Weight-loss drug pioneer Lotte Bjerre Knudsen: ‘The food industry has to listen’

{"text":[[{"start":8.26,"text":"Taking Lotte Bjerre Knudsen to a two-Michelin-starred Indian restaurant is a bit of a gamble. I might have spent the entire glorious meal attempting to exercise self-control, knowing Knudsen invented a cure for excessive appetite. Happily, I instead discover that the pioneering scientist behind weight-loss drugs is a gourmand."}],[{"start":28.24,"text":"“Any allergies?” the waiter asks, as we settle into our dimly lit booth at London’s famed Gymkhana restaurant. “Only to bad food,” she grins."}],[{"start":38.08,"text":"Within minutes of our meeting, the 62-year-old scientist is describing her childhood in rural Denmark, where her parents — a trained chef and a farmer — kept pigs and poultry and grew an abundance of vegetables including varieties of squash, onions and cabbages. Her mother often single-handedly cooked dinner for a dozen farmhands, usually variations of traditional Danish pork and potatoes. “I have pictures of myself from when I was four years old, standing on a stool and helping to pull the insides out of a duck,” she tells me. “Food was just an important part of how we lived.”"}],[{"start":73.56,"text":"As I help translate the menu, Knudsen brims with enthusiasm for aubergine, pomegranate, cauliflower and samosas, golden-crisp Indian pastries stuffed with spiced potatoes and peas, all of which we resolve to order. Her clearest memory from a trip to India, she says, is the food — but also experiencing the joy of eating with her hands for the first time."}],[{"start":94.96,"text":"She has passed on this love of good food to her daughter, she tells me with some pride. During a recent holiday to Italy, her daughter cooked a 16-person dinner from scratch, including hand-rolling fresh pasta, with a flair that she says surpasses her own abilities in the kitchen. After years of cooking for her daughter, and avoiding takeaways and processed food, she feels vindicated: “There’s a lot of lessons here around leadership . . . until you walk the talk, they’re not gonna do it.”"}],[{"start":121.56,"text":"For the past three decades, Knudsen has devoted herself to understanding a single molecule known as GLP-1, a hormone that modulates hunger and appetite. Her work at the Danish pharmaceutical giant Novo (which in September ditched the Nordisk from its name for everyday use) made possible the development of its blockbuster drugs Ozempic and Wegovy, dramatically transforming the treatment of diabetes and obesity. It has won her the Lasker Award, which is seen widely as a pre-Nobel Prize in the field of medical research."}],[{"start":null,"text":""}],[{"start":153.5,"text":"But the drugs her work inspired have assumed a cultural significance far beyond the medicinal, on par with the contraceptive pill or Viagra, shifting western society’s relationship with food, pleasure and even our idea of human willpower."}],[{"start":167.64,"text":"In her pink suit, with a skinny tie looped around her bare neck and cat-eye glasses, Knudsen knows she isn’t your standard biochemist. In fact, she revels in it. The first time she wore a pink suit was to an awards ceremony in Denmark, where she was surprised by the dozens of comments from women, girls and fathers of daughters inspired by her unapologetic femininity, while also championing science. Since then, it has been her signature public look."}],[{"start":192.84,"text":"“There were no female role models when I grew up in science. I had no women to look up to. I had many great male role models, but as a woman you also would like to see someone like yourself be successful,” she says. She acknowledges that there are some men who dislike her for her larger-than-life personality. “But that’s OK. It’s their problem, not mine.”"}],[{"start":211.88,"text":"Her Alphonso mango lassi arrives in a stout steel tumbler, flecked with pistachio crumbs. “It kind of looks like a candy,” she says delightedly, photographing it with the deftness of a food blogger. I later discover she does actually have a food-focused Instagram, featuring snapshots of delicious meals she has eaten around the world."}],[{"start":null,"text":""}],[{"start":229.44,"text":"She is enjoying a newfound freedom to travel, having left her role as chief scientific adviser at Novo earlier this year after nearly four decades at the company. “I’m aware that there’s something that I could do outside of Novo that could be important,” she says. “I can speak more freely about the science, new opportunities in areas like addiction, and about women in science.”"}],[{"start":253.04,"text":"As the waiter appears tableside, I lean into the traditional way of eating, ordering a range of mains and side dishes to share — an overnight-simmered black dal, crispy okra, tandoor-grilled paneer, sweet-and-sour aubergine and tender, slow-cooked lamb shank in a caramelised onion sauce. When it comes to Indian food, I am not one for moderation. But the look on the waiter’s face persuades Knudsen to jump in and prune our extensive list."}],[{"start":279.56,"text":"“I get annoyed with myself sometimes when I overeat,” she explains. Her husband once confessed he had eaten a whole bag of sweets in the car on the way home, which he described as “doing a Lotte”. “Because that’s what I do sometimes. When I open a bag of candy, I can’t stop. So I understand what it feels like.”"