Key Takeaways:
The obesity drug race intensified at the 2026 American Diabetes Association Scientific Sessions as five drugmakers presented clinical data on next-generation candidates.
Eli Lilly, Novo Nordisk, Boehringer Ingelheim, Amgen and Structure Therapeutics all pitched their pipelines to physicians and investors at the New Orleans conference last week, with weight loss results ranging from 16.6% to 30%.
"The data are actually comparable to what our competitor's tri-agonist also showed in phase 2," Martin Holst Lange, chief scientific officer at Novo Nordisk, said in an interview, referring to the company's experimental zenagamtide. "Now we have to see if we can show that in phase 3."
Lilly's retatrutide, a triple agonist targeting GLP-1, GIP and glucagon receptors, led the pack with 28% weight loss at 80 weeks and 30% at 104 weeks at its highest dose in patients with obesity, according to data presented at the conference. RBC Capital Markets analysts called Lilly the "clear winner from ADA" after the meeting wrapped up.
Novo Nordisk's CagriSema, which combines the amylin analog cagrilintide with semaglutide, achieved 23% average weight loss after 84 weeks in a phase 3 obesity trial. The company is running another late-stage study, Redefine 11, designed to explore further weight loss potential through dose re-escalation and longer durations. "The jury is still out" on how CagriSema ultimately compares with retatrutide, Lange said.
In type 2 diabetes, CagriSema showed a 1.91 percentage-point reduction in HbA1c from a baseline of 8.2% at the 2.4-mg dose, compared with a 1.75-point reduction on Novo's own Ozempic. Average weight loss in diabetes patients reached 14.2%, versus 10.2% for semaglutide alone.
Boehringer Ingelheim's survodutide, a dual GLP-1 and glucagon receptor agonist, delivered 16.6% mean weight loss over 76 weeks in the phase 3 SYNCHRONIZE-1 trial. A substudy showed the drug reduced visceral fat by up to 34% and liver fat by up to 63.1%, with lean body mass largely preserved. In the SYNCHRONIZE-MASLD trial, roughly 60% of participants achieved normalization of liver fat levels after 48 weeks.
Novo also highlighted zenagamtide, a unimolecular GLP-1 and amylin receptor agonist that showed 24% weight loss in obesity and more than 14% in diabetes during phase 2 testing. Lange pointed to the asset's potential to be "a very competitive drug."
Beyond the scale
As weight loss numbers converge across drug classes, tolerability and comorbidity benefits are emerging as key differentiators. "I think at some point it's not about the weight loss anymore," Lange said. "How do you live not only a thinner life, but also a better life?"
Gastrointestinal side effects remain the most common adverse events across all candidates. In survodutide's trial, about one in five participants discontinued treatment due to side effects, with nausea, vomiting and diarrhea occurring most frequently during dose escalation.
The competition is pushing developers to target metabolic health beyond body weight. Survodutide's effects on visceral and liver fat address metabolic dysfunction-associated steatotic liver disease, which affects roughly one in three adults. Novo's pipeline also includes cagrilintide as a standalone therapy and the triple-G agonist UBT251, which the company sees filling niches for patients prioritizing tolerability over maximum weight loss.
The data reinforce obesity as the top growth sector in healthcare, with peak sales estimates for next-generation treatments reaching tens of billions of dollars. Investors will watch for phase 3 readouts from Novo's Redefine 11 trial and Amgen's obesity candidate, as well as regulatory filings for retatrutide and survodutide expected over the next 12 to 18 months.
This article is for informational purposes only and does not constitute investment advice.
