The Weight is Over
By Garrett Dempsey
May 2024
In recent years, the treatment of obesity has experienced a significant shift. This change is largely attributed to GLP-1 (glucagon-like peptide-1) agonists, which reduce feelings of hunger by mimicking the effect of a natural hormone produced by food consumption. Since they were identified in the early 1980s, GLP-1 agonists have shown remarkable efficacy in weight loss and management. Their development, like the approval of Exenatide in 2005, initiated a new era in diabetes and obesity treatment.
Recent years have seen further advancements in GLP-1 agonists with the introduction of semaglutide (Ozempic, Wegovy) from Novo Nordisk and tirzepatide (Mounjaro) from Eli Lilly. Initially developed to treat Type 2 diabetes, these agonists have been proven to significantly reduce body weight. Patients have achieved an average weight loss of about 15%, previously only attainable through surgery.
GLP-1 agonists also show promise beyond weight loss. Clinical trials suggest improvements in cardiovascular health, notably in reducing heart attacks, strokes and cardiovascular mortality risks — particularly in individuals with obesity. (Further research is needed to determine if these improvements are independent of weight loss.) Emerging research also indicates a potential role in curbing addictive behaviors, though this area requires more exploration, as well.
Global obesity and its associated diseases come with immense societal and individual costs. The emergence of GLP-1 agonists represents a pivotal milestone in its management.
The market for GLP-1 agonists, valued at $11.3 billion in 2019, is expected to grow to $18.2 billion by 2027, and potentially $71 billion by 2032. This growth stems from their expanding applications and efficacy. Major pharmaceutical companies, including Amgen, Pfizer and Novo Nordisk, are heavily investing in this field, marked by significant acquisitions like Eli Lilly’s $1.92 billion deal for Versanis and Novo Nordisk’s $1.075 billion purchase of Inversago Pharma.
Other therapeutic treatments for weight loss are also attracting attention. Some take novel approaches, such as studying hibernating animals to discover new obesity drug targets. Other innovators, like Equator Therapeutics, an Endurance28 portfolio company, are developing compounds to enhance the body’s natural heat production, aiming to increase energy expenditure and decrease body weight. In some instances, GLP-1 agonists result in a decrease of both fat and muscle mass; the latter can increase frailty and reduce exercise capacity. Equator Therapeutics’ approach aims to increase energy expenditure — similar to exercise — without adversely affecting muscle mass.
Global obesity and its associated diseases come with immense societal and individual costs. The emergence of GLP-1 agonists represents a pivotal milestone in its management. The transformative impact of these treatments is just beginning to unfold, and their full effect on public health is expected to be significant.