Do you know the Serenity Prayer? Everybody knows the Serenity Prayer. It goes, “Lord, give me strength to accept things I cannot change, courage to change the things I can, and friends to post bail when I finally snap.” Is that it? Not really, but close.

Actually, it goes, “Lord, give me chocolate to accept the things I cannot change, and coffee to change the things I can.” No. That’s not quite right. “Lord, give me the serenity to accept the people I cannot change, the courage to change direction when I see them coming, and the wisdom to not try to smack some sense into them.” No, that’s definitely not it.

“Lord, give me the strength to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” Yes, that’s it. The serenity prayer is powerful because life is sometimes very hard. This is one of the reasons the prayer is such a feature of addiction clinics and groups like Alcoholics Anonymous.

Like so many other people, the thing I find really hard is keeping my weight under control. I’ve tried the whole gamut of different techniques, with zero success. I love eating and drinking, it just seems such a natural pleasure.

As we all know, two things have changed in recent history: processed food and desk jobs. The lack of mobility and the availability of cheap but very processed food have led to a world of overweight people. It is amazing to me that South Africa, which has so many poor people, also has so many fat people; more than 30% of South Africans are obese. However, the apparent contradiction between poverty and high obesity rates actually makes some sense, because basic income grants provide people with sufficient income to eat, generally speaking, but not enough to eat well.

The latest research seems to suggest that we somehow establish a base weight and the tendency to return to that base weight. And that tendency is so powerful that it overwhelms our good intentions and our gym subscriptions. And for some, like me, it gets harder as you get older.

Weight loss cash cow

So the advent of a new weight loss drug, which takes the choice factor out of the equation, is a momentous development. The trend started in 2012 when the Danish pharmaceutical giant Novo Nordisk developed a medication called semaglutide, designed to help manage type 2 diabetes. The drug, marketed under the name Ozempic, was approved by the US Food and Drug Administration (FDA) in 2017 and users noticed that they lost quite a lot of weight.

Semaglutide belongs to a class of medications known as glucagon-like peptide-1 receptor agonists, or GLP-1 RAs. It works by mimicking the GLP-1 hormone which is released in the gut in response to eating. One thing GLP-1 does is to prompt the body to produce more insulin, which reduces blood sugar.

That helps diabetes patients, but it also helps people feel sated, and hence, to indulge in less eating and much less snacking. Novo Nordisk knew they were on to something when patients liked the drug a bit more than they should have. They marketed a version of Ozempic called Wegovy, which contains higher doses of semaglutide and is specifically designed for weight loss.

Novo Nordisk’s share price has gone up by 328% over the past five years, making the company worth more than the GDP of its homeland. I am not making this up.

There is now, obviously, a huge rush to jump into this market and new weight-loss drugs are hitting the market. The US company Eli Lilly has produced a drug called Mounjaro which is theoretically even more potent than Wegovy as a weight loss drug. While it’s technically a diabetes drug, Eli Lilly is seeking FDA approval for Mounjaro specifically as a weight-loss medication by the end of 2023. Its share price is up by just over 400% over five years.

Fund manager Bright Khumalo points out in Vestact’s latest newsletter that it’s worth being a little cautious about the hype surrounding these drugs.

“Despite the buzz, the longevity of these weight-loss drugs in the market remains uncertain. Similar to past dieting trends like Atkins, paleo and keto diets, their popularity may eventually wane,” Khumalo said.

But, he says, the good news is that people who use these drugs seem to put the weight back on when they stop. Not great for the customers who are forking out thumping great amounts of cash for the drug. But good for the pharma companies because it won’t be a passing fad.

Or, as they say: Lord, give me the strength to recognise I’m useless at dieting, the courage to trust big pharma, and the wisdom to know that it’s probably not going to work. DM