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Off the Scales: The Inside Story of Ozempic and the Race to Cure Obesity
The inside story of the race to develop Ozempic, and its potentially revolutionary impact on public health and culture.
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 activates hormones in the stomach, making people feel fuller for longer. The treatment is so effective that it is already disrupting many industries--from health care 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 save 40% of American adults from dangerous preventable illnesses. And as their success continues to grow, one question looms in the minds of investors, healthcare workers and are they too good to be true?
In Off the Scales, Reuters 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—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 who first discovered GLP-1 and her fight for recognition while her colleagues were thrust into the limelight, 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 firsthand 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 an informative and entertaining study of the unexpected social consequences of finally getting what we've wanted for so long.
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 activates hormones in the stomach, making people feel fuller for longer. The treatment is so effective that it is already disrupting many industries--from health care 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 save 40% of American adults from dangerous preventable illnesses. And as their success continues to grow, one question looms in the minds of investors, healthcare workers and are they too good to be true?
In Off the Scales, Reuters 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—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 who first discovered GLP-1 and her fight for recognition while her colleagues were thrust into the limelight, 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 firsthand 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 an informative and entertaining study of the unexpected social consequences of finally getting what we've wanted for so long.
320 pages, Hardcover
First published November 18, 2025
24 people are currently reading
4138 people want to read
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Displaying 1 - 30 of 49 reviews
October 31, 2025
Pre-Read Notes:
This is going to be a hard read for me because at its basis, it stigmatizes bodies like mine -- medical bodies. My body is a result of overlapping conditions, whose overlapping treatments share as side effects the development of new conditions, like hyperglycemia and type 2 diabetes. I expect this to be a triggering read for me. However, this journalist is attempting a balanced discussion and I want to read it.
"[...A]nyone who wants to be thin and has the resources to pay over $ 1,000 out of pocket can attain the body they have always dreamed of with the click of an injectable pen, while poorer people who are already more prone to struggle with weight issues and obesity are likely to become even more stigmatized. Meanwhile, many food manufacturers will pursue these poorer customers who do not have the means to arm themselves with the GLP-1 drugs that seem to act as an antidote to highly processed and addictive meals. And if the wealthier people who have more political power feel that their children are getting healthier, and if childhood obesity levels decline in this group, poorer citizens will have fewer people fighting in their corner seeking healthy alternatives or calling out food deserts in inner cities. This widening gulf between thin and rich and poor and overweight will deepen the divide between both classes and races when it comes to health and happiness." p176
Final Review
(thoughts & recs) It's an excellent discussion of a nuanced and critical subject. These shots make me crazy but I love this book.
A Few Things:
✔️ Sarah's story in the opening pages of the book (part shared here) makes me so sad. Because it's true and heartbreaking. I believe Sarah's story because I live it. I have dozens of health issues, many of which require me to take medication that affects my weight. My doctors know everything about my condition. And yet the conversation we have *every time* is about my weight. About how I need to lose more. Help for that? No no not for disabled me on my public health insurance. And diet pills? Along with mental illness meds? They'd call me a drug seeker. And beyond that I have a million food sensitivities and I'm a vegetarian. So I'm down to protein bars (only certain ones), yogurt, and nuts and seeds. That's literally all I eat. So YES it makes me feel terrible to know how worthless this world thinks I am at my current weight. Thirty pounds down, without any diet meds, still not enough! "To Sarah, this star treatment was exciting but also depressing. Her ideas at work were the same, the stories she told her now attentive father were the same, and she was still the same person who went to Starbucks every morning. The only difference? In the past six months, she’d shed seventy pounds." p20 How I would love access to the shot. My dad the retired doctor loves it. The disabetes in my family comes from his side. But like so many useful and necessary technologies, it bypassed the hands of those who need it, like me, and fell right into the hands of those who could afford to buy it no matter how far they drove the price up. Like my dad.
✔️ This book hits all its moral responsibilities included in the topic, including the participation of the beauty, pharmaceutical, and medical industries to come together and sicken every Usian woman with lies about her body. The nineties and two thousands were especially egregious. "It was the peak of what was known as “heroin chic,” an ultra-gaunt look where models often had dark circles under their eyes. Thin was the ultimate fashion symbol of the era. Moss’s views on dieting and weight were encapsulated in an interview with Women’s Wear Daily over a decade later. When the supermodel was asked if she had a motto, she famously responded, “Nothing tastes as good as skinny feels.”⁶⁹ This mantra coincided with a startling rise in eating disorders, which were continuing to spread rapidly." p88
Content Notes: sexism, plagiarism, scientific theft, cruelty to animals, killing of animals, disordered eating, body size, stigmatizing weight and eating, for profit medical system, money motivated science, late stage capitalism, poverty,
Thank you to Aimee Donnellan, St. Martin's Press, and NetGalley for an accessible digital arc of OFF THE SCALES. All views are mine.
This is going to be a hard read for me because at its basis, it stigmatizes bodies like mine -- medical bodies. My body is a result of overlapping conditions, whose overlapping treatments share as side effects the development of new conditions, like hyperglycemia and type 2 diabetes. I expect this to be a triggering read for me. However, this journalist is attempting a balanced discussion and I want to read it.
"[...A]nyone who wants to be thin and has the resources to pay over $ 1,000 out of pocket can attain the body they have always dreamed of with the click of an injectable pen, while poorer people who are already more prone to struggle with weight issues and obesity are likely to become even more stigmatized. Meanwhile, many food manufacturers will pursue these poorer customers who do not have the means to arm themselves with the GLP-1 drugs that seem to act as an antidote to highly processed and addictive meals. And if the wealthier people who have more political power feel that their children are getting healthier, and if childhood obesity levels decline in this group, poorer citizens will have fewer people fighting in their corner seeking healthy alternatives or calling out food deserts in inner cities. This widening gulf between thin and rich and poor and overweight will deepen the divide between both classes and races when it comes to health and happiness." p176
Final Review
(thoughts & recs) It's an excellent discussion of a nuanced and critical subject. These shots make me crazy but I love this book.
A Few Things:
✔️ Sarah's story in the opening pages of the book (part shared here) makes me so sad. Because it's true and heartbreaking. I believe Sarah's story because I live it. I have dozens of health issues, many of which require me to take medication that affects my weight. My doctors know everything about my condition. And yet the conversation we have *every time* is about my weight. About how I need to lose more. Help for that? No no not for disabled me on my public health insurance. And diet pills? Along with mental illness meds? They'd call me a drug seeker. And beyond that I have a million food sensitivities and I'm a vegetarian. So I'm down to protein bars (only certain ones), yogurt, and nuts and seeds. That's literally all I eat. So YES it makes me feel terrible to know how worthless this world thinks I am at my current weight. Thirty pounds down, without any diet meds, still not enough! "To Sarah, this star treatment was exciting but also depressing. Her ideas at work were the same, the stories she told her now attentive father were the same, and she was still the same person who went to Starbucks every morning. The only difference? In the past six months, she’d shed seventy pounds." p20 How I would love access to the shot. My dad the retired doctor loves it. The disabetes in my family comes from his side. But like so many useful and necessary technologies, it bypassed the hands of those who need it, like me, and fell right into the hands of those who could afford to buy it no matter how far they drove the price up. Like my dad.
