The obesity drug boom keeps getting bigger
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Illustration: Sarah Grillo/Axios
Eli Lilly's expectation-busting financial results on Wednesday underscore how for all the attention anti-obesity drugs have already received, the age of medication-induced weight loss is just getting started.
Why it matters: Lilly's weight loss shots are only the first generation of effective anti-obesity treatments to hit the market, and the race is on to develop even better options.
Driving the news: Eli Lilly on Wednesday announced its fourth-quarter net income was $6.64 billion, up from $4.41 billion in 2024.
- Worldwide revenue for Mounjaro, which is its GLP-1 used to treat diabetes, increased by 110% year-over-year. U.S. revenue of Zepbound, which is used for weight loss, increased 122%.
The big picture: Analysts predict that only a fraction of the weight loss market has been tapped so far, and pharmaceutical giants are spending billions to make sure they can compete for market share going forward.
- The end of 2025 featured a bidding war between Pfizer and Novo Nordisk over Metsera, an anti-obesity biotech without any approved products on the market.
- And AstraZeneca recently announced a multibillion-dollar licensing deal with Chinese biotech CSPC Pharmaceuticals, giving it the rights outside of China to the company's four experimental weight loss drugs.
Where it stands: Eli Lilly has established itself as the player to beat in what's been a two-horse race with Novo Nordisk — the maker of Ozempic and Wegovy — which has fallen behind in market share.
- Novo reported more sober earnings on Wednesday, saying it expects sales and profits to decrease in 2026. It cited patent expirations of its GLP-1 in some markets and a deal it struck with President Trump last year in which it agreed to charge lower prices in certain markets.
- Yet the company's January rollout of a daily pill version of Wegovy has become "the fastest drug launch ever," Leerink analyst David Risinger wrote in a recent note.
- Lilly is preparing to launch its own oral anti-obesity drug in the second quarter of this year.
Between the lines: In the near term, it'll be weight loss pills that define the next phase of the obesity drug boom.
- "For patients, oral therapies promise greater convenience, improved adherence, and broader access, particularly for those reluctant to use injectables," an IQVIA analysis declared.
- "For manufacturers, this shift opens new competitive battlegrounds, where efficacy, tolerability, and pricing strategies will determine leadership in a new market dimension."
What we're watching: Plenty of other next-generation options are under development as well.
- New drug candidates may help better support long-term use, including by having fewer side effects. Others may simply require monthly doses or lead to even greater weight loss.
- And still others may eventually offer patients something more resembling a cure than an ongoing treatment. Several gene therapies that target the underlying biological causes of obesity are under development, the Washington Post recently reported.
Yes, but: Access questions still loom large, with insurers still wary of the pricey drugs.
- Lilly and Novo's deal with the Trump administration last year essentially offered lower prices in some markets in exchange for limited Medicare coverage of weight loss drugs.
- Lilly has said the expanded patient pool will more than offset the price reductions.
- But some analysts have lowered their expectations for the eventual size of the anti-obesity market, because prices are coming down faster than expected, Reuters recently reported.
The bottom line: The global health implications of the rise of anti-obesity drugs are massive — as are the pots of money at stake.
