A New Book on GLP-1’s Contested Scientific Roots and Complex Cultural Impact — Plus Further Reading

In this weekend’s Wall Street Journal, I review Off the Scales, a fascinating new book by Reuters journalist Aimee Donnellan about the discovery and development of GLP-1 agonists and their impact on medicine, culture, and society.

The review, aimed at a generalist audience, focuses mostly on the societal and cultural implications, but TR readers may be especially interested in the book’s extensive discussion of the science that led to semaglutide. This agent is now marketed by Novo Nordisk as Ozempic (injection for type two diabetes), Wegovy (injection for obesity), and Rybelsus (pill for type 2 diabetes).

Donnellan describes the early work at the Massachusetts General Hospital (MGH), subsequent product development at Novo Nordisk, and even some of the commercial decisions and leaders. One example: the brash American marketing executive, Jeremy Shepler, who came up with the earworm Oh-Oh-Oh Ozempic jingle, based on Pilot’s “Magic,” that contributed to the category’s success.

In relating the discovery of GLP-1, Donnellan is particularly attuned to contribution of peptide chemist Svetlana Mojsov, who played a critical role in identifying and purifying the active form of GLP-1 while she was at MGH, serving as an Instructor of Medicine in the Endocrine Unit at Massachusetts General Hospital and director of the Howard Hughes peptide-synthesis core facility. 

Mosjsov was initially not included on key GLP-1 patents; these initially were awarded to MGH physician-scientist Joel Habener alone. She subsequently spent more than a decade in an exhausting, ultimately successful legal battle to be added as an inventor. Today, Mojsov is Lulu Chow Wang and Robin Chemers Neustein Research Associate Professor at New York’s Rockefeller University, the institution where she originally trained.

Donnellan writes that Mojsov’s story “reveals the ruthless nature of science,” and “is yet another example of how women are often sidelined.” From her disheartening account it is hard to discern how much of the patent snub involved gender, and how much was the result of factors such as seniority, training (Ph.D. rather than M.D.), and function (tool-builder vs. orchestrator). 

Also not included on the patent: Dr. Daniel Drucker, at the time an early-career physician-scientist at MGH working on the biology of GLP-1 as a member of the Habener lab. Drucker collaborated with Mojsov on critical early GLP-1 research, but did not join her in contesting the patents, as Donnellan discusses. Drucker is now at the University of Toronto, where he is University Professor in the Department of Medicine’s Division of Endocrinology, Chair in Incretin Biology, and a Senior Investigator at Sinai Health’s Lunenfeld-Tanenbaum Research Institute. 

Readers can get a sense of how recognition for Mojsov has evolved by starting with the 2021 historical review in Cell of GLP-1’s development penned by distinguished endocrinologist Stephen O’Rahilly. The article was written on the occasion of the 2021 Canada Gairdner International Award bestowed upon Habener, Drucker, and University of Copenhagen physician-scientist Jens Juul Holst for the trio’s early work on the chemistry and biology of GLP-1. O’Rahilly subsequently wrote a correction once he was more fully apprised of Mojsov’s substantial role.

Those interested in learning more may also want to look at Jennifer Couzin-Frankel’s 2023 Science feature on Mojsov, entitled “Sidelined,” as well as Couzin-Frankel’s 2024 piece on Mojsov’s “yearlong journey out of obscurity.”  

Also notable: Mojsov’s selection in 2024 as a co-recipient (along with Habener and Novo Nordisk drug developer Lotte Bjerre Knudsen) of the Lasker–DeBakey Clinical Medical Research Award, which honored the development of GLP-1–based therapies for obesity and type 2 diabetes. Inevitably, perhaps, this award omitted other key researchers who might reasonably have been included (Holst, Drucker, and Novo’s Mads Krogsgaard Thomsen come to mind).

It remains entirely unclear who (if anyone) will ultimately receive a Nobel for GLP-1, given the Prize’s cap of three awardees. My guess: Habener, Holst, Mojsov, and Drucker will all be in contention for their work on the foundational science, and recipients may be determined by survival as much as by merit (since the Nobel cannot be awarded posthumously).

Further Reading

I’ve been captivated by the endocrinology of metabolism since I was a medical resident at MGH. I discussed the biology of ghrelin, known as the “hunger hormone,” in my second year talk. Later, as an endocrinology trainee at MGH (where I recall almost no personal interaction with Habener) I provocatively gave a Fellow talk on the question, “Is type 2 diabetes a surgical disease?” I emphasized the remarkable efficacy of bariatric surgery for this condition, and the unexpectedly rapid endocrine effects associated with the procedure.

 As TR readers appreciate, I’ve remained fascinated by the topic, and written quite a bit about GLP-1, weight, weight management, and type 2 diabetes management over the ensuing years. Those who’d like to explore more may find the following selected pieces useful; they are grouped thematically.