✔️ This book hits all its moral responsibilities included in the topic, including the participation of the beauty, pharmaceutical, and medical industries to come together and sicken every Usian woman with lies about her body. The nineties and two thousands were especially egregious. "It was the peak of what was known as “heroin chic,” an ultra-gaunt look where models often had dark circles under their eyes. Thin was the ultimate fashion symbol of the era. Moss’s views on dieting and weight were encapsulated in an interview with Women’s Wear Daily over a decade later. When the supermodel was asked if she had a motto, she famously responded, “Nothing tastes as good as skinny feels.”⁶⁹ This mantra coincided with a startling rise in eating disorders, which were continuing to spread rapidly." p88
Content Notes: sexism, plagiarism, scientific theft, cruelty to animals, killing of animals, disordered eating, body size, stigmatizing weight and eating, for profit medical system, money motivated science, late stage capitalism, poverty,
Thank you to Aimee Donnellan, St. Martin's Press, and NetGalley for an accessible digital arc of OFF THE SCALES. All views are mine.
June 25, 2025
I received a free copy of, Off the Scales, by Aimee Donnellan, from the publisher and Netgalley in exchange for an honest review. This book talks about the new super drug for weight loss Ozempic. Obesity has always been an issue with people, people have tried many ways to lose wight. This book talks about how Ozempic came to be. This was an interesting read, I do not know if I like it though, I know somebody who passed away from using these new weight loss medications, they have side side affects, that are not really talked about.
June 28, 2025
As a nurse, this book was an interesting look at the discovery of the revolutionary GLP-1 drugs. I have seen many patients come through the ER who have seen amazing weight loss and control of their diabetes that they had previously felt helpless to manage. I have also seen some with serious gastrointestinal side effects from these drugs, although the vast majority were short lived and went away after stopping the medications. As an obese person throughout most of my adult life and a newly diagnosed type 2 diabetic, I was of course eager to learn more about these drugs and how they came about. I definitely recommend this book to others who like reading about scientific issues and research and to anyone curious about this class of drugs in general. I especially appreciated the many citations (a whopping 15% of the book!). Thank you to the publisher and to NetGalley for the advance digital copy to review.
August 21, 2025
Off the Scales did a great job of explaining the science without becoming overly dense or boring. Furthermore, the author did a wonderful job of exploring the far-reaching impacts of Ozempic. She brings the humanities to the sciences and vice versa. Off the Scales is a book I would recommend to anyone remotely interested in the topic.
October 19, 2025
this focused a lot more on the discovery of ozempic than the impact it has on health and culture. I found the second half of the book to be way more interesting. Wish it went more into depth on fatphobia and the impact of weight loss drugs.
June 23, 2025
Off the Scales by Aimee Donnellan is a fascinating overview of the rise of Ozempic, and is a super engaging and surprisingly accessible look into the wild story of how Ozempic went from a diabetes treatment to a full on cultural phenomenon. If you’re even a little curious about how this drug came to dominate headlines, diet culture, and the pharmaceutical industry, this is a great place to start. As someone who has explored the thought of trying this medication but was hesitant to make a commitment because of all the things I do not know about it, this really opened my eyes and eased my fears about it.
To be clear: this isn’t a deep dive medical textbook or walk through of every clinical trial. Instead, it’s more of a smart overview. Aimee Donnellan gives you a solid understanding of the key players, the science behind GLP-1 drugs, and how marketing, money, and media helped fuel its explosive popularity.
I also really appreciated the parts that touched on bigger conversations, like body positivity, beauty standards, and how entire industries (hello, fast food and fashion) might be rethinking how they operate. There’s also some powerful discussion around the overlooked contributions of women scientists, which was both frustrating and important to read. Additonally, I really liked that the severe side effects that can occur were discussed because these are important to not overlook, especially for those who might be considering it but are wary.
Overall, this book helped me understand the why behind the Ozempic craze, where the science might be headed next, and how our society is grappling with it all. It’s definitely a thought provoking, informative read with plenty to chew on.
Big thanks to NetGalley, Aimee Donnellan, and St. Martin’s Press for the eARC of this book.
To be clear: this isn’t a deep dive medical textbook or walk through of every clinical trial. Instead, it’s more of a smart overview. Aimee Donnellan gives you a solid understanding of the key players, the science behind GLP-1 drugs, and how marketing, money, and media helped fuel its explosive popularity.
I also really appreciated the parts that touched on bigger conversations, like body positivity, beauty standards, and how entire industries (hello, fast food and fashion) might be rethinking how they operate. There’s also some powerful discussion around the overlooked contributions of women scientists, which was both frustrating and important to read. Additonally, I really liked that the severe side effects that can occur were discussed because these are important to not overlook, especially for those who might be considering it but are wary.
Overall, this book helped me understand the why behind the Ozempic craze, where the science might be headed next, and how our society is grappling with it all. It’s definitely a thought provoking, informative read with plenty to chew on.
Big thanks to NetGalley, Aimee Donnellan, and St. Martin’s Press for the eARC of this book.
June 20, 2025
Ozempic is everywhere right now, and Off the Scales by Aimee Donnellan takes a look at the drug’s wild rise from medical breakthrough to pop culture obsession. This book digs into the science, the shady pharma backstory, and the chaos in healthcare, beauty, and even fast food.
It is definitely interesting, especially when it covers lesser-known parts of the story, like the scientist who never got credit for her role in the drug’s discovery. But parts of it felt repetitive or surface-level. If you’re already following the Ozempic drama online, this may not add much. Still, if you want a beginner-friendly overview of how we got here, it is worth a skim.
It is definitely interesting, especially when it covers lesser-known parts of the story, like the scientist who never got credit for her role in the drug’s discovery. But parts of it felt repetitive or surface-level. If you’re already following the Ozempic drama online, this may not add much. Still, if you want a beginner-friendly overview of how we got here, it is worth a skim.
December 15, 2025
I have super mixed feelings about this book.
The good: the scientific background on the Svetlana Mosjov and other women involved in the research in the early days of developing this drug. Unsurprisingly, I had heard of most of the male researchers but not their female counterparts. I like that this sets the story straight a bit and acknowledged their contributions. I also liked (don't know if that's quite the right word) learning about how suspect of a character Joel Habener was, and what he allegedly appropriated from those who worked in his lab and others.
I liked the discussion of the socio-economic factors around access, and thought that was quite nuanced as well.
The bad: Despite its discussion of the body positivity movement, the book itself is a perpetrator of fatphobia, discussing how it is a good thing that people are wearing smaller sizes, dating more, and being more confident at smaller sizes (as though you can't be fabulous and date at a larger size).
There are also discussions of trauma and bullying and how these can be avoided. But the unspoken or implied focus is that you avoid these things because you lose weight and not because the stigma has actually been eradicated. The focus again comes back to food choices and behaviors, rather than changing metabolic pathways, so even though the author explicitly calls obesity a disease, the implication is still there that it is somehow changing our choices rather than hormone imbalances. It's not one or the other (hello multi-factorial causes), but the implication left a bad taste in my mouth. (If this is the case for you as well, I recommend the Fat Science podcast hosted by Dr. Emily Cooper and two others).
Additionally, there are sweeping generalizations about side effects, as though it is guaranteed that you will have any and all of them, and it is implied as a price you pay to be on the medication (I would argue if you are experiencing these side effects, you are probably on too high of a dose).
Finally the writing: At times I liked that it was conversational, but at other times, it read like an overly dramatized screenplay- how do we know he sighed at that specific moment, or there was a rap at the door? It took me out of the actual facts of the situation at times. Additionally, it seems the author had more access to Novo Nordisk than Eli Lilly, because there is much more insider perspective into their process and products, so I wouldn't call it particularly balanced or comprehensive on the players in the space (though they do talk about AstraZeneca, Roche, and others later on).
