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Health

Why You Can’t Find Wegovy, the Weight-Loss Drug

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Novo Nordisk

NVO 0.61%

A/S flubbed the launch of its buzzy new weight-loss drug Wegovy, missing out on hundreds of millions of dollars in sales and squandering a head start before a rival could begin selling a competing product.

Wegovy is among a new class of drugs that health regulators have approved to cut the weight of people who are obese, a goal long sought by doctors and patients. Their weight-dropping potential became a viral sensation on social media. Elon Musk tweeted about Wegovy in October. And a related drug for diabetes, Ozempic, is a hot topic in Hollywood among celebrities seeking to stay thin, according to doctors.

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Yet Denmark-based Novo underestimated how big demand for the drug would be, and wasn’t ready to make enough to fill the prescriptions that flooded in after U.S. approval last year. Then a contract manufacturer halted production to address inspection issues.

“We should have forecasted better, which we did not,” Novo Chief Executive

Lars Fruergaard Jørgensen

said. “Had we forecasted that, we would have built a different supply chain.”

The missteps have proven costly for Novo, which was forced to ration Wegovy to patients who already had started taking it. The company has recorded around $700 million in sales to date, well short of the $2 billion in 2021 and 2022 sales that some analysts had projected before supply issues hit.

Novo Nordisk Chief Executive Lars Fruergaard Jørgensen admits the drug company misjudged how popular Wegovy would be.



Photo:

Carsten Snejbjerg/Bloomberg News

Amber Blaylock, a music teacher from Springfield, Mo., said she has been trying to get Wegovy to help her reduce weight since hearing about the drug on TikTok and YouTube. She asked her doctor in September to prescribe it, but hasn’t been able to find it. 

“Frustrated and impatient for sure,” said Ms. Blaylock, 29 years old.

To turn things around, Mr. Jørgensen said Novo has increased its capacity to make Wegovy and plans a “relaunch” early next year, which should fulfill all orders.

Novo, however, lost valuable time establishing a beachhead in the lucrative obesity-drug market before rival

Eli Lilly

LLY 1.20%

& Co. can enter. Lilly is expected to launch a similar, competing drug named Mounjaro late next year or in early 2024.

The market for anti-obesity drugs, now worth $2.4 billion worldwide, could reach $50 billion in 2030, Morgan Stanley estimates.

“Novo has left the door open for Lilly,” said BMO Capital Markets analyst Evan David Seigerman. 

Mr. Jørgensen said the company can regain lost ground because of high demand for Wegovy and the large potential for what is still a mostly untapped market. He said he was unconcerned with the looming competition with Lilly’s drug, because there is room for both products.

“We disappointed physicians and patients in the first round,” he said. “The company wants to be better prepared for the second round.” Novo lists Wegovy at $1,349 a month. Some commercial insurers cover the drug.  

Wegovy works by imitating a hormone called GLP-1, which occurs naturally in the body and suppresses appetite, among other effects. 

Novo developed GLP-1 drugs to treat diabetes. In 2017, the company began selling semaglutide, the active ingredient in Wegovy, under the brand name Ozempic to treat diabetes. 

During the drug’s development, Novo found that weight loss was a side effect, prompting the company to probe using semaglutide to treat obesity. A key trial found that Wegovy helped people with a high body-mass index shed up to 15% of their weight, surpassing the results for older obesity drugs like Novo’s Saxenda. 

Saxenda and other older weight-loss drugs had sold modestly, partly due to their limited weight loss, as well as some unpleasant side effects and the refusal of many health insurers to pay up. 

Novo worked with Catalent to fill its Wegovy weight-loss drug into syringes.



Photo:

yara nardi/Reuters

Given the experience, Novo figured Wegovy sales would increase gradually. To augment its own production, Novo contracted with a single manufacturer,

Catalent Inc.,

to fill the drug into syringes. Novo said it thought it would have time to add manufacturing capacity to meet a gradual increase in demand.

