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GLP-1 drugs (Ozempic, Wegovy)
exenatide 2005; semaglutide for weight 2021· Invention or discovery· Germs, drugs & genetics
Well documentedSolid records, physical evidence or scientific consensus.
Drugs that mimic a gut hormone, GLP-1, to control blood sugar and curb appetite, producing large weight loss.
See it on the Technology & Medicine map →How it works
GLP-1 is a hormone the gut releases after meals: it prompts insulin release, slows the stomach and signals fullness to the brain. Natural GLP-1 lasts only minutes, so drugmakers built longer-lasting versions. The first, exenatide (2005), came from a compound in Gila monster venom. Novo Nordisk's semaglutide, a once-weekly shot, was approved for diabetes as Ozempic (2017) and for weight loss as Wegovy (2021); trial patients lost about 15% of body weight.
Why it mattered
They are the first drugs giving many people large, lasting weight loss, and one big trial showed about 20% fewer heart attacks and strokes. Demand made Novo Nordisk, for a time, Europe's most valuable company.
How we know
Large randomized trials (STEP for weight, SELECT for heart outcomes, 2021–23); FDA approvals; the 2024 Lasker Award to Joel Habener, Svetlana Mojsov and Lotte Bjerre Knudsen.
Still unknown or debated
Credit for discovering the active form of GLP-1 is disputed among several 1980s labs; long-term effects, muscle loss and weight regain after stopping are still being studied.
Connections (2)
▸Insulin was joined in diabetes care by GLP-1 drugs (Ozempic, Wegovy)Well documented
The connection
Since 1922, insulin injections have replaced the hormone that diabetics lack or cannot use well. GLP-1 drugs work one step earlier: they mimic a gut hormone that prompts the pancreas to release its own insulin when blood sugar rises, and they also curb appetite. Many type 2 patients now take them before or alongside insulin.
When and how
Insulin in Toronto, 1921–22; GLP-1's insulin effect described in the 1980s by teams in Boston, Copenhagen and elsewhere; exenatide approved in the US in 2005.
How we know
Treatment guidelines, such as the American Diabetes Association's, now recommend GLP-1 drugs early; trials compare them directly with insulin.
Debates and open questions
Whether GLP-1 drugs can delay or prevent the need for insulin over the long term in type 2 diabetes is still being studied.
▸Biotech drugs (human insulin) pioneered the protein manufacturing behind GLP-1 drugs (Ozempic, Wegovy)Mostly agreed
The connection
Genentech's 1978 human insulin showed that engineered microbes could manufacture human hormones at scale. Novo Nordisk, the Danish insulin maker, applied the same skills: liraglutide and semaglutide are peptides, short protein chains, made in genetically engineered yeast and then chemically modified to last longer in the blood.
When and how
Genentech in South San Francisco, 1978; Novo Nordisk in Denmark, making yeast-grown insulin from the 1980s; liraglutide approved 2010, semaglutide 2017.
How sure are we?
Regulatory filings describe semaglutide's production by recombinant DNA in yeast, followed by chemical modification.
Debates and open questions
Newer pill candidates such as orforglipron are small chemical molecules, not proteins, so future GLP-1 drugs may not need biotech manufacturing.