Final pet peeve: I feel like the anecdote about reducing violent behavior needed a footnote- it sounded so preposterous, so I would have loved to check references (can you tell I spent too many years getting degrees?).
The good: the scientific background on the Svetlana Mosjov and other women involved in the research in the early days of developing this drug. Unsurprisingly, I had heard of most of the male researchers but not their female counterparts. I like that this sets the story straight a bit and acknowledged their contributions. I also liked (don't know if that's quite the right word) learning about how suspect of a character Joel Habener was, and what he allegedly appropriated from those who worked in his lab and others.
I liked the discussion of the socio-economic factors around access, and thought that was quite nuanced as well.
The bad: Despite its discussion of the body positivity movement, the book itself is a perpetrator of fatphobia, discussing how it is a good thing that people are wearing smaller sizes, dating more, and being more confident at smaller sizes (as though you can't be fabulous and date at a larger size).
There are also discussions of trauma and bullying and how these can be avoided. But the unspoken or implied focus is that you avoid these things because you lose weight and not because the stigma has actually been eradicated. The focus again comes back to food choices and behaviors, rather than changing metabolic pathways, so even though the author explicitly calls obesity a disease, the implication is still there that it is somehow changing our choices rather than hormone imbalances. It's not one or the other (hello multi-factorial causes), but the implication left a bad taste in my mouth. (If this is the case for you as well, I recommend the Fat Science podcast hosted by Dr. Emily Cooper and two others).
Additionally, there are sweeping generalizations about side effects, as though it is guaranteed that you will have any and all of them, and it is implied as a price you pay to be on the medication (I would argue if you are experiencing these side effects, you are probably on too high of a dose).
Finally the writing: At times I liked that it was conversational, but at other times, it read like an overly dramatized screenplay- how do we know he sighed at that specific moment, or there was a rap at the door? It took me out of the actual facts of the situation at times. Additionally, it seems the author had more access to Novo Nordisk than Eli Lilly, because there is much more insider perspective into their process and products, so I wouldn't call it particularly balanced or comprehensive on the players in the space (though they do talk about AstraZeneca, Roche, and others later on).
Final pet peeve: I feel like the anecdote about reducing violent behavior needed a footnote- it sounded so preposterous, so I would have loved to check references (can you tell I spent too many years getting degrees?).
July 16, 2025
Advanced Readers Copy - A fascinating book on the history of glp-1 medications. It includes stories of individuals, who've struggled with their weight. It's an easy read. There are some parts of this book that seem out of place or that might not be missed if not included but, all-in-all, I found it very interesting, especially in light of my being on a glp-1 medication for over 15 months. I feel confident that I'm taking a safe drug after reading about its discovery. This book won't be everyone's cup of tea, but I'm glad I read it.
October 1, 2025
A sharp, thoroughly researched read that looks at the rise of Ozempic, from 1980s gut hormone discoveries to today’s billion-dollar weight-loss race. The book captures the scientific rivalries and corporate competition while raising critical questions.
Fascinating, unsettling, and timely.
Fascinating, unsettling, and timely.
November 19, 2025
2.5 stars! I was excited to learn more about Ozempic since that word alone is a cultural phenomenon these days. The first half regarding the discovery and backstory got a little long - I found the second half slightly more interesting. Overall, the book didn’t have a great flow to it and I ended up skimming a bit. I think plenty of readers could find this book interesting but it wasn’t really for me. Thanks to NetGalley and St. Martin’s Press for the advanced copy in exchange for my honest review - it’s out today!
November 13, 2025
Aimee Donnellan – Off the Scales
St. Martin’s Press – thank you to the publisher and NetGalley for my gifted ARC.
I devoured Off the Scales in two sittings, then sat in stunned silence thinking about what it all means—for healthcare, for culture, for every single person who’s ever stood in front of a mirror and thought “if only.” This isn’t just a book about Ozempic. It’s about the price of perfection, the illusion of control, and how a so-called “miracle drug” is reshaping our bodies, industries, and moral compass in real time. Aimee Donnellan didn’t just write a health book—she cracked open a cultural reckoning and handed us the blueprint.
From the very first chapter, Donnellan makes it clear: Ozempic is no overnight sensation. Its story begins decades ago with obscure gut hormones and long-ignored female scientists whose research was overlooked in favor of flashier names. And from there, the book builds momentum like a thriller—except the stakes aren’t fictional. They’re playing out right now in doctor’s offices, red carpets, fast-food boardrooms, and Instagram feeds everywhere.
Donnellan, a Reuters journalist with a background in financial reporting, brings just the right mix of curiosity, skepticism, and razor-sharp analysis. Her reporting is thorough—this woman did the work. You can tell from the citations alone. But what makes this book different is how she blends science, economics, and social commentary without ever talking down to the reader. You don’t need a PhD to follow the science here. You just need a pulse and a little concern for the fact that people are literally vomiting themselves into ERs to fit into size fours again.
She walks us through how GLP-1 drugs like Ozempic and Wegovy work: they mimic hormones that make us feel full longer and slow down digestion, helping users eat less—sometimes dramatically less. Sounds great in theory, right? And for many people—especially those with type 2 diabetes or severe obesity—these drugs are life-changing. But Donnellan doesn’t stop at the surface. She digs into the hidden costs: the supply shortages, the staggering price tags, the side effects ranging from nausea to intestinal paralysis, and perhaps most devastating, the resurgence of body image ideals we thought we left behind in the early 2000s.
One of the most powerful parts of the book is her discussion on the return of the “heroin chic” aesthetic. Just as the world was beginning to embrace diverse body types and fight back against toxic beauty standards, Ozempic hit the scene like a wrecking ball. Suddenly, celebrities and influencers were melting before our eyes, the message loud and clear: thin is back, and you’d better keep up.
She doesn’t just speak in hypotheticals. Donnellan interviews real patients, real scientists, and real corporate insiders to show the human faces behind the data. There’s a woman who describes losing 60 pounds and her appetite for life right along with it. A scientist whose life’s work was ignored because she wasn’t “camera-ready.” Executives from the snack food industry panicking as profits drop. And quietly humming in the background? The threat of this entire industry turning from life-saving intervention to vanity-fueled obsession.
A line that hit me like a gut punch: “We asked for a cure, but what we got was a mirror.”
What makes Off the Scales especially compelling is that Donnellan refuses to take the easy route. She doesn’t frame Ozempic as a villain—or a savior. She’s brutally honest about the lives saved and improved by GLP-1s, while also holding the pharmaceutical industry accountable for its profit-first mindset. She asks hard questions about access and equity: Who gets to use these drugs? Who gets left behind? And what happens when the medicine runs out?
The pacing is brisk, the tone is conversational without sacrificing depth, and the humor is dry and dark in all the right places. I laughed. I cringed. I even Googled side effects just to make sure this wasn’t some dystopian satire (spoiler: it’s not).
If you think this book is only for health nuts, doctors, or diet culture obsessives, think again. It’s for anyone who wants to understand how modern medicine, media, and capitalism collide—and what happens when the most important decisions about our health are being made in boardrooms and TikToks instead of exam rooms.
In the end, Off the Scales is a deeply necessary, thoroughly researched, and wildly readable examination of the drug of our time. It doesn’t offer easy answers, but it will leave you asking better questions. And maybe that’s the point.
