Off the Scales

The Inside Story of Ozempic and the Race to Cure Obesity

Aimee Donnellan

$55

Hardback

Forthcoming
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English

Fourth Estate Ltd
15 January 2026

Illness & addiction: social aspects; Chemical industries; Dietetics & nutrition; Popular medicine & health; Diets & dieting

The inside story of the race to develop Ozempic – the world’s first truly effective and safe obesity drug – and its potentially revolutionary effects on public health, and our deeper culture and values.

A ‘cure’ for obesity has long been the holy grail for the pharmaceutical industry, one that seemed unattainable until recent breakthroughs in type 2 diabetes research led to the development of Ozempic, a weight loss medication that makes people feel fuller for longer. The treatment is so effective that it is already disrupting many industries – from healthcare to fast food to fashion – and it has quickly made its creator, Denmark’s Novo Nordisk, the most valuable company in Europe. But the impact of these drugs goes far beyond billion-dollar profits; a true long-term cure for obesity could significantly reduce dangerous preventable illnesses. And as their success continues to grow, one question looms in the minds of investors, healthcare workers and politicians: are they too good to be true?

In Off the Scales, journalist Aimee Donnellan illuminates the history of the latest medical breakthrough that is poised to change the world, while bringing difficult social questions about inequality and morality to the forefront. Through original reporting and rigorous research, she forecasts the future of Ozempic and similar medications like Mounjaro and Wegovy, and examines what their explosive popularity tells us about our ideals of beauty, the lengths to which people will go in order to become thin, the current state of healthcare and the inner workings of the pharmaceutical industry.

Along the way, Donnellan profiles the scientist whose contributions to the discovery of GLP-1 were overlooked and her fight for recognition, and offers new insights into the ways that the food and beauty industries made billions while promoting unhealthy and unrealistic body image standards and accelerating the obesity crisis. She also reveals the lengths that the celebrity class went to obtain this medication when supplies were limited and prescriptions were costly, and relates the first-hand accounts of several early Ozempic users and the transformative effect the drug has had on their weight loss journeys. Above all, Off the Scales is a gripping and informative study of the unexpected social consequences of finally getting what we've wanted for so long.

By: Aimee Donnellan
Imprint: Fourth Estate Ltd
Country of Publication: United Kingdom
Dimensions: Height: 240mm, Width: 159mm, Spine: 23mm
Weight: 270g
ISBN: 9780008719081
ISBN 10: 000871908X
Pages: 320
Publication Date: 15 January 2026
Audience: General/trade , ELT Advanced
Format: Hardback
Publisher's Status: Forthcoming

Aimee Donnellan has been a columnist at Reuters for six years, where she has closely followed Big Pharma (among many other topics). Previously she was banking correspondent at the Sunday Times (London). She has been a journalist for over 15 years and started her career investigating the opaque worlds of hedge funds and online gambling. She also covered the bond market after the 2008 financial crash for the investment bankers' bible, International Financing Review. Aimee grew up in Galway in the west coast of Ireland and lives in London with her wife and two children. Off the Scale is her first book.

Reviews for Off the Scales: The Inside Story of Ozempic and the Race to Cure Obesity

'Donnellan chronicles the search for miracles, the ensuing gold rush, the lives impacted, the biases overturned and solidified, and where this paradigm shift will leave us. Off the Scales is the definitive account of a singular global force—essential reading to help us understand what has been unleashed and what may be coming next' Andy Slavitt, author of Preventable 'Donnellan provides a riveting and impeccably researched deep-dive into the murky world of drug development and casts a light on the little-known characters who have dedicated their lives to rewriting the rules of science … Ultimately, the book presents a scathing critique of the big corporations that have shamelessly leveraged people’s insecurities to get rich, and offers a mixed prognosis for the future: Ozempic may hold a world of promise, but there could be a far darker side that we’re only just starting to see' Josie Cox, journalist and author of Women, Money, Power 'Ozempic and the other GLP-1 medications are among the most important medical breakthroughs of our time. Off the Scales captures the many facets of this fast-moving story, including the decades of scientific research that led to their creation, the stories of early patients and the culture change required to understand obesity as a medical condition rather than a character flaw. Donnellan is a gifted storyteller who brings complicated subjects to life and offers a hopeful vision for how these therapies are transforming lives and reshaping our approach to health care' Leana Wen, M.D., Washington Post contributing columnist and author of Lifelines