• The recent media debate around popular weight loss drugs such as Wegovy indicated that pharma companies might lack a deeper understanding of how obesity is discussed in the public discourse.
  • Our media analysis around obesity suggested that pharma companies should prioritise transparency, be careful with reinforcing weight stigma and emphasise the importance of lifestyle changes.
  • In addition, Big Pharma should develop ESG messaging around obesity as a social issue and use social media to combat eating disorders.

View a one-page infographic summary of the analysis

For a long time, obesity drug development was out of favour as Big Pharma focused on other lucrative arenas such as cancer. Now obesity medicines are making a roaring comeback, thanks to a new class of diabetes drugs that also turn out to be surprisingly potent weight loss agents. 

Obesity was officially classified as a chronic disease by the American Medical Association in 2013 and the European Commission last year, with the potential to become the next blockbuster pharma category. Companies including Eli Lilly, Pfizer and Amgen are trying to match the success of Novo Nordisk, the maker of the highly effective Wegovy injection.

But how can pharma effectively promote its solutions to a condition that is such a sensitive topic in the public discourse? To find out, we analysed 641 English-language articles published during the last year in specialised outlets like Pharma Phorum, Pharma Times and FiercePharma, as well as in mainstream publications like the Guardian, Wall Street Journal and Financial Times. Here are our top suggestions:

1. Prioritise transparency

That’s the first lesson after an Observer investigation revealed that “experts who praised new ‘skinny jab’ received payments from drug maker.”

The story, which was briefly the front-page lead on The Guardian’s website, discussed the fact Novo Nordisk donated “£21.7 million to health organisations and professionals who in some cases went on to praise the treatment without always making clear their links to the firm.” One “clinical expert” who received Novo Nordisk money testified that the so-called “skinny jabs” were a “gamechanger.”

There is now concern about what one expert described as an “orchestrated PR campaign” by the drug company as it sought to shape the obesity debate. The Observer investigation became such a hot topic namely because it had to do with obesity – an issue whose sensitivity Novo Nordisk didn’t seem to fully realise.

The lively debate that followed the investigation made Transparency and corporate responsibility the second most prominent topic in the media discussion around obesity, following Drug innovation:

The thing is, there’s nothing inherently wrong with any of this. Even The Observer acknowledges: “There is no suggestion the payments broke any rules.” However, if you’re not doing anything wrong, you shouldn’t act as if what you’re doing is sneaky and underhand.

As a consequence, Novo Nordisk was suspended by The Association of the British Pharmaceutical Industry, which said the company engaged in actions “likely to bring discredit on, or reduce confidence in, the pharmaceutical industry”. This helped make Novo Nordisk the most influential company in the debate:

It would have been the simplest thing in the world for Novo Nordisk to do all the things it did in this instance openly and transparently, to ask obesity charities to be transparent about the sources of their funding (especially when interacting with the media). Such financial relationships are subject to legal disclosure rules anyway, so there is no reason they should not also be revealed when dealing with the media or the public.

As Paul Holmes, founder and chair of PRovoke Media, put it, the principle here should apply to everything public relations firms do: provide the audience with all the information they might find useful in making a good decision, particularly whether the source of information and advice has been funded by specific interests. The news that scientists sometimes receive industry funding is more shocking and alarming when it is apparently kept secret; transparency normalises it and makes it less sinister.

This is even more important right now, as the pharmaceutical industry faces an onslaught of misinformation and conspiracy theories from people who would demonise it.

2. Educate the public on weight stigma

Not everybody embraces new obesity medications. Some of the most vocal opposition has come from weight-neutral health advocates, who criticise how the drugs medicalise obesity. They point to the longstanding debate about whether obesity is in and of itself a disease state and argue that body size is not a good health metric. 

Some of obesity’s health consequences may also be caused by stigma and discrimination, including on the part of healthcare providers who under-treat patients with obesity, attributing medical issues to excess weight even when they have other causes. The situation is especially risky for people of colour, who also have higher rates of obesity in the US and are less likely to be accurately diagnosed by body mass index, or BMI — the tool that’s most frequently deployed to gauge obesity and its risks.

Raising such concerns made organisations like Obesity Health Alliance and Diabetes UK among the most influential non-profits in the debate after government agencies:

This pushback has gained traction in a moment when weight discrimination has been holding firm or worsening — even while discrimination based on other factors, such as race or sex, has been declining, and obesity rates have been rising. There are legions who’ve struggled with their weight and share a history of failed weight loss attempts.