⭐️⭐️⭐️⭐️⭐️
#OffTheScales #AimeeDonnellan #OzempicBookReview #GLP1Drugs #PharmaceuticalIndustry #BodyPolitics #HealthAndWellness #WeightLossDrugs #NetGalleyARC #StMartinsPress #ScienceWriting #CulturalCritique #NonfictionReview #OzempicSideEffects #WomenInScience #BeautyStandards #ObesityEpidemic #HealthcareInequality #Bookstagram #BookReviewersOfInstagram #BookBlogger #MustRead2025
St. Martin’s Press – thank you to the publisher and NetGalley for my gifted ARC.
I devoured Off the Scales in two sittings, then sat in stunned silence thinking about what it all means—for healthcare, for culture, for every single person who’s ever stood in front of a mirror and thought “if only.” This isn’t just a book about Ozempic. It’s about the price of perfection, the illusion of control, and how a so-called “miracle drug” is reshaping our bodies, industries, and moral compass in real time. Aimee Donnellan didn’t just write a health book—she cracked open a cultural reckoning and handed us the blueprint.
From the very first chapter, Donnellan makes it clear: Ozempic is no overnight sensation. Its story begins decades ago with obscure gut hormones and long-ignored female scientists whose research was overlooked in favor of flashier names. And from there, the book builds momentum like a thriller—except the stakes aren’t fictional. They’re playing out right now in doctor’s offices, red carpets, fast-food boardrooms, and Instagram feeds everywhere.
Donnellan, a Reuters journalist with a background in financial reporting, brings just the right mix of curiosity, skepticism, and razor-sharp analysis. Her reporting is thorough—this woman did the work. You can tell from the citations alone. But what makes this book different is how she blends science, economics, and social commentary without ever talking down to the reader. You don’t need a PhD to follow the science here. You just need a pulse and a little concern for the fact that people are literally vomiting themselves into ERs to fit into size fours again.
She walks us through how GLP-1 drugs like Ozempic and Wegovy work: they mimic hormones that make us feel full longer and slow down digestion, helping users eat less—sometimes dramatically less. Sounds great in theory, right? And for many people—especially those with type 2 diabetes or severe obesity—these drugs are life-changing. But Donnellan doesn’t stop at the surface. She digs into the hidden costs: the supply shortages, the staggering price tags, the side effects ranging from nausea to intestinal paralysis, and perhaps most devastating, the resurgence of body image ideals we thought we left behind in the early 2000s.
One of the most powerful parts of the book is her discussion on the return of the “heroin chic” aesthetic. Just as the world was beginning to embrace diverse body types and fight back against toxic beauty standards, Ozempic hit the scene like a wrecking ball. Suddenly, celebrities and influencers were melting before our eyes, the message loud and clear: thin is back, and you’d better keep up.
She doesn’t just speak in hypotheticals. Donnellan interviews real patients, real scientists, and real corporate insiders to show the human faces behind the data. There’s a woman who describes losing 60 pounds and her appetite for life right along with it. A scientist whose life’s work was ignored because she wasn’t “camera-ready.” Executives from the snack food industry panicking as profits drop. And quietly humming in the background? The threat of this entire industry turning from life-saving intervention to vanity-fueled obsession.
A line that hit me like a gut punch: “We asked for a cure, but what we got was a mirror.”
What makes Off the Scales especially compelling is that Donnellan refuses to take the easy route. She doesn’t frame Ozempic as a villain—or a savior. She’s brutally honest about the lives saved and improved by GLP-1s, while also holding the pharmaceutical industry accountable for its profit-first mindset. She asks hard questions about access and equity: Who gets to use these drugs? Who gets left behind? And what happens when the medicine runs out?
The pacing is brisk, the tone is conversational without sacrificing depth, and the humor is dry and dark in all the right places. I laughed. I cringed. I even Googled side effects just to make sure this wasn’t some dystopian satire (spoiler: it’s not).
If you think this book is only for health nuts, doctors, or diet culture obsessives, think again. It’s for anyone who wants to understand how modern medicine, media, and capitalism collide—and what happens when the most important decisions about our health are being made in boardrooms and TikToks instead of exam rooms.
In the end, Off the Scales is a deeply necessary, thoroughly researched, and wildly readable examination of the drug of our time. It doesn’t offer easy answers, but it will leave you asking better questions. And maybe that’s the point.
⭐️⭐️⭐️⭐️⭐️
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November 19, 2025
Aimee Donnellan’s Off the Scales is a highly readable, detailed account of the rise of GLP-1 drugs, primarily focusing on Ozempic’s development. While some of the book was scientific, Donnellan successfully detailed the early days of narrowing down the hormone to the gut and the decades between the initial discoveries and the artificial development of the hormone through the release of the drug for diabetics and eventually it’s growth as a “miracle” cure for obesity. What makes the book so readable is the human stories of people who have suffered with obesity, as well as the people involved in big pharma who continued to fight for development of an obesity drug. Many overlooked women researchers were responsible for isolating the hormone and developing a synthetic version.
Donnellan’s journalistic background resulted in a balanced, detailed account of the positive effects of GLP-1 drugs as well as the negative side-effects, both on the people taking the drugs and society. She writes about the negative effect obesity can have, not only on people’s health, but also on their self-worth with stories of people who were never noticed or promoted until they lost a significant amount of weight. She makes it clear that for many the disease starts in childhood, and diet and exercise, which the doctors have prescribed for years, rarely works, resulting in mental health issues as people berate themselves for not making better choices and having no willpower. It can become a vicious cycle as psychological factors and trauma can also make people more susceptible to weight issues. Donnellan includes stories of people whose lives have been changed with the drug, as well as those who have suffered long-term physical issues and medical complications, such as gastric paralysis, from taking Ozempic.
This book delves into the ramifications of the drug on body image and examines social issues relating not only to the cost of the drug but the cost to society and businesses, both positive and negative. My biggest concern with the last part of the book were the grandiose statements about “how the medications that curb unhealthy behaviors and boost confidence could lead to a much happier world for all of us.” She goes on to say that “they could help alleviate some of the demographic problems of aging populations and declining birth rates that are weighing on the economic outlooks of countries like the U.S., Britain, Russia, South Korea, and Germany.” What? There is no further explanation about how these drugs will help with declining birth rates. I truly hope she is not implying that because people are losing weight and are more attractive, relationships will form and more children will be born. She continues in that same vein making sweeping statements about new businesses forming to advise cities on how they can adapt to a healthier community and food manufacturers pivoting to sell healthier and fresher food or their profits will fall. If only that were true. Not everyone is interested in and can afford healthy food or the drugs that will help curb their appetite for cheaper, less healthy foods. Having said that, I just read that Novo Nordisk is slashing direct-to-consumer prices for both Wegovy and Ozempic for its existing cash-paying patients. However, the highest dose of Ozempic will remain at $499/month. Apparently, the current president made an agreement with Novo Nordisk and Eli Lilly to make GLP-1 obesity drugs more affordable and is planning to offer decreased costs on his upcoming direct-to-consumer website, another conflict of interest which should be the subject of another book.
But I digress. It was interesting to read about the endocrinologist, Dr. Gillian Goddard, whose patients were having trouble getting insurance to pay for the lower doses. Their rationale – if you want to lose weight, you might as well do it faster so just start with the higher dose, no matter the side effects. She happens to be my endocrinologist who several years ago announced that she and her practice were no longer accepting insurance. If you still want to see her, you must pay out of pocket. I wonder if her experiences trying to get these drugs for her patients with diabetes were a factor in her decision.