Wegovy may be superior to older drugs, but “we thought it would still be a journey to open up the market,” Mr. Jørgensen said. 

When Novo started selling Wegovy in the U.S. in June last year, however, demand took off. Doctors with large followings on social media touted Wegovy as groundbreaking, while users posted photos holding injection pens and shared their progress losing weight. 

“Demand for these new agents has been unlike anything I’ve ever seen in my time in medicine,” said Dr. Michael Albert, a physician specializing in weight-loss treatment at telehealth provider Accomplish Health who has consulted for Novo. Many of his patients began asking about Wegovy, he said, after they heard about it in Facebook groups or on TikTok.

It took only five weeks for doctors to write new prescriptions for Wegovy at the same weekly volume that Saxenda took four years to reach, according to Mr. Jørgensen. “It’s a completely different ballgame that we’re in,” said Ambre Brown Morley, the company’s vice president of media and digital global communication. 

Within weeks, supplies were strained. Novo warned that patients might experience delays in receiving their prescriptions. Then in December 2021, Catalent temporarily stopped deliveries and manufacturing at its plant after Food and Drug Administration inspections found faulty air filters and damaged equipment.

To date, Novo has recorded around $700 million in Wegovy sales compared with the $2 billion in 2021 and 2022 sales that some analysts had projected before supply issues emerged.



Photo:

JACOB GRONHOLT-PEDERSEN/REUTERS

Many people who couldn’t get Wegovy for weight loss have sought prescriptions for Novo’s Ozempic and Lilly’s Mounjaro, according to analysts, even though the FDA hasn’t approved the latter two drugs for such use. Ozempic sales increased so much that certain doses are in short supply through at least January, the FDA said.

Lilly is studying Mounjaro, its GLP-1-containing drug for diabetes, for weight loss. 

Novo and Lilly said they don’t promote their diabetes drugs for the “off-label” use treating obesity.

A Catalent spokesman said the company is still making improvements to the plant and working with customers to limit the impact of supply constraints on patients. The company restarted filling Wegovy syringes at the facility in the spring. 

Novo has been amassing a sufficient inventory before the Wegovy relaunch, Mr. Jørgensen said. When Wegovy relaunches, he said, insurance coverage will be broader than when the drug first went on sale. 

Write to Peter Loftus at Peter.Loftus@wsj.com and Denise Roland at denise.roland@wsj.com

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Health

Six Exercises to Prevent or Relieve Lower-Back Pain

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Poor posture is a common culprit, says

Matt Nichol,

a Toronto-based strength and performance coach. But so is exercise. Lifting heavy weights might cause strain, when not done properly. And while a weak core can lead to back pain, so can performing hundreds of sit-ups in the quest for six-pack abs, he says.

Spinal-biomechanics expert

Stuart McGill,

a professor at the University of Waterloo in Ontario, conducted studies on commonly prescribed abdominal exercises. He found that while many were effective for strengthening the abs, they often caused damage to the spine and lumbar discs. 

“Holding planks for upwards of five minutes has become a fun social-media challenge, but really, less is more,” says Mr. Nichol, who has worked with National Hockey League stars including

Tyler Seguin

of the Dallas Stars and Florida Panthers captain

Aleksander Barkov.

“As with all exercises, the focus should be on quality versus quantity.”

When you try to hold a plank pose for too long and your form falls apart, you can actually do more harm than good. You might start feeling a pinch in the lower back, he says.

These exercises work to safely strengthen the abdominals and lower back, which make up the body’s core, Mr. Nichol says. Complementing body-weight exercises with resisted-strength exercises challenges the muscles so they grow stronger, he says. But don’t add weight until you have mastered proper technique, he cautions.

The Workout

Side Plank

Why: After studying common abdominal exercises, Dr. McGill found that the side plank provided high activation levels for the abdominals. It also causes the least damage to the lumbar spine, Mr. Nichol says. As a bonus, the side plank trains the muscles along the outside of the body, which are often neglected in exercise programs. 

