The town that Ozempic and Wegovy built

Novo Nordisk’s drug is helping millions to lose weight. It is also changing Denmark

This article was originally published on 12 February, 2024 in 1843 magazine.

 

Mads Damkjær, a friendly civil servant with a parka and a side parting, took his foot off the gas as he pointed to the factory that is making fat people thin. We were driving through the small Danish town of Kalundborg, where icicles hung from the roofs of colourful crooked houses and the five towers of a medieval church reached like a claw into the sky. Ahead of us, dotted with flags and guards, was the complex where Novo Nordisk, a Danish pharmaceutical company, makes the “miracle” weight-loss drugs Ozempic and Wegovy, as well as half the world’s insulin.

 

In Kalundborg, whose population is just 16,000, it felt like everybody had a connection to Novo Nordisk. Damkjær said his brother used to work at the company’s factory in North Carolina. We drove to the harbour where the locals bathe in one-degree water, the two of us bonding over a shared love of Liverpool FC. There we met a café owner, Shaun Gamble, a native New Zealander. Gamble, who roasts his own coffee beans, had once worked for Novo Nordisk as a forklift-truck driver.

 

A century after it was founded to produce insulin, Novo Nordisk is becoming a household name outside Denmark. In the past year the company has overtaken LVMH, which makes Louis Vuitton and other luxury products, to become Europe’s most valuable company. (Its sales grew by more than a third in 2023; net profit rose by 51%, to $12.1bn.) If its weight-loss drugs, already loved by celebrities, can help to ease the world’s obesity crisis, millions of lives could be changed.

 

In the canteen at Novo Nordisk’s headquarters, employees chatted over soup served with pineapple and quinoa, and salads garnished with linseed

 

As I warmed my hands on a flat white, Damkjær gave me an information sheet about Kalundborg. “The problem about things moving so fast”, he said, smiling as he apologised, “is that the statistics are already out of date.” Earlier I had watched cranes assemble the skeletons of four factories Novo Nordisk was building at the cost of 18bn Danish kroner ($2.6bn). In November 2023 the company announced it would invest another $6.1bn into the town – 12 times the municipality’s annual budget.

 

In a country of nearly 6m people, Novo Nordisk distorts the national economy, too. From the first half of 2022 to the first half of 2023, the Danish economy grew by 1.7%. Without Novo Nordisk, the country would probably have been in recession. Factor in everyone who works with the firm – lorry drivers, canteen workers, welders – and almost 3% of the total Danish workforce depends on Novo Nordisk. The company has the power to influence health budgets, tax rates and even the cost of people’s mortgages. There is hardly a diabetes or obesity specialist in Denmark who will not have received money from Novo Nordisk or its foundation.

 

 

The company’s headquarters are 100km (62 miles) east of Kalundborg in Bagsværd, an unspectacular suburb of Copenhagen. I visited the circular building, which was inspired by the helical structures of the insulin molecule. In the canteen, employees chatted over soup served with pineapple and quinoa, and salads garnished with linseed. Others hung around coffee machines, waiting patiently for their oat-milk lattes.

 

The relaxed mood was illusory. Novo Nordisk is racing to respond to the demand for semaglutide, the active ingredient in Ozempic and Wegovy, and to maximise profits before it goes off-patent (probably in about a decade). It is competing with its biggest rival, Eli Lilly, an American pharmaceutical company which has developed its own GLP-1 agonist product – a class of drugs that mimics the effects of an appetite-suppressing hormone in the gut.

 

Novo Nordisk is also trying to develop the next blockbuster medicine for weight loss and the treatment of other health problems, such as cardiovascular and rare blood diseases. At Måløv, another Novo Nordisk site near Copenhagen, labs stretch out of the main building like rays from the sun, many of them now automated to increase the chances of another great discovery. Production sites in Kalundborg are running 24/7 and scientists are promoted quicker if they move there from the headquarters.