I highly recommend this book to anyone who wants to learn more about this scientific breakthrough in a book that is readable and balanced and includes many human-interest stories. Thank you to the author, St. Martin’s Press, and NetGalley for the digital ARC. All opinions expressed are my own.
Donnellan’s journalistic background resulted in a balanced, detailed account of the positive effects of GLP-1 drugs as well as the negative side-effects, both on the people taking the drugs and society. She writes about the negative effect obesity can have, not only on people’s health, but also on their self-worth with stories of people who were never noticed or promoted until they lost a significant amount of weight. She makes it clear that for many the disease starts in childhood, and diet and exercise, which the doctors have prescribed for years, rarely works, resulting in mental health issues as people berate themselves for not making better choices and having no willpower. It can become a vicious cycle as psychological factors and trauma can also make people more susceptible to weight issues. Donnellan includes stories of people whose lives have been changed with the drug, as well as those who have suffered long-term physical issues and medical complications, such as gastric paralysis, from taking Ozempic.
This book delves into the ramifications of the drug on body image and examines social issues relating not only to the cost of the drug but the cost to society and businesses, both positive and negative. My biggest concern with the last part of the book were the grandiose statements about “how the medications that curb unhealthy behaviors and boost confidence could lead to a much happier world for all of us.” She goes on to say that “they could help alleviate some of the demographic problems of aging populations and declining birth rates that are weighing on the economic outlooks of countries like the U.S., Britain, Russia, South Korea, and Germany.” What? There is no further explanation about how these drugs will help with declining birth rates. I truly hope she is not implying that because people are losing weight and are more attractive, relationships will form and more children will be born. She continues in that same vein making sweeping statements about new businesses forming to advise cities on how they can adapt to a healthier community and food manufacturers pivoting to sell healthier and fresher food or their profits will fall. If only that were true. Not everyone is interested in and can afford healthy food or the drugs that will help curb their appetite for cheaper, less healthy foods. Having said that, I just read that Novo Nordisk is slashing direct-to-consumer prices for both Wegovy and Ozempic for its existing cash-paying patients. However, the highest dose of Ozempic will remain at $499/month. Apparently, the current president made an agreement with Novo Nordisk and Eli Lilly to make GLP-1 obesity drugs more affordable and is planning to offer decreased costs on his upcoming direct-to-consumer website, another conflict of interest which should be the subject of another book.
But I digress. It was interesting to read about the endocrinologist, Dr. Gillian Goddard, whose patients were having trouble getting insurance to pay for the lower doses. Their rationale – if you want to lose weight, you might as well do it faster so just start with the higher dose, no matter the side effects. She happens to be my endocrinologist who several years ago announced that she and her practice were no longer accepting insurance. If you still want to see her, you must pay out of pocket. I wonder if her experiences trying to get these drugs for her patients with diabetes were a factor in her decision.
I highly recommend this book to anyone who wants to learn more about this scientific breakthrough in a book that is readable and balanced and includes many human-interest stories. Thank you to the author, St. Martin’s Press, and NetGalley for the digital ARC. All opinions expressed are my own.
November 13, 2025
Aimee Donnellan’s Off the Scales is a fascinating look at the rise of GLP-1 drugs, with a focus on their amazing ability to help people control their weight. In particular the book focuses on Novo Nordisk’s Ozempic, with its ability to help people lose 15 to 20% of their body weight.
Before Ozempic there was the discovery of the hormone glucagon-like peptide 1, or GLP-1. Just exactly who discovered GLP-1, and realized its significance as a treatment for diabetes, and its side effect of reducing obesity, and at what institution, are topics covered in the book. There is some dispute, and conflicting claims as to who was responsible for what, but Svetlana Mojsov is credited with the discovery of the hormone itself, and her research helped lay the groundwork for the development of treatments based on GLP-1 for diabetes and weight loss.
Donnellan takes us through those early days in the late 1970s and early 1980s. It would be decades between those initial discoveries and the release of Ozempic and other GLP-1 drugs. In the meantime, obesity was becoming a larger and larger problem. So, Donellan dives into the rise of high fat / high sugar ultra-processed foods, and the need for the makers of those foods to get us all to eat more of them to increase their bottom lines. As consumption of these foods, first in the US but now globally, increased, obesity tended to follow.
This all lays the groundwork for the rest of the book about the true believers in Ozempic at Novo Nordisk. Donnellan takes us inside their multiyear effort to champion the drug through internal politics and then clinical trials. The result? They finally get the drug to market, first for type 2 diabetes and then for weight loss. Donnellan focuses on the personalities and the timelines rather than taking too deep a dive into the science, and the result is a smart and highly readable account.
This is exactly the kind of book I enjoy — a highly readable overview of a scientific breakthrough. It’s easily the best reportorial nonfiction book I’ve read this year.
Four and a Half Stars ⭐⭐⭐⭐🌠
Before Ozempic there was the discovery of the hormone glucagon-like peptide 1, or GLP-1. Just exactly who discovered GLP-1, and realized its significance as a treatment for diabetes, and its side effect of reducing obesity, and at what institution, are topics covered in the book. There is some dispute, and conflicting claims as to who was responsible for what, but Svetlana Mojsov is credited with the discovery of the hormone itself, and her research helped lay the groundwork for the development of treatments based on GLP-1 for diabetes and weight loss.
Donnellan takes us through those early days in the late 1970s and early 1980s. It would be decades between those initial discoveries and the release of Ozempic and other GLP-1 drugs. In the meantime, obesity was becoming a larger and larger problem. So, Donellan dives into the rise of high fat / high sugar ultra-processed foods, and the need for the makers of those foods to get us all to eat more of them to increase their bottom lines. As consumption of these foods, first in the US but now globally, increased, obesity tended to follow.
This all lays the groundwork for the rest of the book about the true believers in Ozempic at Novo Nordisk. Donnellan takes us inside their multiyear effort to champion the drug through internal politics and then clinical trials. The result? They finally get the drug to market, first for type 2 diabetes and then for weight loss. Donnellan focuses on the personalities and the timelines rather than taking too deep a dive into the science, and the result is a smart and highly readable account.
This is exactly the kind of book I enjoy — a highly readable overview of a scientific breakthrough. It’s easily the best reportorial nonfiction book I’ve read this year.
Four and a Half Stars ⭐⭐⭐⭐🌠
December 1, 2025
This was a super book giving a fantastic overview of the rise of Ozempic and other weight loss drugs, focusing a lot on how Ozempic went from a diabetes treatment to a full on cultural phenomenon. If you are like me, and interested in how this drug came into existence and is splashed all over the headlines daily, this is a great book for you. As someone who has struggled with weight her entire adult life, tried every diet and fad out there, tried multiple medications, even had gastric surgery, this book really explained the science behind the new prescription drugs out there today and how they work in great detail. It also makes me feel like I am not alone in my struggles, and that there is hope for me moving forward.
I am very thankful that topics like body positivity, beauty standards, and how entire industries might now have to rethink their marketing and how they work. I also liked how they brought to light the side effects of these drugs and that they should not be taken lightly.
Overall, this book really helped me understand the who, what, why, and when surrounding the weight loss drugs on the market today, beginning with Ozempic, and where it came from and where it's going in the future. I never knew a lot of the science behind it and it really helps to know what people are putting in their bodies (including me), and why. It definitely makes you think and marvel at what science can do!
I am very thankful that topics like body positivity, beauty standards, and how entire industries might now have to rethink their marketing and how they work. I also liked how they brought to light the side effects of these drugs and that they should not be taken lightly.