}],[{"start":null,"text":""}],[{"start":297.68,"text":"Knudsen has spent her entire career generating evidence and educating people on how GLP-1s work. Her scientific success has now been widely recognised, but she is only just starting to appreciate the real-world ripple effects the drugs are having."}],[{"start":311.96,"text":"Obesity, once viewed by some as a weakness of character or failure of willpower, has been proven to be a physiological illness, acting on both our bodies and our brains. “People with obesity can live a different kind of life, because it’s more accepted that it’s a biological disease, and because there actually is something that can help them now,” she says."}],[{"start":331.68,"text":"The widespread use of GLP-1s has also revealed, unexpectedly, how many of our behaviours are actually shaped by external forces beyond our conscious control, including centuries of biology, industry and our environment."}],[{"start":345.5,"text":"“It was a little bit of a surprise that the GLP-1 medicines are forcing the food industry to think differently.” she says."}],[{"start":350.32,"text":"“It makes me feel very proud to have had something to do with that, because for decades I have felt saddened to see what has happened. It’s about time.”"}],[{"start":358.52,"text":"Knudsen first began work on GLP-1s in the 1990s, as part of a diabetes research team searching for alternatives to insulin. But when she returned from maternity leave in 1994, that team had been disbanded."}],[{"start":371.92,"text":"Her new boss asked her to continue the project on her own. It was a lonely time, but “it became sort of like my baby”, she says of the molecule, which triggers the release of insulin into the bloodstream."}],[{"start":382.8,"text":"“GLP-1 is increasing in your body right now, because you’re eating,” she says, pointing at my generous helping of aloo chaat, a street-food snack of crispy potatoes, chickpeas and yoghurt, drizzled with crunchy noodles and tamarind chutney. I pause, allowing the marvels to occur inside me. “But it’s very short-acting, and it’s only going to work for 30 minutes after you eat. So what we needed was something that would be sustained for 24 hours a day,” she explains."}],[{"start":410.38,"text":"Her breakthrough was the invention of the first GLP-1 drug molecule, known as liraglutide, in 1997, which lasted long enough in the blood to treat both diabetes and obesity effectively. In the case of weight loss, it acts on the brain to make people feel sated more quickly and slows the rate at which food empties out of the stomach, leading to fewer calories ingested."}],[{"start":432.36,"text":"Knudsen’s cracking of this problem — known in the pharmaceutical industry as the “druggability puzzle” — kick-started the birth of a new class of drugs now used by millions of people to lose weight. The next generation of the medications, based on a molecule called semaglutide, which Knudsen helped to push forward at Novo, was even more potent, resulting in far more dramatic weight loss."}],[{"start":451.76,"text":"Despite known side effects such as nausea, diarrhoea and dizziness, patients on GLP-1s describe the results of the drug as a sort of miracle: a quieting of the hungry voice inside their heads, a freedom from food cravings, and an inability to overeat without feeling sick. “The [drugs] don’t make people feel that they don’t enjoy food at all. They just help them be contented with less,” she says."}],[{"start":474.24,"text":"Today, though, more is more. Traditional copper pots filled with fragrant pulao, garlicky naans and simmering rich sauces are laid out before us. It’s a veritable feast. Knudsen looks relieved that we pared back our original order."}],[{"start":489.48,"text":"Estimates show roughly one in 10 Americans and 5 per cent of UK adults now take weight-loss medications. In 2023, Novo’s blockbuster drugs briefly catapulted it to Europe’s most valuable company, with new Wegovy prescriptions soon hitting 40,000 a week. Hundreds of people have written to Knudsen over the years, or approached her in person, on the train or in the street in Denmark where she is recognisable, to tell her how their lives have changed."}],[{"start":515.56,"text":"“They say, ‘I’ve been hungry for 20 years. I just didn’t know how to stop. Now I can behave like a normal person.’ Or, ‘I was fat for so many years. I just couldn’t find a way out, and now I can.’”"}],[{"start":527.28,"text":"I ask Knudsen if she has tried the drugs she helped create. Yes, of course, she says. A low dose just for a month that made her feel fuller, thirstier and eat less, as expected. She supplemented it, as she has always done, with regular exercise, running twice a week, swimming and lifting weights. If she can’t access any exercise equipment, she does an hour of energetic indoor dancing, usually to Led Zeppelin or her favourite Danish alt-rock band Dizzy Mizz Lizzy."}],[{"start":554.96,"text":"Although the invention of liraglutide was a flashpoint in the story of weight-loss drugs, Knudsen points out that science isn’t like the movies. There was no single moment that vindicated her work, but a series of what she calls “mini-moments”."}],[{"start":571,"text":"“You choose a molecule in the laboratory, but it takes years to get it to people. I still knew that there were going to be 10, 15 years ahead, even after that first moment,” she says."