The landscape of weight loss medications is undergoing a significant transformation, marked by the emergence of new therapies and intensified competition among pharmaceutical giants. Recent clinical trial data and ongoing research efforts suggest a shift towards more effective and comprehensive approaches to obesity treatment.
Zepbound Demonstrates Superior Weight Loss
In a recent 72-week head-to-head trial, Eli Lilly's Zepbound outperformed Novo Nordisk's Wegovy in terms of weight loss. Patients taking Zepbound experienced an average weight loss of just over 20% of their body weight, while those on Wegovy lost a little under 14%. Furthermore, a greater proportion of individuals achieved significant weight loss with Zepbound, with over 31% losing a quarter of their body weight or more, compared to 16% with Wegovy. These findings suggest that Zepbound may offer a more potent option for individuals seeking substantial weight reduction.
New Drugs Focus on Muscle Preservation
Concerns about muscle loss associated with existing GLP-1 therapies like Wegovy and Zepbound have spurred the development of new weight loss drugs that aim to preserve or even promote muscle growth. Several companies, including Eli Lilly, Regeneron, Scholar Rock, and Veru, are actively pursuing this approach, targeting proteins tied to muscle preservation or growth.
Veru's enobosarm, for example, demonstrated in a 168-person trial that it helped older patients lose 71% less muscle when taken with Wegovy. Eli Lilly is also testing bimagrumab, a muscle mass-preserving drug, both alone and in combination with Zepbound. These efforts reflect a growing recognition of the importance of maintaining muscle mass during weight loss, particularly for older or infirm individuals at greater risk of falls and fractures.
Oral GLP-1 Agonists in Development
While injectable GLP-1 receptor agonists have dominated the obesity market, several companies are vying to develop oral alternatives that offer greater convenience and potentially lower costs. Eli Lilly's orforglipron is one such candidate, currently in late-stage testing. Novo Nordisk also has an oral semaglutide on the market for diabetes (Rybelsus) and is trialing a higher-dose version for weight loss. The availability of oral GLP-1 agonists could significantly expand access to obesity treatment and further intensify competition in the market.
A Booming Market with Room for Innovation
The obesity treatment market is experiencing unprecedented growth, driven by the success of GLP-1 therapies and the increasing recognition of obesity as a chronic disease. Goldman Sachs estimates that the market for anti-obesity drugs could exceed $100 billion by 2030. This burgeoning market has attracted numerous players, with over 300 GLP-1R drugs currently in development. Companies are exploring various strategies to differentiate their products, including novel mechanisms of action, improved tolerability, and longer-lasting formulations.
Trial Readouts to Watch in 2025
Several upcoming trial readouts in 2025 could further reshape the obesity market. Metsera expects topline data from a phase 2b study of MET-097i, an ultra-long-acting injectable GLP-1, in mid-2025. Skye Bioscience anticipates interim data from a phase 2 trial of nimacimab, a cannabinoid receptor 1 inhibitor, in the second quarter of 2025. Eli Lilly is expected to release data on orforglipron, its oral GLP-1 candidate, in the third quarter of 2025. These readouts will provide valuable insights into the potential of new therapies to address unmet needs in obesity treatment.
