The race to the first obesity pill: ‘A pill offers added value, but there is a risk’

Many drug companies are testing anti-obesity pills, from challenger Viking Therapeutics to leader Novo Nordisk. “Over time, this will be a potentially $100 billion market.”

Today, patients rely on injectable medications for the treatment of obesity, such as the blockbuster drugs Wegovy and Zepbound from the Danish pharmaceutical company Novo Nordisk and the American Eli Lilly, respectively, the leaders in the rapidly growing market.

“If pills were introduced, it would mean great added value for both the drug companies and the patients,” says Bart Van der Schueren, chairman of the Belgian Association for the Study of Obesity.

“Current manufacturers of injectable medications are finding it very difficult to meet demand, partly because the supply chain and production of such medication is complex,” he says. ‘You have to make the active ingredients and the injection pens and this involves specialized cold chain transport. If you can make pills, this offers a lot of logistical advantages. At the same time, the prices of such pills would probably be a lot lower. And of course there is the ease of use for the patients.’

There is certainly more than enough room for newcomers and new obesity medications, says Suzanne van Voorthuizen, analyst at the investment bank Van Lanschot Kempen.

‘Over time, this will be a potentially $100 billion market. Even with a fraction of that market you are talking about blockbuster potential (a medicine with an annual turnover of at least 1 billion dollars, ed.). It is logical that companies want to position themselves in different ways, including through medication with fewer side effects than those of the first generation or through pills.’

Despite the promising early developments, it will probably take a few years before the first obesity pills are on the market.

Novo Nordisk will commence its Phase 2 study in the second half of the year. The results are expected in early 2026 – a drug will go through three phases of clinical trials before possible approval. Viking Therapeutics indicated last week that it would also start a phase 2 study with its pill in the second half of the year.

Yet, despite all the benefits, obesity expert Bart Van der Schueren warns of the potential dangers. ‘I fear that with pills the risk of use without medical supervision is greater. We must continue to emphasize this: the treatment of obesity requires a total approach, in which, in addition to medication, sufficient exercise and a balanced diet are very important.’