🤰 Several new obesity drugs on the way

• Studies show that combination treatments of new drugs can lead to weight reductions of up to 24 percent.
• Over 100 new drug candidates against obesity are under development, including medications that preserve muscle mass during weight loss.
• The obesity drug market is expected to grow to over 100 billion dollars before the end of the decade.

More and better alternatives on the way

Muscle loss is a major concern for people using anti-obesity medications like semaglutide. These "GLP-1 agonists" mimic a natural gut hormone to suppress appetite and regulate metabolism. When calorie intake decreases, an energy deficit occurs that the body often compensates for by burning muscle.

A study tested a combination of the weight-loss drug semaglutide (known under the brand names Ozempic or Wegovy) and an experimental drug called bimagrumab, designed to preserve muscle mass during weight loss.

Next generation treatments

More than 100 drug candidates against obesity are in various stages of development. Those expected to reach pharmacy shelves in the coming years resemble drugs already on the market, but with improved properties.

The surge in anti-obesity drug development has been made possible by the enormous success of semaglutide and its competitor tirzepatide (sold as Zepbound or Mounjaro). These drugs have unlocked the potential for a global market projected to exceed 100 billion dollars by 2030.

But semaglutide and tirzepatide have limitations. They require weekly injections and frequently cause unpleasant side effects such as nausea, vomiting, and diarrhea. In the long term, loss of muscle mass and the risk of weight regain after ending treatment are also problematic. Additionally, the drugs don't work sufficiently for an estimated 10-30 percent of those who take them.

Multiple mechanisms of action provide better results

Semaglutide and tirzepatide are often grouped under the umbrella of GLP-1 drugs, but they differ in one key aspect: tirzepatide mimics not only GLP-1 but also a complementary hormone called GIP. This hormone further increases energy metabolism and affects how the body stores and burns nutrients.

In a large comparative study, sponsored by tirzepatide's manufacturer Eli Lilly, participants who took tirzepatide lost an average of 20 percent of their body weight, outperforming the 14 percent reduction achieved with semaglutide.

Upcoming treatments

Several new drugs are on the way:

• Orforglipron (Eli Lilly): An oral medication that activates the GLP-1 receptor, expected 2026
• CagriSema (Novo Nordisk): An injection that activates amylin and GLP-1 receptors, expected 2026
• Survodutide (Boehringer Ingelheim): An injection that activates glucagon and GLP-1 receptors, expected 2027
• Retatrutide (Eli Lilly): An injection that activates GLP-1, GIP, and glucagon receptors, expected 2027

Retatrutide, dubbed "triple G" for its ability to target GLP-1, GIP, and glucagon receptors, delivered an average weight reduction of 24 percent after 48 weeks in phase II testing.

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