The next generation of treatments aims to help patients lose a quarter of their weight
For decades, people who are overweight have been given simple advice: move more and eat less. However, in more than 80% of cases, this approach only works in the short term. A 2023 article published in Science highlighted that, despite what popular culture and many doctors believe, there is little consensus on the causes of the obesity pandemic. “Although it is often asserted that increasing sedentary behavior is a major cause of the obesity pandemic, this is far from clear, and present evidence does not support this conclusion,” the authors wrote. An editorial in The Lancet in February lamented the lack of consensus on a clear definition of obesity, despite it affecting nearly an eighth of the world’s population.
In 2017, the U.S. Food and Drug Agency (FDA) approved the use of semaglutide, the popular drug Ozempic, which was originally intended for diabetes. It quickly became a miracle solution to obesity by reducing the uncontrollable desire for food and achieving weight loss of up to 15% in 68 weeks. It was the first in a series of drugs that are, for the first time, effective against obesity and can help lessen the moral judgment that accompanies it.
Semaglutide’s main competitor is tirzepatide, produced by the U.S. pharmaceutical company Eli Lilly. While semaglutide mimics GLP-1 (glucagon-like peptide), a hormone that suppresses appetite and regulates metabolism, tirzepatide adds an analog of another gastric hormone, GIP (gastric inhibitory peptide), which increases insulin release and reduces blood sugar. This combination of hormone imitators has led to an average weight loss of 20% in 72 weeks in clinical trials.
The pharmaceutical industry is not stopping there. There are already 100 new drug candidates in trials, all vying for a slice of the obesity treatment market, which could reach $100 billion by 2030. Nearly all of the major pharmaceutical companies are making their bets on the weight-loss business.
Retatrutide, also from Eli Lilly, adds glucagon — a hormone that regulates blood sugar levels — to GLP-1 and GIP. Although it is not yet approved, this compound has shown a reduction of nearly a quarter of the participants' weight (24%) in its trials and could be approved as early as 2027.