Alongside the cultural movement, there’s a growing pile of scientific evidence from obesity and diabetes researchers showing that the health risks of excess fat are more difficult to untangle than the public has been led to believe.

Pharma companies can use their marketing and PR campaigns to educate the public about the causes of obesity and the negative impacts of weight stigma. They can also promote messages of body positivity and acceptance of all body types, partnering with patient advocacy groups to help promote positive messages about body image and to raise awareness about the harmful consequences of weight discrimination.

3. Emphasise the importance of lifestyle changes

While weight-loss drugs like Wegovy and Ozempic have been regarded by many as “weight loss miracles,” one of the most common criticisms in the media has been that when people can’t afford to keep taking these weight loss drugs, they often experience rebound weight gain that is difficult to control.

For instance, according to a popular 2022 study published in Diabetes, Obesity, and Metabolism, most people gain back a majority of their weight within one year of stopping Wegovy.

Pharma companies should avoid promoting their weight loss medications as a “quick fix” or a substitute for healthy behaviours. Focusing too much on the products and not enough on communicating the advantages of a healthy lifestyle could mean that health and wellness messaging fails to have the desired impact, especially in disadvantaged local communities where multiple factors influence purchasing decisions. 

Big Pharma should promote their medication as a complement to healthy lifestyle changes – it can provide educational resources that promote healthy behaviours, such as a healthy diet, regular physical activity, and stress reduction.

Look at another industry where health and wellness initiatives are becoming increasingly important – the FMCG (fast-moving consumer goods) sector. In recent years, the biggest players in FMCG have been going beyond cutting sugar and reformulating their products, and focused their attention on community-based initiatives to engender cultural change.

4. Develop ESG messaging around obesity as a social issue

Weight loss drugs ignited an old conversation – the personal responsibility vs. societal factors debate. The first camp criticises weight loss drugs because they seem to excuse the obese of “personal responsibility”.

Meanwhile, the other side of the debate has argued that promoting anti-obesity drugs reinforces the notion that obesity is solely an individual problem, rather than a societal issue. Such critics have claimed that more attention should be paid to addressing the underlying social determinants of obesity, such as access to healthy foods, safe environments for physical activity, and economic inequality.

The social dimensions of obesity have been a particular focus of media outlets such as The Guardian and the New York Times, which reported on how many individuals do not have access to affordable, healthy foods, particularly in low-income areas.

Without explicitly taking sides in this debate, pharma companies can develop ESG (environmental, social, and governance) messaging around obesity as a social issue by highlighting their commitment to social responsibility, promoting a positive impact on public health, and addressing the social aspects of health that contribute to obesity.

For instance, pharma companies can address the social determinants of health that lead to obesity, such as lack of access to healthy foods and safe places to exercise, by investing in community-based programs and initiatives that support healthy behaviours. These initiatives could be part of pharma’s overall push to address health equity issues, which have gathered particular media attention after the pandemic.

5. Use social media to combat eating disorders

Weight loss garners huge social media attention. Multiple celebrities are rumoured to use these drugs, and TikTok videos containing the hashtag #ozempic have garnered over 360 million views and the number continues to rise. The social media frenzy and influencer endorsements have provoked a huge increase in demand.

@mariannas_pantry

#stitch with @fastnutrition another celebrity pretending like they don’t take ozempic even after they had an ozempic party…. #ozempic #weightloss

♬ Blade Runner 2049 – Synthwave Goose

Elon Musk himself espoused the benefits of Ozempic and Wegovy to his over 120 million Twitter followers, which also made him the second most influential person in the obesity media debate, second only to Novo Nordisk CEO Novo NordiskLars Fruergaard Jørgensen:

The rise in weight loss medication also coincides with changing body standards, which are now more akin to those of two decades ago. A New York Times article from November 2022 announced the return of “heroin chic”, the 90s fashion trend of looking extremely thin to the point of illness.

41% of TikTok’s 800 million users are between the ages of 16 and 24, an age group that is particularly vulnerable to developing eating disorders – the deadliest mental illnesses, second only to opioid overdose. The lack of effective regulation on global platforms like TikTok only exacerbates this vulnerability.

In this regard, pharma companies can use their social media platforms to promote positive messages about body image and to celebrate diversity in body size and shape. They can share educational resources about eating disorders, their signs and symptoms, and how to seek support. This can help raise awareness about the dangers of social media trends that promote unhealthy body standards.

In addition, pharma players can collaborate with social media influencers who promote healthy behaviours and positive body image. They can encourage influencers with large audiences to do a better job of using their platforms responsibly and consider the broader impact that a focus on weight loss has on their young followers.

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