How: Lie on your right side with your legs extended and the foot of the top leg placed in front of the foot of the bottom leg. With your right elbow directly below your right shoulder, engage your abdominal muscles and lift your hips up. At the top of the movement, your torso should be perfectly straight from your head to your hips. Your top hand can rest on your top hip or be raised straight in the air. Hold for six seconds, then lower down. Complete one to two sets of five to 10 repetitions on each side. Try to work your way up to a 10-second hold at the top.

Options: Make it easier by bending your legs to a 90-degree angle and stacking your knees, then lift your hips. For an extra challenge, balance on your bottom hand rather than on your forearm. For a true core burner, lift the top leg during the hold. 

Mr. Nichol holds a side plank.



Photo:

Steph Martyniuk for The Wall Street Journal

Front Plank

Why: Front plank hits all of the muscles along the front of the body, specifically the transverse abdominis, which is important for lower-back stability and can be difficult to target in many conventional exercises, Mr. Nichol says. It is a great core-strengthener, with low risk for aggravating the low back when performed properly, he says. The key is focusing on short holds versus attempting a plank marathon.

How: Lie face down with your elbows squeezed tight to the body and your hands placed directly underneath your shoulders. Press through the hands and forearms, contract your quadriceps, and extend through your heels to lift into a high plank. Keep your chin tucked and maintain level hips and a straight spine. Hold for five to 10 seconds. Repeat five to 10 times.

Options: Make it easier by dropping to your knees and keeping a straight line from head through hips to knees. Challenge yourself by breathing only through your nose while performing the exercise.

Mr. Nichol engages his core to hold a front plank.



Photo:

Steph Martyniuk for The Wall Street Journal

Glute Bridge

Why: Although not technically a back exercise, the bridge strengthens your glutes and stretches the hip muscles along the front of the body, such as the psoas. “Weak glutes and tight hips are major contributors to lower-back pain,” Mr. Nichol says. “Strong glutes help to stabilize the pelvis and dissipate some of the load from the lumbar spine when picking up or carrying heavy objects.”

How: Lie on your back with your knees bent and feet flat on the floor. Lift your toes and keep your weight in your heels to work the glutes more. Raise your hips without overextending your lower back. At the top of the movement, contract your glutes. Hold three to six seconds, then slowly lower. Perform eight to 12 sets. 

Option: Many athletes increase the challenge of the glute bridge by loading barbells or dumbbells atop the hips, Mr. Nichol says. He prefers the more spine-friendly single-leg hip thrust.

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Rest your shoulders on an exercise bench or couch. Your arms can extend out or you can bend your elbows to rest your head in your hands. Place your feet flat on the floor, knees bent. A pillow can be put underneath the glutes for padding. Lift your right foot off the ground and bend the right knee to 90 degrees. Contract the left glute as you press through the left foot to drive your hips up to full extension. At the top of the pose, squeeze your glute, then slowly lower the hips to the ground. Don’t let the right foot touch the floor. Perform two to three sets of seven to 10 repetitions on each leg.

Mr. Nichol performs a glute bridge.



Photo:

Steph Martyniuk for The Wall Street Journal

Bird Dog 

Why: The bird dog challenges many of the less-glamorous muscles of the back that create stability between the vertebrae of the spine, Mr. Nichol says. “This exercise is much more challenging than it looks when performed properly,” he says.

How: Start on your hands and knees with a flat back. Contract your abdominals as you slowly extend your right arm straight in front of you, in line with your head. Keep your chin tucked. Visualize a glass of water on top of your back and keep your hips level enough so it doesn’t spill. Hold for three to five seconds. Return to start and perform three to five repetitions. Switch sides.

Option: Make it more challenging by simultaneously extending the opposite leg. 

Mr. Nichol demonstrates the advanced version of bird dog.