GLP-1s, obesity, and weight-loss drugs

• “Here’s the Skinny on Four New GLP-1 Podcasts” – TR, May 13, 2024. A tour of four GLP-1–focused podcasts, using them as a lens to consider how the drugs are reshaping conversations around obesity, stigma, and responsibility.
• “The Tao of Drucker: Lessons For Drug Developers From GLP-1” – TR, May 26, 2024. Uses the GLP-1 story — especially Dr. Daniel Drucker’s work, as he discusses on a Ground Truths podcast with Dr. Eric Topol — to explore what their development reveals about persistence, mechanistic curiosity, and the messy reality of translational research.
• “Obesity Drugs Don’t Just Offer Weight Loss. They Give Patients Agency.” – STAT First Opinion, June 17, 2025. Emphasizes the psychological shift GLP-1s can catalyze for people who had come to view their weight as immutable.
• “This Era of Weight Loss Drugs Requires a New Kind of Health Platform.” – STAT First Opinion, November 13, 2025. Suggests that if GLP-1s are going to achieve their full potential, we’ll need platforms designed not just to prescribe injections, but to support movement, strength, sleep, and engagement in ways that fit real lives.

Type 2 diabetes prevention, digital interventions, and AI

• “Can A Graduate of Rock Health’s First Class Democratize Diabetes Prevention?” – Forbes, December 11, 2012. Early profile of Omada Health’s effort to translate the Diabetes Prevention Program (DPP) into a scalable digital intervention.
• “Can Silicon Valley Cure Diabetes With Low Carbs And High Tech?” – Forbes, March 8, 2017. Looks at Virta Health and related efforts to combine intensive lifestyle interventions, remote coaching, and technology to treat and potentially reverse type 2 diabetes.
• “Closing Medicine’s Feedback Gap: Can Tech Help Integrate Clinical Care and Clinical Research?” – TR, July 31, 2020. Uses programs like Omada and Virta as examples of how tightly coupled data and care delivery might enable more continuous learning in metabolic disease.
• “Obesity Is Rising; Can Health Coaches And Tech Drive Durable Behavior Change?” – TR, November 29, 2021. Looks at coaching-plus-technology models for obesity and asks how realistic it is to expect durable change at scale.
• “Seeking Pockets of Reducibility in Personalized Medicine: Lessons from Google’s AI Health Coach Study” – TR, August 20, 2025. Explores where AI coaching might realistically move the needle, and where it probably won’t.
• “The Outsized Significance of a New Study of AI in Diabetes Prevention” – TR, October 30, 2025. Discusses a randomized trial showing a fully AI-led DPP-style intervention can match human coaching on key outcomes, and considers what this might mean for scaling behavior-change programs in prediabetes and obesity.

Behavior change, digital fitness, and health coaching

• “After Devastating New Study, Is There a Future for Workplace Wellness – And Has Peloton Figured It Out?” – TR, June 15, 2021. Uses a sobering evaluation of workplace wellness programs as a jumping-off point to ask what, if anything, seems to work — and whether Peloton hints at a better model.
• “Motivating a Modicum of Exercise: The HealthTech Opportunity” – TR, November 15, 2021. Explores how digital tools might help nudge non-athletes toward small, sustainable increases in activity, rather than aspiring to CrossFit-style heroics.
• “From Fitness to Flourish: Expanding the Scope of Digital Exercise” – TR, May 27, 2021. Argues that the real opportunity for digital fitness lies not just in performance metrics but in helping people feel better, function better, and participate more fully in life.
• “Three Core Questions Underlying Durable Behavior Change” – TR, December 8, 2021. Attempts to distill what we actually know (and don’t) about sustaining behavior change, and how this might inform the design of digital health and coaching programs.
• “Enticing Some With Social Cues, Others With Health, Exercise Rewards Body And Mind” – TR, March 20, 2021. Describes how different people respond to different motivators, highlighting the role of Peloton, social cues, and framing.
• “Can Digital Fitness Extend Beyond Hardy Base To Reach Those Who May Benefit Most?” – TR, March 25, 2021. Uses Daniel Lieberman’s Exercised to think about how digital fitness might reach the less-fit and less-confident, not just the already-committed.

Food App and Food Intelligence

• “‘Food Intelligence’: Make Healthy the Default — In Public Spaces and Private Kitchens” – TR, October 6, 2025. A discussion of Kevin Hall and Julia Belluz’s Food Intelligence, focusing on how we might design environments that make healthier choices the path of least resistance rather than a constant act of willpower.
• “Tech-Enabled Power To The People: Ingratiating Chatbots and a Virtuous Food App” – TR, May 4, 2025. Uses Yuka as an example of bottom-up food-environment nudges and “democratization.”

Personal experience with weight loss

• “What I Learned Losing 80 Pounds in 2018” – Forbes, January 2019. Personal account of major weight loss and what actually sustained it.
• “Losing 80 Lbs Was Hard; Keeping It Off Was So Much Harder” – TR, December 26, 2019. On the fragility of weight loss and the challenge of long-term maintenance.