Lilly, Novo and Pfizer are looking for new weight loss drugs
Drugmakers have been months into introducing GLP-1 pills and navigating huge changes in the way patients pay for weight-loss drugs.
Nevertheless, they are already outlining their visions for the future of anti-obesity drugs.
At the American Diabetes Association’s scientific sessions last week in New Orleans, drugmakers pitched doctors and investors the idea of new shots and pills, drugs that can be taken less often, and new treatments beyond GLP-1 that could be associated with fewer side effects. Attendees discussed where all of these new treatments might fit, especially since Eli Lilly currently dominates the injection market and impressed attendees with data on its experimental triple-acting drug retatrutide, which produced the greatest weight loss to date.
Lilly and rival Novo Nordisk presented new GLP-1 pills that they had introduced earlier this year. Both companies argued that oral options were attracting more people to the weight-loss drug market, with Novo announcing that prescriptions for its Wegovy pill had reached more than 3 million just five months after its launch.
Behind the two market leaders is a wave of new entrants hoping to enter the huge market in the coming years.
Structural therapeutics And AstraZeneca Each shared interim data on their respective GLP-1 pills. If these oral drugs succeed in Phase 3 trials, they would likely hit the market around 2029, three years behind Lilly, which launched its small-molecule pill Foundayo earlier this year (the Wegovy pill is an oral peptide).
Ray Stevens, CEO of Structure Therapeutics, believes there will still be plenty of room in the market until then.
“At the end of the day, who wins in the competition? Patients, and that’s really what it’s all about,” Stevens said, adding that being the second small molecule drug will be important. “We are working really hard to get to second place behind Orforglipron, now Foundayo.”
Pfizer Also revealed interim data from an opportunity the company gained through its $10 billion acquisition of Metsera. The drug showed the potential to be administered monthly, which Pfizer said would be more convenient than the current weekly injections. Another drug manufacturer, Amgenis testing a different drug that could be administered monthly or possibly even quarterly.
Susan Sweeney, executive vice president of obesity and related diseases at Amgen, said the company sees a benefit in people not needing weekly injections and instead only considering treatment four times a year.
“For someone who has lived with obesity for a long time, not remembering the disease can be a huge advantage,” she said.
Novo Nordisk CEO Mike Doustdar (left) and Eli Lilly CEO David Ricks listen as President Donald Trump speaks during an event about weight loss medications in the Oval Office on Nov. 6, 2025.
Andrew Caballero Reynolds | Afp | Getty Images
Some companies are looking beyond GLP-1 and other key targets like GIP and glucagon to new areas like amylin, another hormone produced in the pancreas that helps people feel full. A company is Zealand Pharmawhich presented medium-term data on a drug it is developing called petrelintide Roche.
The experimental shot helped people lose nearly 11% of their body weight – less than the currently available Wegovy and Zepbound shots. But Zealand said fewer people taking the drug vomited than those in the placebo group.
“I really believe that if this amylin [drugs] At launch, we may have what I have described as an iPhone moment because patients are so aware of the experience they are having with the GLP-1s, and as soon as you bring a new modality to market that gives you a better experience, people will line up to get access to that new weight loss drug rather than sticking with the more cumbersome medications,” said Adam Steensberg, CEO of Zealand.
As with the other potential new entrants, it will be years before the drug becomes available from New Zealand. Market leader Lilly is developing its own amylin analogue called Eloralintide, which is already in phase 3 trials.
At this year’s ADA, Lilly also presented Phase 3 results of its triple agonist retatrutide. This drug activates the GLP-1, GIP and glucagon receptors and results in dramatic weight loss.
At the highest dose, participants lost an average of 28% of their body weight when taking retatruide and taking it as prescribed in the study. Lilly CEO Dave Ricks sees the drug as a way to help people with a body mass index over 40, the highest level of obesity, reach a healthy weight, which isn’t possible if they have an average response to Lilly’s current vaccine, Zepbound.
“We have shown what is possible and useful: almost half of people lose more than 30% of their body weight,” said Ricks. “So if you start at a higher level, you can really get to a healthier state, which I think is everyone’s goal.”
Beyond Lilly and Novo?
Investors are now trying to figure out whether the market will remain a duopoly between Lilly and Novo or whether the potential new entrants will become major players. The newcomers point out that, according to World Health Organization statistics, about 2.5 billion people in the world are considered overweight and 890 million are considered obese.
“The big question is not volume, but pricing,” said Goldman Sachs analyst Asad Haider. “Where does this end?”
Lilly and Novo have cut prices on their weight-loss drugs over the past year as they compete with each other and line up pharmacies that sell cheaper knockoffs of their drugs. Both Lilly and Novo are also trying to improve health insurance coverage for GLP-1 weight loss drugs.
In a few weeks, millions of Medicare seniors will be able to access the drugs out of pocket for $50 a month.
Novo Nordisk CEO Mike Doustdar believes this will happen in the coming years Obesity will look like mental health once did, when people referred to it as a disease.
“Today it’s depression, bipolar disorder, schizophrenia, many, many different problems with very different medications and support for patients. We look at obesity that way,” he said.
With so many drugs in the pipeline, the future of obesity treatment and who uses what treatment could look very different. At least that’s what the drug manufacturers, who want to capture a larger market share, hope.
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