Photo:

Steph Martyniuk for The Wall Street Journal

One-Arm Dumbbell Row

Why: The latissimus dorsi (lats) are huge muscles that take up the majority of our mid- to lower-back area. They connect the arm to the torso and “help stabilize the spine anytime someone is attempting to pull, lift or carry something heavy,” Mr. Nichol says. “This exercise strengthens your lats while also improving your core stability.” Unlike the standard row, it helps to prevent muscular imbalances since it is performed one side at a time.

How: This exercise will require a chair, bench or box for support. Put the dumbbell on the right side of the bench. Place your left knee and left hand firmly on the bench and your right foot on the floor. Find a neutral spine position. Keep your chin tucked and your shoulder blades pulled down and back as you reach down and pick up the dumbbell with the palm of your right hand facing inward. With a very slight arc motion, pull the dumbbell toward the top of your right hip. At the top of the movement, squeeze your back muscles, trying to pull the right shoulder blade back as much as possible. Lower with control, slightly slower than you lifted the weight, following the same slight arc motion. Perform two to three sets of eight to 10 repetitions. Switch sides.

Mr. Nichol does a one-arm dumbbell row.



Photo:

Steph Martyniuk for The Wall Street Journal

Pallof Press

Why: This exercise works the glutes, core, back, arms and shoulders. It trains the large and small muscles around the spine to resist rotation, so the next time your dog dashes to the right, you can stay stable, instead of getting tugged along.

How: Loop a resistance band around a stable anchor point at waist height. Kneel in a split stance perpendicular to the anchor point, far enough away to create tension in the band. Interlock the fingers of both hands around the band and keep your hands in contact with your torso at sternum height. Squeeze your shoulder blades down and back, and contract your core muscles as you press the band forward. Aim to keep the hands in line with the knee of the forward leg. Don’t let your torso twist from the resistance. Slowly return the band to your chest. Brace your core tight as you hold your arms in the extended position for five seconds. Perform two to three sets of six to eight repetitions.

Option: This can also be done using a cable machine.

Mr. Nichol uses a resistance band to perform a Pallof press.



Photo:

Steph Martyniuk for The Wall Street Journal

Write to Jen Murphy at workout@wsj.com

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Technology

Games That Push the Brain to the Limit Get Scientists’ Attention in Fight Against Dementia

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You may be able to prevent or delay dementia with changes in diet and exercise, research has found. Now another possible tool for avoiding dementia is getting researchers’ attention: specially designed videogames.

Companies are marketing a crop of digital games that promise a workout for the brain, with a battery of speed, attention and memory exercises. Researchers are working on them, too. Scientists are studying whether such “brain training” games can help stave off or delay age-related deterioration in the brain.

These games aren’t what people typically think of as videogames or puzzles. In some, players must differentiate and recall sounds, patterns and objects, making snap decisions that grow harder as the games progress. One game gives users a split second to locate two matching butterflies in a swarm before the image disappears. 

Many scientists say it’s too early to tell whether the games really can prevent dementia, and question whether they can lead to long-term improvements in memory and daily functioning. But some scientists think the games are promising enough that they’re pouring millions of dollars into studying them. 

Neuroscientists have long recommended traditional games, such as bridge, Sudoku and crossword puzzles, to keep the brain sharp. Crosswords don’t help people process information speedily, though, a skill whose age-related deterioration can progress to dementia.

The newer games, such as one called Double Decision developed by scientists, try to stimulate and speed up neural activity and slow deterioration in brain physiology that occurs with age. 

In a healthy brain, myelin, a layer of insulation, keeps nerve fibers taut and densely bundled, says

Chandramallika Basak,

an associate professor at the University of Texas at Dallas. Our myelin frays and unravels with age, interfering with memory and clear thinking, she says.

In recent imaging studies, her team and scientists from the University of Iowa observed that people who played brain training games maintained or increased myelin in some parts of the brain compared with control groups that played other types of games that didn’t require speed or increasing levels of difficulty.  

Interest in studying brain-training games has grown since a 2020 report published in the journal Lancet said that as many as 40% of dementia cases could theoretically be prevented or delayed with lifestyle changes, such as adjusting diet and exercise and managing hypertension. 