 

“Not many people in the community work there,” said a woman in a café in the hard-up neighbourhood of Værebro Park

 

On the other side of the motorway from the campus at Bagsværd are the high-rises of Værebro Park, a hard-up neighbourhood full of social housing. Half the residents are, in the government’s language, “non-Western” immigrants and the area suffers from high unemployment. I was interested to see how it had been touched by Novo Nordisk’s success.

 

“Not many people in the community work there,” said one woman in the local café, dishing up a portion of shepherd’s pie which cost substantially less than my flat white in Kalundborg. “As a taxpayer, it makes a difference,” said another woman outside, as she stubbed out her cigarette in the snow. A considerable understatement about a company that is by far the biggest contributor to Danish corporation tax, which helps fund the country’s bountiful welfare state. (In November the government announced that higher-than-expected revenues meant that it could spend more on welfare while also cutting taxes for workers.)

 

 

In the fruit-and-veg section of the local discount supermarket I met Bhagya Laxmi Kaxhati, a small, smiling woman who used to work at Novo Nordisk as a cleaner. “There are lots of new buildings,” she said. “The area has changed a lot.” In India Kaxhati had been a chemical engineer, but since moving to Denmark 12 years ago she has only been able to find unskilled work. She kept applying to Novo Nordisk for other jobs, she said, but without success.

 

Novo Nordisk started because of a love story, as its marketing department likes to say. August Krogh, a scientist who had won a Nobel prize for his research into blood vessels, was married to Marie, a doctor. In 1922 Marie, who had diabetes, persuaded her husband to accompany her on a trip to Canada, where a team had worked out how to extract insulin from animal pancreases. The couple secured an agreement to sell insulin in the Nordic states and the following year founded what would become Novo Nordisk.

 

Martin Damm used to drive torpedo boats on NATO exercises across the North Sea. Being the mayor of Kalundborg seemed almost as exciting

 

The company chugged steadily along, specialising in the treatment of diabetes. Then, around a decade ago, scientists began to notice that one of their most promising medicines, semaglutide, also suppressed appetite. In 2017 the American Food and Drug Administration (FDA) approved it to treat diabetes under the brand name Ozempic. Four years later the FDA approved it for obesity as Wegovy, with the EU soon following suit. The drug was an instant success; demand was so high that Novo Nordisk initially struggled to keep up with orders.

 

After our coffee in Kalundborg, Damkjær took me to the new town hall to meet the mayor, Martin Damm (Novo Nordisk connection: his sister’s husband works there). As a young man in the Danish navy, Damm, 60, used to sail torpedo boats on NATO exercises across the North Sea to the Orkney Islands in Scotland. Being the mayor of Kalundborg seemed almost as exciting. Novo Nordisk pays so much tax, Damm explained, his blue eyes widening, it has enabled the municipality to reduce income tax. Kalundborg’s unemployment rate, traditionally high, has tumbled. Thousands of construction workers have descended on the town. Damm told me about the food stall that now sells over 500 hot dogs a day. The petrol station, known for its roast-pork sandwiches, must order 30kg of meat a day to meet demand.

 

 

But transformational growth can sometimes feel destructive. The locals grumbled about traffic jams, the poaching of employees from other companies and the changes to the rhythms and rituals of their small town. For Kalundborg to grow more would involve even more disruption: more students, more infrastructure, a motorway (the latter heavily lobbied for by Novo Nordisk). Above all it would mean building more houses for workers to live in. Although the local economy is growing, Kalundborg’s population has slightly declined. Many workers commute from elsewhere, said Damm.

 

The municipality goes to great lengths to persuade Novo Nordisk workers to relocate from Copenhagen. It promises to move them to the top of waiting lists for rental properties and share their spouses’ CVs with local employers. Women are recruited to the local football team; their husbands fast-tracked into sailing clubs. One worker the firm had not yet convinced was Damkjær: “In Copenhagen, I can watch any movie I want in the movie theatre, I can buy tomatoes at 3 o’clock in the morning. Even if I never do it.”