}],[{"start":null,"text":""}],[{"start":583.04,"text":"Knudsen acknowledges that part of the reason for her uphill climb was her gender, coupled with the fact that she had not earned a PhD at the time. Despite this, she was never afraid to speak up, something she attributes to the non-hierarchical and open Nordic culture that Novo was steeped in. And, ultimately, her tireless championing of weight-loss drugs did push the company to invest in GLP-1s all the way to the clinic."}],[{"start":607.52,"text":"Knudsen tells me that the former chief executive Lars Rebien Sørensen, under whom the first weight-loss drug of its kind was approved, described her in a newspaper interview as “completely insufferable to be around”. It would have been nice to have a heads-up, she says, but she takes this as a compliment."}],[{"start":625.12,"text":"As we meticulously work our way through our food, I ask Knudsen if she anticipated how the medicines would change people’s food choices rather than simply reducing their appetites."}],[{"start":635.02,"text":"She pauses, savouring something she can’t quite identify. It could be the flash-fried okra tossed in dry spices that offsets the heavier courses, such as our fig-and-cashew-smeared slabs of tender paneer. It isn’t the roasted cauliflower topped with a green mango garnish, though, by which we are both slightly underwhelmed."}],[{"start":654.04,"text":"The drugs’ effect on food choice has been on her mind since 2005, when she and a colleague ran an experiment on rats. The rodents were given different kinds of treats, as well as normal rat food. She was surprised to observe that the GLP-1 rats preferred to eat the healthy rat chow."}],[{"start":670,"text":"Another study with alcohol found that those on the medications also drank less. There are already indications from clinical work that show the positive effects of GLP-1s on human addiction to alcohol and drugs, and also gambling."}],[{"start":683.96,"text":"“We are designed to live in a cave, and have a hard time finding food. We’re not designed to have . . . all of this,” she says, waving at the banquet laid out for us, “and we’re not designed to have [refined] sugar at all.”"}],[{"start":696.8,"text":"The way generations of humans have survived is to eat the food that was available and store it as fat. She points out how, in supermarkets, you have to walk past rows and rows of snacks and sugary treats before you get to the vegetables and meat aisles. “It’s just tricking people’s minds, right? People can’t say no, it’s in our genetic make-up.”"}],[{"start":717,"text":"Now, medicines such as Wegovy are changing people’s fundamental desire for poor-quality and processed foods. “They have a new relationship with food. They still feel pleasure from food, but they want less of it. And they don’t want all the candy and the chocolate . . . or the same amount of alcohol,” she says. “So now the food industry finally has to listen. They have to start thinking about who their future customers are.”"}],[{"start":741.08,"text":"In the near future, she can already see that the drugs will become far more accessible to the wider public as their cost plummets. She points out that liraglutide is already off patent, as others soon will be, and the cost of the medications is already being driven down by the market as every pharma company develops its own GLP-1. “That’s the life cycle in pharma. You get those 20 years to make the money. And I think the money has been made,” she says, raising her eyebrows exaggeratedly."}],[{"start":769.84,"text":"While she is one of the named inventors of the liraglutide molecule, it was always the company that owned the intellectual property. She quickly sold the incentive shares she had been awarded because she “didn’t want to sit there and write papers about the science and then have to disclose that I own shares in the company. So I got rid of them as soon as I could.”"}],[{"start":790.26,"text":"She surveys the spoils of the feast with slight dismay. “We have ordered way too much food,” she says. She hates to see it wasted, and makes me promise to take the leftovers home with me."}],[{"start":801.86,"text":"She had thought it too early in the day to drink at the start of the meal, but at this point, feeling replete, she decides to finish off with a glass of her favourite red wine, a 2019 Brunello from Tuscany. She describes her farewell party from Novo, where she invited two special guests — her 93-year-old mother and her daughter. Knudsen tells me that the father of her daughter died when the latter was 11; Knudsen often brought her to work during those difficult years. Her mother’s help with childcare allowed Knudsen to travel to scientific conferences and build out her exceptional career. “I really wanted them to be there because it’s such a big part of their lives. It was the end of an era for all of us,” she says."}],[{"start":842.94,"text":"She hasn’t decided what she will do next, but she has promised herself she won’t take any new jobs for 12 months. “The world is very bright, and my inner voice is telling me . . . I need to go down the unknown,” she says. Like all great scientists, though, she does want to leave behind a legacy larger than herself. “I hope I inspire people to be brave in the pursuit of scientific ideas that can solve real problems in the world,” she says. “With a touch of pink to it.”"}],[{"start":870,"text":"Madhumita Murgia is the FT’s artificial intelligence editor"}],[{"start":873.76,"text":"Find out about our latest stories first — follow FT Weekend on Instagram, Bluesky and X, and sign up to receive the FT Weekend newsletter every Saturday morning"}],[{"start":888.72,"text":""}]],"url":"https://audio.ftcn.net.cn/album/a_1793413002_3813.mp3"}