MW After key conference, here's how the race to a $150 billion weight-loss drug market is shaping up

By Jules Rimmer

A key industry conference gave a glimpse into the next generation of weight-loss drugs - which will focus not just on weight reduction but tolerability and differentiation.

After the annual American Diabetes Association conference - almost a third of the obese is diabetic - analysts at Panmure Gordon led by Susana Cruz provided insight on the latest treatments, prevention strategies and research.

With patents expiring and the obesity market opening up, major players in the weight-loss market are lining up to see what will follow the likes of Wegovy and Zepbound. With Morgan Stanley estimating the market could expand to $150 billion globally by 2035, there are 157 different competitors aiming to replicate the success of the likes of Novo's $(NVO)$ Wegovy and Eli Lilly's $(LLY)$ Zepbound.

Although so-called GLP-1 drugs - which mimic the gut hormone that can control blood-sugar levels and reduce appetite - still dominate the landscape, amilyn agonists - which mimic a hormone from the pancreas - - could be the next big thing. Novo (DK:NOVO.B) , Roche (CH:ROG) , Zealand Pharma (DK:ZEAL) and AstraZeneca $(AZN)$ (UK:AZN) are the big actors in this space.

New mechanisms are emerging, allowing for greater tolerability, fat-targeted weight loss and greater efficiency dealing with comorbidities, Cruz said.

Among the large, publicly-listed companies present, Novo Nordisk shares have dropped around a quarter this year as it has lost market share in injectables. The company is shifting focus to the amylin receptor agonists that appears to be the next wave of innovation. Novo plans to apply for regulatory approval for a label expansion of Rybelsus, an oral semaglutide proven to reduce incidents of adverse cardiovascular events.

Novo is also prioritizing the application - at higher doses - of its most successful weight management drug, Wegovy. The higher dose led to average weight loss of 21% after 72 weeks, with one in three participants achieving weight loss of 25% or more. Wegovy accounted for a fifth of Novo's revenue in 2024 and the company projects sales in excess of EUR11.4 billion in 2025, up almost a half on last year.

Wegovy's clinical results thus far compare favorably to Eli Lilly's Zepbound and Novo hopes to reverse the market share losses it has suffered since the end of 2024. Zepbound's success is owing to its higher weight loss rates (20.9%) versus Wegovy (17%) at the same 2.4 mg dosage, and also the composition data showing greater reduction in fat at 75% versus 61%.

Novo's response to Eli Lilly's obesity pipeline is CagriSema, a combination of semaglutide and amylin analogue but thus far, trial data is falling short of the company's 25% weight-loss targets.

For their part, Eli Lilly's pipeline focused on Orforflipron, an oral GLP-1 achieving similar results in tests to its injectable, as well as other weight-loss treatments such as Bimagrumab, Mazdutide and Eloralintide.

AstraZeneca, also active in the amylin race, presented results for its phase 2 drug, AZD6234, a long-acting analogue. This will compete with petrelintide, Zealand Pharma's flagship weight-loss drug on which they agreed a licensing deal worth up to $5.3 billion with Roche.

-Jules Rimmer

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June 25, 2025 05:43 ET (09:43 GMT)

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