Dementia is marked by age-related losses in memory, attention and thinking speed that are severe enough to interfere with daily living. Alzheimer’s, a neurodegenerative disease, is the most common type of dementia. Women who are 45 years old have a 20% lifetime chance of developing Alzheimer’s, according to the Alzheimer’s Association. Men the same age have a 10% chance. 

Cognitive training, which includes anything from computerized exercises to puzzles and bridge, has been identified by the National Academies of Sciences, Engineering and Medicine as a promising area of dementia-intervention research. There’s no recommended age to start playing these games. You can find games online or at libraries, community colleges or local chapters of the Alzheimer’s Association.

Brain-training games haven’t been proven to prevent dementia, says the National Institute on Aging, part of the National Institutes of Health. Studies so far have yielded mixed results on the games’ effectiveness; doubts remain over their ability to produce long-term practical improvements. 

Still, the research to date has been encouraging enough—and dementia so prevalent—that scientists are studying the games further. The World Health Organization in 2019 recommended cognitive training for older adults as a way to reduce the risk of dementia even though the science behind it isn’t definitive.

The National Institute on Aging is funding 21 clinical trials to try to learn what types of games might improve factors such as memory and attention and reduce the long-term risk of developing dementia. A series of studies of nearly 3,000 people funded in part by the NIA suggested that the benefits of a course of exercises requiring speedy observations and snap decisions appeared to help older people 10 years later and lower their dementia risk by 29%.

The training in the study consisted of 10 initial 60- to 75-minute sessions where people played speed-and-recall games, and eight booster sessions later. The study wasn’t designed at the outset to assess dementia risk, according to

Dana Plude,

a deputy director at the National Institute on Aging. But the results are a key reason for his interest in cognitive training, and the NIA is currently funding a $7 million clinical trial to further test the results.

Brain training games can be fun but frustrating, regardless of your age and mental stamina. Apps generally charge a monthly or annual fee; some offer a training routine that may be personalized.

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What “brain exercises” do you do to keep sharp? Join the conversation below.

CogniFit, one such app, offers online cognitive assessments and brain training for $19.99 a month for its basic 20-game plan and $29.99 for its 60-game premium plan. It suggests users spend 10 to 15 minutes three times a week on nonconsecutive days to increase their cognitive scores.

Double Decision is sold by Posit Science, whose games are offered commercially and have been used in studies funded by the U.S. Defense Department, the NIA and others. 

The goal of Double Decision is to progressively increase the amount of visual information a brain can take in and the speed at which it processes the information—capabilities that typically decline with age. Repeated gameplay trains the brain to think and react more quickly,  focus better and remember more, says

Michael Merzenich,

chief science officer of Posit Science. 

In the exercise, two different cars appear in the middle of a screen with a Route 66 sign floating in the periphery. One of the cars plus the road sign flash onto the screen and then disappear. A player must recall which car they just saw and the location of the road sign. The game speeds up and adds distractions like a herd of cows or dozens of road signs. 

“Brain health is manageable,” says Dr. Merzenich. “We should treat brain health as seriously as our physical health.”

Double Decision is designed to improve attention, memory and processing speed by forcing the brain into split-second observations and decisions. Content hosted by BrainHQ

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Business

Peloton’s Quarterly Loss Tops $1.2 Billion

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Peloton Interactive Inc.,

PTON -19.32%

racing to save itself, will reject some of the most fundamental aspects of its decade-old business model. 

The once-hot maker of connected fitness equipment posted losses of more than $1.2 billion in the most recent quarter as revenue plunged and the company warned it would spend more cash than it brings in for several more months. Peloton lost $2.8 billion in the year ended June 30, compared with a $189 million loss in the prior year.

Losses come as demand for Peloton’s bikes and treadmills has plunged and the company’s count of people who subscribe to its fitness classes stagnated after growing fourfold since early 2020. The company had about 3 million subscribers to its connected fitness offering at the end of the June quarter.

