst, told Wired in an interview that most people stop taking it after a couple of years because the lack of interest in food makes them "miserable".
And a study found that a year after going off the drug, people regain on average two thirds of the weight they lost.
A treatment for addiction?
When Alexander Fleming was trying to cure the flu, he stumbled upon penicillin. When Pfizer scientists were trying to cure heart disease, they stumbled upon Viagra.
And when Danish scientists were trying to cure diabetes, they stumbled upon a weight-loss drug, but that may not be all it can do.
Some people using semaglutide have found their other addictive impulses have begun to subside.
In addition to losing weight, they say they've lost their addiction to smoking, drinking, shopping and nail biting.
Proper clinical trials haven't been done on humans yet, but this has been backed up with research on monkeys.
If it turns out to be true, it would make Ozempic and drugs like it one of the biggest medical breakthroughs of the century, a treatment for three of the most serious modern health dilemmas - diabetes, obesity and addiction.
This story was first published by the ABC.