Overall, this book really helped me understand the who, what, why, and when surrounding the weight loss drugs on the market today, beginning with Ozempic, and where it came from and where it's going in the future. I never knew a lot of the science behind it and it really helps to know what people are putting in their bodies (including me), and why. It definitely makes you think and marvel at what science can do!
December 18, 2025
Closer to 3.5 stars
I think this book suffers from a bit of an identity crisis. As published, it primarily tells the story of the scientific development of GLP-1s and then the race to get them to market. It also weaves in stories of the side effects people who take the drugs face, the impact of them on the body positivity movement, and some of the societal implications of declining obesity rates. All of those pieces are interesting on their own (though perhaps less on the side effects issue), but because they are only small parts of the book, they feel under-explored. I felt this was particularly the case with the discussion around the decline in fat acceptance, which is probably the biggest side effect of the explosion of these drugs.
The book is at its best when it traces the scientific roots of GLP-1s and then the takeover in development by the pharmaceutical companies. It's a compelling story, we have dueling scientists on opposite sides of the Atlantic. Women being sidelined in STEM and in the story of the development of GLP-1s. A battle for which company will make it to market first and an interesting look at the start-up industry of selling new potential drugs. Had the book just focused on this, I think it would have been significantly stronger.
* Thank you to St. Martin's Press and NetGalley for the eARC in exchange for my honest review! *
I think this book suffers from a bit of an identity crisis. As published, it primarily tells the story of the scientific development of GLP-1s and then the race to get them to market. It also weaves in stories of the side effects people who take the drugs face, the impact of them on the body positivity movement, and some of the societal implications of declining obesity rates. All of those pieces are interesting on their own (though perhaps less on the side effects issue), but because they are only small parts of the book, they feel under-explored. I felt this was particularly the case with the discussion around the decline in fat acceptance, which is probably the biggest side effect of the explosion of these drugs.
The book is at its best when it traces the scientific roots of GLP-1s and then the takeover in development by the pharmaceutical companies. It's a compelling story, we have dueling scientists on opposite sides of the Atlantic. Women being sidelined in STEM and in the story of the development of GLP-1s. A battle for which company will make it to market first and an interesting look at the start-up industry of selling new potential drugs. Had the book just focused on this, I think it would have been significantly stronger.
* Thank you to St. Martin's Press and NetGalley for the eARC in exchange for my honest review! *
November 25, 2025
An in-depth look at the history, science, hype, and controversies surrounding GLP-1 medications. Given the growing popularity of the drugs, I was intrigued to pick this one up.
I think the only thing I had a hard time with was getting through the “backstory.” There was a lot of science, detail, and time given to the discovery and creation of the drugs, and it felt a bit long. I of course appreciate the scientists and all their work that went into the research, but for the lay person, it was overkill. That being said, I did like that Donnellan shed light on a female researcher whose contributions were almost overshadowed.
What I really enjoyed, and why I was originally sucked in, was a deeper look into the implications of the medications. The book touches on effects to various industries like food, alcohol, clothing, plastic surgery, dating, etc.; eating disorders and the body positivity movement, how it’s being abused by celebrities and suburban housewives, pediatric usage, and more. Donnellan also touched on the potential side effects, the brand battles between competitors, and mentions the usage of compounded forms. While this was all fascinating, this is where I wish she would have spent more time and gone more in depth. There’s so much more to dig into with why compounds exist and their availability, more on side effects, and even the life long usage required. Not that I needed a pro/con list for people, but highlighting all of the topics mentioned above I personally would have found more educational than trying to digest the science and historical timeline.
Overall, interesting, especially if you can make it through the first section on the discovery and creation of the drugs. I realize there’s only so much time and space for the details that I was craving, but Donnellan did a good job summarizing many elements.
Thank you NetGalley and St. Martin’s Press for the advanced digital copy in exchange for my opinions.
I think the only thing I had a hard time with was getting through the “backstory.” There was a lot of science, detail, and time given to the discovery and creation of the drugs, and it felt a bit long. I of course appreciate the scientists and all their work that went into the research, but for the lay person, it was overkill. That being said, I did like that Donnellan shed light on a female researcher whose contributions were almost overshadowed.
What I really enjoyed, and why I was originally sucked in, was a deeper look into the implications of the medications. The book touches on effects to various industries like food, alcohol, clothing, plastic surgery, dating, etc.; eating disorders and the body positivity movement, how it’s being abused by celebrities and suburban housewives, pediatric usage, and more. Donnellan also touched on the potential side effects, the brand battles between competitors, and mentions the usage of compounded forms. While this was all fascinating, this is where I wish she would have spent more time and gone more in depth. There’s so much more to dig into with why compounds exist and their availability, more on side effects, and even the life long usage required. Not that I needed a pro/con list for people, but highlighting all of the topics mentioned above I personally would have found more educational than trying to digest the science and historical timeline.
Overall, interesting, especially if you can make it through the first section on the discovery and creation of the drugs. I realize there’s only so much time and space for the details that I was craving, but Donnellan did a good job summarizing many elements.
Thank you NetGalley and St. Martin’s Press for the advanced digital copy in exchange for my opinions.
November 24, 2025
Thank you to St. Martin's Press for the ARC!
My husband and I both work in healthcare, and are deep in the trenches with the plethora of weightloss drugs that have hit the market. And I will say, for as short as this book is, it accomplishes a lot--it feels more like an ethnography than medical nonfiction, so this is super accessible to readers who may struggle with reading nonfiction!
The topic of weight loss and obesity is a very complicated one, because it ties in patriarchal beauty standards, medical neglect, pharmaceutical shenanigans, and the VERY new concept that obesity is a disease as opposed to a moral failing (even if everyone hasn't caught up to that yet). I actually think this book did a great job of discussing how these things play into each other and did so with nuance--because there isn't a one size fits all answer here, there are still a plethora of barriers to obtaining healthcare (and these pricy medications!), and concerns for long term implications.
If you're interested in learning about how GLP-1s came about and their current role in healthcare, this is a really great read! I'd love to see a follow-up in a few years as the long-term effects on such a large scale--both physically and mentally--are more widely known.
My husband and I both work in healthcare, and are deep in the trenches with the plethora of weightloss drugs that have hit the market. And I will say, for as short as this book is, it accomplishes a lot--it feels more like an ethnography than medical nonfiction, so this is super accessible to readers who may struggle with reading nonfiction!
The topic of weight loss and obesity is a very complicated one, because it ties in patriarchal beauty standards, medical neglect, pharmaceutical shenanigans, and the VERY new concept that obesity is a disease as opposed to a moral failing (even if everyone hasn't caught up to that yet). I actually think this book did a great job of discussing how these things play into each other and did so with nuance--because there isn't a one size fits all answer here, there are still a plethora of barriers to obtaining healthcare (and these pricy medications!), and concerns for long term implications.
If you're interested in learning about how GLP-1s came about and their current role in healthcare, this is a really great read! I'd love to see a follow-up in a few years as the long-term effects on such a large scale--both physically and mentally--are more widely known.