 

Damm told me about a petrol station, known for its roast-pork sandwiches, that must order 30kg of meat a day to meet demand

 

Kalundborg had been burned by the bright lights of opportunity before. In the early 20th century it had a burgeoning shipbuilding industry – until it collapsed soon after the first world war. In the 1960s two men invented heated hair rollers in a basement; thousands of women were bussed in from across the region to make them (a story retold by a recent hit TV series). The Carmen curlers revolutionised hairstyling worldwide, until they were superseded by electric curling tongs. “Third time’s the charm!” Damm said optimistically.

 

Not long ago, Denmark was trying to make people eat more, not less. In the early 2000s, Noma, a three-Michelin-starred restaurant in Copenhagen, made Nordic cuisine famous. It launched a trend for foraging seasonal ingredients and led to a tourist boom in Denmark, with foodies fighting to secure the hottest table in town. As with fine dining, most of the customers who can afford Wegovy, at least for now, are rich. In Vesterbro, a trendy part of Copenhagen, I met Dr John Rosenberg, an energetic general practitioner sporting hiking boots. In the waiting room of his surgery, people looked slim underneath their puffy winter coats. The surgery had 140 patients who were taking the drug, said Dr Rosenberg. He complained that Wegovy was eating up multiple appointments for blood tests, consultations and health checks. Across the country, some 100,000 Danes pay between $189 and $335 a month to take it.

 

America, where Wegovy is much more expensive, accounts for 79% of Novo Nordisk’s total sales in obesity care. This has unanticipated consequences. Last December Forbes, a business magazine, quoted a post on X (Twitter) by a Danish economist: “Big shoutout to the overweight Americans keeping my mortgage low.” Novo Nordisk pulls in so many dollars that the central bank has to keep interest rates at a lower rate than the European Central Bank  to stop the Danish krone rising too much in value (it is loosely pegged to the euro).

 

 

And if the firm were to crash? Some Danes worry that it might be like Nokia, a mobile-phone company which in 2000 generated 4% of Finland’s GDP but was then swept aside by the likes of Apple and Samsung. Novo Nordisk is mentioned 31 times in the government’s latest forecast for the Danish economy. But Denmark is not Finland, said Professor Martin Jes Iversen when we met at Copenhagen Business School. Denmark has the world’s largest toy producer in Lego, the second-largest shipping business in Maersk and the largest producer of wind turbines in Vestas. The story of Novo Nordisk is not the unique success of one company, he argued. Rather it is the product of an ecosystem nourished with open research, competitive tax rates and talent.

 

The university was silent – term hadn’t started yet and the academics were working from home to avoid the snow. But Iverson was animated as he gestured to a thin blue line on a graph showing Novo Nordisk’s market value. It rose steadily for years and then whooshed up, almost vertical. Some 30% of investors are Danish; another 28% of shares (and 70% of the voting rights) belong to the Novo Nordisk Foundation. Like Carlsberg, a beermaker, its foundation model means in effect that the company cannot be sold. The foundation sprays money into grants for health and life sciences, mostly within Denmark.

 

The locals grumbled about traffic jams, the poaching of employees from other companies, the distortion of the rhythms and rituals of their small town

 

You can see Novo Nordisk’s influence everywhere: in the woman decorating a new boutique in Kalundborg; in a new research facility there that offers fellowships to a conveyor-belt of master’s students; in a new bio-entrepreneurship course at Copenhagen Business School; in the English menus for students and international workers; in the latest GDP statistics. Kalundborg’s GDP grew by 27% in 2022, more than any other Danish municipality. The next highest growth was in Gladsaxe (where Novo Nordisk’s Bagsvaerd headquarters is), Hillerød (another manufacturing site), and Ballerup, where Måløv is located. Together, these four municipalities accounted for two-thirds of the total increase in national GDP.

 

When it was announced that Novo Nordisk was buying a plot in Odense, Denmark’s third largest city, the locals celebrated “without even knowing what it was for”, Damm told me. Officials have already visited three times to see what it is like to be a “Novo city”. Perhaps it could have been different. “Maersk, Vestas – we could have been having a conversation about them,” said Iversen, shepherding me out. Except we’re not. For now at least, this is all about Novo.