Monthly injections, once-daily pills, and even lifelong gene therapies could soon become options for people looking to lose some weight.
The arrival of semaglutide and similar GLP-1 drugs in recent years has ushered in a new era of obesity treatment. These drugs, which mimic the GLP-1 hormone, help people lose substantially more weight than they typically would with diet and exercise alone.
Semaglutide was developed by Novo Nordisk. It’s the active ingredient in the type 2 diabetes drug Ozempic and the obesity treatment Wegovy, both taken as a weekly shot. Though only Wegovy is approved for obesity, Ozempic has become the cultural shorthand for GLP-1 therapy (notably, Ozempic is often prescribed off-label for weight loss). But Ozempic’s reign on top looks to be coming to a close, if it isn’t already here.
Eli Lilly’s tirzepatide (Zepbound and Mounjaro) combines GLP-1 with a second hunger-related hormone called GIP and provides greater weight loss on average than semaglutide. And there’s a bevy of GLP-1-based drugs on the horizon vying for approval, with some likely to reach the public this year. Even Novo Nordisk is looking to upgrade its products. Last December, it won FDA approval for a once-daily pill form of Wegovy.
So here are some of the Ozempic rivals most likely to make a splash in the world of obesity treatment in the years to come.1. Orforglipron
Developed by Eli Lilly, orforglipron mimics the GLP-1 hormone. Unlike most GLP-1 drugs, however, it’s taken as a once-daily pill.
In Phase III clinical trial data released last year, people on the highest dose of orforglipron lost, on average, 10% of their baseline body weight, compared to the 2.5% average weight loss seen in people taking a placebo. A study released last month also found that orforglipron could help people maintain most of the weight they lost on other GLP-1 drugs such as semaglutide or tirzepatide. Eli Lilly has since petitioned the FDA to approve orforglipron as an obesity treatment, with a decision expected sometime this spring.
Should it win approval, though, orforglipron will likely face some headwinds. The drug’s effectiveness might be below that of other popular drugs on the market, including Novo Nordisk’s oral version of Wegovy, approved late last year. But the company is banking on orforglipron having enough advantages to entice some doctors and patients.
For starters, many may prefer a daily pill over a weekly injection, either as a first-line treatment or as maintenance therapy. And unlike the Wegovy pill, orforglipron can be used without any food or timing restrictions (oral Wegovy needs to be taken in the morning on an empty stomach, at least 30 minutes before eating, to be most effective).