Read
December 22, 2025This was a fascinating overview of the business, science and culture behind the new weight loss drugs being developed as we speak. Donnellan discusses the causes of the rapid rise in obesity (food industry, marketing departments, media influences, sedentary & busier lifestyles). Obesity and all of its related health issues (type 2 diabetes, heart issues, certain cancers) are the focus for drug companies trying to develop drugs to improve health and make money. The reader learns about the scientists who first discovered GLP-1 (Glucagon-Like Peptide-1) (natural gut hormone that helps control blood sugar and appetite) and figured out how to make the hormone in a lab. We learn about the pharmaceutical business and who and how it was decided to proceed with GLP-1 drug development. We learn about the incredible benefits for many who take the drugs and the sometimes horrible side effects for others. Donnellan also discusses the cultural changes that have occurred (worshiping thinness to body positivity) and how the new drugs could turn us back away from body acceptance to worshiping thinness again. And of course the possibility of increasing disparity between rich/thin and poor/heavy. An interesting book about a potentially game-changing development.
June 16, 2025
Thank you to the publisher and NetGalley for an advance copy of this book in return for an honest review.
This is the inside story of the race to develop Ozempic as a once-a-week injection for diabetics. The author includes interviews with the first scientist to discover GLP-1, glucagon-like peptide-1 which decreases blood sugar levels. Once the side effect of weight loss was known, the drug was marketed as a cure for obesity. But is it too good to be true? The dream of being thin comes with alarming side effects for some: pancreatic issues, muscle wastage, uncontrollable vomiting (up to 200 times a week, or until your teeth fall out), need for a feeding tube or gastric paralysis which results in colostomy. No, it’s not all patients who experience this, but there is an ethical question of prescribing this as a vanity drug. Or making it seem like it’s safe by just handing out free samples at the Indy 500 without any doctor recommendation. Then there is the question of prescribing this to children.
Very informative and thought-provoking look at where do we draw the line in our quest for being thin?
https://candysplanet.wordpress.com/
This is the inside story of the race to develop Ozempic as a once-a-week injection for diabetics. The author includes interviews with the first scientist to discover GLP-1, glucagon-like peptide-1 which decreases blood sugar levels. Once the side effect of weight loss was known, the drug was marketed as a cure for obesity. But is it too good to be true? The dream of being thin comes with alarming side effects for some: pancreatic issues, muscle wastage, uncontrollable vomiting (up to 200 times a week, or until your teeth fall out), need for a feeding tube or gastric paralysis which results in colostomy. No, it’s not all patients who experience this, but there is an ethical question of prescribing this as a vanity drug. Or making it seem like it’s safe by just handing out free samples at the Indy 500 without any doctor recommendation. Then there is the question of prescribing this to children.
Very informative and thought-provoking look at where do we draw the line in our quest for being thin?
https://candysplanet.wordpress.com/
July 7, 2025
Thank you NetGalley for this advanced copy!
Very interesting look at the "behind the scenes" of Ozempic and GLP-1 drugs in general and how they came to be. Helpful especially to the narrative out there that these drugs came out of nowhere and haven't been in use all that long - when in fact they took over 40 years to develop and have been used in patients for 20+ years.
While I found the subject matter interesting, I don't feel like the book was written all that well and it didn't flow all that well either.
The author would use overly dramatic storytelling in odd places that didn't seem to fit. It was like she was trying to make it a story instead of a work of non-fiction and/or getting confused in going back and forth.
There would also be drastic changes in subject from paragraph to paragraph almost like she was writing and had a thought about something and just started talking about that next without really connecting the two points together in some way.
I feel like this needs more editing and re-work before it's published!
The subject matter is super interesting though and important so hopefully it gets some re-work and does well once it gets published in November!
Very interesting look at the "behind the scenes" of Ozempic and GLP-1 drugs in general and how they came to be. Helpful especially to the narrative out there that these drugs came out of nowhere and haven't been in use all that long - when in fact they took over 40 years to develop and have been used in patients for 20+ years.
While I found the subject matter interesting, I don't feel like the book was written all that well and it didn't flow all that well either.
The author would use overly dramatic storytelling in odd places that didn't seem to fit. It was like she was trying to make it a story instead of a work of non-fiction and/or getting confused in going back and forth.
There would also be drastic changes in subject from paragraph to paragraph almost like she was writing and had a thought about something and just started talking about that next without really connecting the two points together in some way.
I feel like this needs more editing and re-work before it's published!
The subject matter is super interesting though and important so hopefully it gets some re-work and does well once it gets published in November!
August 9, 2025
Aimee Donnellan did a wonderful job chronicling the development of Ozempic, GLP-1, and other Type 2 diabetes and obesity drugs that have popped up over the last several years. She delved into the scientists and their interpersonal relationships, as well as the competitive or collaborative relationships between the drug companies working on these medications.
Donnellan also described the effects of these new medications on some of those who had high hopes for them. Patients hoped to improve their blood sugar levels, and those who had lived with being overweight all their lives hoped to remedy that situation. Some did. Others did not.
These were early days and scientists would refine dosages as improvements were made to the drugs and as their effects were better understood.
“Off the Scales” is a well-written book that answers many of the questions I had about this new approach to Type 2 diabetes and overweight. I suspect that this is just the beginning and will lead to other pharmaceuticals with different mechanisms of action.
Thank you to Edelweiss for the advance reader copy. This is my honest review.
Donnellan also described the effects of these new medications on some of those who had high hopes for them. Patients hoped to improve their blood sugar levels, and those who had lived with being overweight all their lives hoped to remedy that situation. Some did. Others did not.
These were early days and scientists would refine dosages as improvements were made to the drugs and as their effects were better understood.
“Off the Scales” is a well-written book that answers many of the questions I had about this new approach to Type 2 diabetes and overweight. I suspect that this is just the beginning and will lead to other pharmaceuticals with different mechanisms of action.
Thank you to Edelweiss for the advance reader copy. This is my honest review.
November 29, 2025
It’s impossible in this day and age to not be aware of Ozempic and other GLP-1 drugs, but I wanted to know more about them, and this book is perfect for that. It goes back decades to the identification of GLP-1 in the body, followed by the attempts to replicate it. I appreciate that this section elevates the female scientists who were involved in this process and have largely been ignored, as has too often happened historically. The book then moves through the process of FDA approval and patient experiences with the drug. I appreciate the amount of time spent on how these drugs have damaged the body positivity movement as well as showing some of the people who have had terrible, life-altering side effects. Overall, I really enjoyed and appreciated this book for letting me learn more about these drugs, but I am concerned that it is overly optimistic about them. I remember what happened with Fen-phen and even if that is not the case here, there is no magic pill or wand in medicine and treating these drugs as though they are before having long term data is a dangerous prospect. I’m still waiting for the other shoe to drop, but I’m glad I read this book.
November 24, 2025
This was interesting. The story behind the discovery of the GLP and how it was taken to market. I am and was even more a bigger girl. My insurance said no to me being on the drug. Which pissed me off and I have lost quite a bit of weight.
Why I wanted it was the FOOD noise! I think about food just about constantly and this drug amazes me with the fact that it makes that easier to handle.
Now there are hits and misses with the stories in this book. You have some people that the drug has greatly helped and some that it caused life altering disabilities. I wish that the people stories had more in the book.
Another thing I never even thought of is that if people are changing their eating habits and not buying as much junk what are the major companies going to do? I wanted more of this in the book also.
So basically if you want basic information this book is great. To me there just is not enough known about these drugs to go much more in depth with. I'm one of the nosey ones that just wants all the information.
Booksource: Netgalley in exchange for review.
Why I wanted it was the FOOD noise! I think about food just about constantly and this drug amazes me with the fact that it makes that easier to handle.
Now there are hits and misses with the stories in this book. You have some people that the drug has greatly helped and some that it caused life altering disabilities. I wish that the people stories had more in the book.