Peloton CEO Barry McCarthy aims to make Peloton primarily a subscription-based company.



Photo:

Kevin Dietsch/Getty Images

Peloton shares were down nearly 20% in morning trading, as the company posted steeper losses and weaker revenue than analysts had projected. Through Wednesday’s close, its share price was down 88% from a year ago.

“The naysayers will look at our [fourth-quarter] financial performance and see a melting pot of declining revenue, negative gross margin, and deeper operating losses. They will say these threaten the viability of the business,” Chief Executive

Barry McCarthy

said in a letter to shareholders. “But what I see is significant progress driving our comeback and Peloton’s long-term resilience.”

Peloton has long sought out an affluent base of customers with stationary bikes that cost up to $2,500, and has worked to ensure only owners of its equipment are able to connect to its popular workout classes.

Mr. McCarthy, who took over in February, said the company also will court more frugal customers and make its workout classes, often accessed through screens on Peloton equipment, compatible with competitors’ exercise products.

He said the company is also trying to bring more people in through selling equipment and clothes through Amazon.com Inc.’s e-commerce platform to letting people rent bikes through a subscription. Peloton historically has offered two subscription options, one in which courses connect to bikes and treadmills and cheaper options in which classes aren’t connected.   

“You never know which initiative is going to get us where we want to go, but I am confident of the cumulative effect,” Mr. McCarthy said in a call with analysts. 

The efforts come as Peloton’s finances deteriorate. 

Revenue for the June quarter fell to $679 million, a nearly 30% drop from a year ago as declining exercise equipment sales more than offset higher revenue from subscriptions. 

Efforts to restructure the company contributed to it burning through $412 million in cash in the latest quarter, after going through $650 million in each of the prior two periods. It ended June with $1.25 billion in cash reserves and a $500 million credit line. 

Peloton is taking steps to shore up its finances, from sweeping layoffs to outsourcing manufacturing of its fitness equipment. The company said earlier this month it would cut around 800 jobs in an effort to reduce costs, after announcing in February it would lay off about 2,800 workers. Executives said cost-cutting aims to ensure the company maintains at least $1 billion in available cash.

One of the pandemic’s biggest winners, Peloton has struggled to adapt as Americans revert to prepandemic habits and tighten spending amid inflation near its highest level in decades. Americans are spending less on in-home fitness, from sales of equipment to connected workouts, as they return in droves to gyms and become increasingly cautious about spending available cash amid economic uncertainty.

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How has your Peloton use changed over the course of the pandemic? Join the conversation below.

Mr. McCarthy’s predecessor, Peloton co-founder

John Foley,

spent hundreds of millions of dollars to expand the company’s manufacturing and supply, betting that demand would hold as the pandemic waned. Along with replacing Mr. Foley, the company earlier this year made changes to its board and said it would cancel plans for a $400 million factory in Ohio.

For the first time, in the most recent quarter, Peloton’s subscription revenues were greater than equipment sales. Mr. McCarthy, who previously worked at

Spotify Technology SA

and

Netflix Inc.

, aims to make Peloton primarily a subscription-based company. Subscriber revenue for the quarter was $383 million; equipment sales were $296 million. 

Peloton’s subscriber count rose by just 4,000 in the quarter ended June 30 and the company predicts that the total number of subscribers will remain flat in the current quarter.

It is a big change from the start of 2021, when Peloton’s quarterly revenue peaked at $1.2 billion, and exercise equipment comprised more than 80% of sales. 

The company said it expects total revenue between $625 million and $650 million for the current quarter, which ends Sept. 30.

Mr. McCarthy, in his investor letter, likened Peloton to a dangerously tipping cargo ship he was aboard as a high-schooler when the crew managed a dramatic recovery.

“Peloton is like that cargo ship,” he said. “We’ve sounded the alarm for general quarters. Everyone’s at their station.”

Write to Sharon Terlep at sharon.terlep@wsj.com

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