Another thing I never even thought of is that if people are changing their eating habits and not buying as much junk what are the major companies going to do? I wanted more of this in the book also.
So basically if you want basic information this book is great. To me there just is not enough known about these drugs to go much more in depth with. I'm one of the nosey ones that just wants all the information.
Booksource: Netgalley in exchange for review.
November 30, 2025
This was such a fascinating read.
I wasn't sure what to expect going in but it is written in a really accessible way. It speaks to how this drug was invented,by who and how it came to market. I enjoyed learning about how new drugs are developed and tested and how companies go about marketing them.
For me, I was really drawn into the frenzy that was created when this drug designed to help those with diabetes was discovered to be so good at weight loss. This led to shortages for those who truly needed it. The personal stories that were shared about what it meant to take the drug and the side effects it caused. They even shared the regret and people who wished they never knew anything about it.
There was a thread woven through about how culture expects you to be thin, how we made some progress with body positivity and the possibility that this may have set us back. I honestly couldn't put it down and I feel so much more informed about this class of medication.
Highly recommend if you are interested in learning more.
Huge thanks to St. Martin's Press for my gifted copy!
I wasn't sure what to expect going in but it is written in a really accessible way. It speaks to how this drug was invented,by who and how it came to market. I enjoyed learning about how new drugs are developed and tested and how companies go about marketing them.
For me, I was really drawn into the frenzy that was created when this drug designed to help those with diabetes was discovered to be so good at weight loss. This led to shortages for those who truly needed it. The personal stories that were shared about what it meant to take the drug and the side effects it caused. They even shared the regret and people who wished they never knew anything about it.
There was a thread woven through about how culture expects you to be thin, how we made some progress with body positivity and the possibility that this may have set us back. I honestly couldn't put it down and I feel so much more informed about this class of medication.
Highly recommend if you are interested in learning more.
Huge thanks to St. Martin's Press for my gifted copy!
December 5, 2025
Everything you ever wanted to know about Ozempic, and then some, is covered in this riveting account. Seriously, this reads like a thriller. From the science to the operational scaling, insurance, marketing, and politics, I couldn't put this down. Woven throughout are anecdotes and stories from people around the world, people who have struggled with obesity for decades and what the impact of these drugs has made to their lives. Most of it good, some not so good.
Donnellan doesn't shy away from the moral quandaries either. The economic disparities of who can afford these drugs, cultural bias against the overweight and obese, the contradiction to the redefining beauty movement, the response by the big food manufacturers to the population eating less of its addictive offerings, the use of these drugs to remedy obesity in children, and of course the long term impacts.
Off the Scales is enlightening, giving the reader much to ponder.
My thanks to NetGalley and St. Martin's Press for the Advance Reader Copy. (pub. date 11/18/2025)
Donnellan doesn't shy away from the moral quandaries either. The economic disparities of who can afford these drugs, cultural bias against the overweight and obese, the contradiction to the redefining beauty movement, the response by the big food manufacturers to the population eating less of its addictive offerings, the use of these drugs to remedy obesity in children, and of course the long term impacts.
Off the Scales is enlightening, giving the reader much to ponder.
My thanks to NetGalley and St. Martin's Press for the Advance Reader Copy. (pub. date 11/18/2025)
July 19, 2025
This is an in-depth look at the creation and marketing of Ozempic (and other GLP-1 drugs). How they came to be, how they work on the human body, and side effects. I found it fascinating, but could have done without the biographical sketches of key scientists. I did skim over most of the 149 footnotes.
My doctor once mentioned Ozempic to me, but the cost was prohibitive, so I never tried it or any of the other similar drugs. I have since been diagnosed with gastroparesis and would not wish this disease on anyone. Knowing that it is a possible side effect of GLP-1 drugs is even more reason for me to shy away. Thank you to the author for this warning.
I appreciated the way that the author tied Big Pharma to Big Food, fashion and other industries: how each of them "feed off" of each of the others' successes and failures.
Thank you to Booktrovert for making the ARC of this book available.
My doctor once mentioned Ozempic to me, but the cost was prohibitive, so I never tried it or any of the other similar drugs. I have since been diagnosed with gastroparesis and would not wish this disease on anyone. Knowing that it is a possible side effect of GLP-1 drugs is even more reason for me to shy away. Thank you to the author for this warning.
I appreciated the way that the author tied Big Pharma to Big Food, fashion and other industries: how each of them "feed off" of each of the others' successes and failures.
Thank you to Booktrovert for making the ARC of this book available.
August 5, 2025
a book about obesity and the new drugs developed to help those suffering from that. much research has been done to find and refine the hormones responsible for the development of GLP-1. did not know that some of that hormone was found in the venom of the gila monster, and some found in the intestines of pigs. it makes sense that this hormone comes into play when the monster kills a food product and then without food for a long time. of interest are some of the side effects for the GLP-1. the non stop GI effects of nausea, diarrhea, rectal bleeding. it does sound like this drug should not be used by the elderly because of the loss of muscle mass which could lead to falls. the book does say that these side effects could be worse than obesity. as a side note, there is concern about people not buying food products causing a loss of revenue for food companies. apparently these drugs can ease the use of alcohol and illegal drugs. much to think about.
This entire review has been hidden because of spoilers.
September 17, 2025
Thanks to Aimee Donnellan, St. Martin’s Press, and NetGalley for the Advanced Reader Copy of this book in exchange for an honest review.
Off The Scales tells the story of the development of Ozempic and related drugs. Starting from first discoveries through laboratory politics and on into product development, marketing and sales. It is an interesting story of the product that has changed millions of lives.
When reading a nonfiction book, I am always pleased to see that the author has done deep and thorough research on the topic. Here the author has drawn from her news reporting background to deliver a comprehensive description of the topic starting with the obesity epidemic to development of Ozempic and current state of use. Along the way she includes examples of Ozempic customers to highlight results – good and bad. Extensive notes are included. Recommended.
Off The Scales tells the story of the development of Ozempic and related drugs. Starting from first discoveries through laboratory politics and on into product development, marketing and sales. It is an interesting story of the product that has changed millions of lives.
When reading a nonfiction book, I am always pleased to see that the author has done deep and thorough research on the topic. Here the author has drawn from her news reporting background to deliver a comprehensive description of the topic starting with the obesity epidemic to development of Ozempic and current state of use. Along the way she includes examples of Ozempic customers to highlight results – good and bad. Extensive notes are included. Recommended.
June 23, 2025
I really liked this overview of how Ozempic came to be.
I thought that the author did a great job of how it came to be, who was involved and how it lead to explosive growth.
To be clear this is NOT an indepth reporting of how Ozempic came to be, you will not find play by plays. You will get a general overview of the development and marketing of Ozempic.
It also talked about body positivity, how the food, alcohol, and gambling industries are going to reimagine their products.
Overall I thought it was a great book that let me get a grasp on how Ozempic came to be and where scientists are going for the next round of GLP1.
Thank you to Netgalley and the publisher for this ARC in exchange for this honest review.
I thought that the author did a great job of how it came to be, who was involved and how it lead to explosive growth.
To be clear this is NOT an indepth reporting of how Ozempic came to be, you will not find play by plays. You will get a general overview of the development and marketing of Ozempic.
It also talked about body positivity, how the food, alcohol, and gambling industries are going to reimagine their products.
Overall I thought it was a great book that let me get a grasp on how Ozempic came to be and where scientists are going for the next round of GLP1.
Thank you to Netgalley and the publisher for this ARC in exchange for this honest review.
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