^{Ozempic drug to treat diabetes. | Courtesy: Ozempic}

‍

The global weight loss drug industry is entering a historic new phase — one defined by record-breaking sales, pharmaceutical rivalries, and the growing hope of turning obesity into a treatable, manageable condition.

At the center of this transformation are Eli Lilly and Novo Nordisk, two pharmaceutical giants locked in a race for dominance in what could soon become a $100 billion market by 2030, according to analysts. Their groundbreaking GLP-1 drugs have not only redefined obesity and diabetes treatment but are also fueling one of the fastest-growing sectors in healthcare history.

Yet, behind the success lies a complex story — one involving supply shortages, pricing controversies, copycat drugs, and the next big question: Will weight loss pills replace injections?

Eli Lilly Pulls Ahead in the Race for Global Dominance

For the fifth straight quarter, Eli Lilly has expanded its market share, now accounting for nearly 60% of all GLP-1 injectable prescriptions in the U.S. The company’s powerful lineup — led by Mounjaro for diabetes and Zepbound for obesity — has outperformed Novo Nordisk’s Ozempic and Wegovy, both in terms of weight loss efficacy and tolerability, according to real-world data and head-to-head trials.

In contrast, Novo Nordisk has faced a challenging year. Supply chain disruptions, compounded drug competition, and disappointing trial data for new treatments have pushed its stock down nearly 40% in 2025, forcing the Danish drugmaker to cut profit forecasts twice this year.

To regain its footing, Novo Nordisk brought in new CEO Mike Doustdar in July, launched a global restructuring that cut 9,000 jobs, and promised to accelerate new drug rollouts. However, internal board tensions and regulatory scrutiny continue to cloud its recovery.

A $100 Billion Opportunity — and Growing

McKinsey projects that between 25 million and 50 million Americans could be using GLP-1-based drugs by 2030, signaling a market expansion that could rival the rise of cholesterol and insulin therapies in past decades.

Dozens of other pharmaceutical companies — from biotech startups to industry titans like Pfizer, Amgen, and Merck — are racing to capture a slice of the market. Amgen’s MariTide, a once-monthly weight loss injection now in late-stage trials, showed promising mid-stage results with patients losing up to 20% of their body weight. Meanwhile, Merck recently paid $2 billion to license a GLP-1 pill from China’s Hansoh Pharma, underscoring the global arms race for the next generation of treatments.

The Compounding Challenge: A Shadow Market for Weight Loss

While Eli Lilly and Novo Nordisk have ramped up manufacturing to end global shortages, both face a major challenge from compounded GLP-1 drugs — cheaper, unregulated versions made by pharmacies.

Roughly 1 million U.S. patients currently use compounded semaglutide, despite the FDA declaring the shortages over. Novo Nordisk claims many compounding pharmacies are still illegally marketing these versions as “personalized treatments,” often through telehealth platforms like Hims & Hers.

Analysts warn that these copycats are eroding market trust and revenues. TD Cowen’s Michael Nedelcovych described Novo Nordisk as “on its back foot,” particularly vulnerable to these cheaper alternatives.

The Insurance Coverage Battle

At an average cost of $1,000 per month, GLP-1 drugs remain out of reach for many patients. Insurance coverage — or the lack of it — has become one of the industry’s biggest barriers.

While Medicare still doesn’t cover GLP-1s for obesity, some private employers have started offering partial coverage. According to a May 2025 IFEBP survey, 36% of companies now cover GLP-1s for both weight loss and diabetes, up slightly from 34% in 2024. However, most employers remain hesitant due to cost concerns, short employee tenure, and side effects like nausea and vomiting.

Eli Lilly and Novo Nordisk have tried to bridge the gap with direct-to-consumer programs, offering their injections for around $500 per month. Still, experts say broader adoption will depend on whether Medicare expands coverage — a change the U.S. government is reportedly considering for 2026, according to recent policy discussions.

All Eyes on Pills — The Next Evolution in Weight Loss Treatment

After revolutionizing injections, both companies are now racing to bring oral weight loss drugs to market.

Novo Nordisk’s 25-milligram oral semaglutide could become the first FDA-approved pill for obesity by the end of the year. Meanwhile, Eli Lilly’s orforglipron — a small-molecule, needle-free alternative — is showing promising results and could launch globally by late 2026.

Goldman Sachs forecasts that oral GLP-1 drugs could capture 24% of the total weight loss market, worth about $22 billion by 2030. They estimate Eli Lilly will control 60% of that share — roughly $13.6 billion in annual revenue — compared to 21% ($4 billion) for Novo Nordisk.

While pills may make weight loss drugs more accessible, experts remain cautious. Many physicians argue injections are still more effective and better tolerated, and warn that switching from injections to pills could lead to weight regain.

New Entrants and Future Innovations

Competition is heating up across the biotech landscape. Companies like Viking Therapeutics, Pfizer, and Structure Therapeutics are testing next-generation weight loss drugs that aim to:

• Reduce side effects such as nausea.
• Maintain or build muscle mass.
• Require less frequent dosing — even as little as once a month.

Amgen’s MariTide is particularly notable, showing up to 19.9% weight loss among participants who completed its mid-stage trial. However, its high rate of side effects prompted the company to slow dosing schedules in later trials to improve tolerability.

Experts like Dr. Caroline Apovian from Brigham and Women’s Hospital believe the next wave of treatments may come from amylin analogs — drugs that mimic a natural hormone involved in appetite regulation. “We don’t need more dramatic weight loss,” she said. “We need safer, more personalized treatments.”

The Road Ahead

The weight loss drug market is now one of the most profitable — and competitive — industries in modern medicine. Eli Lilly’s early lead, Novo Nordisk’s restructuring, and the rush toward oral drugs are shaping a new healthcare era where obesity treatment is mainstream, not niche.

But the future will depend on a delicate balance of pricing, access, and innovation. As pills become available, insurance policies expand, and new players enter the scene, the next five years could determine who dominates a market expected to exceed $95–100 billion by the end of the decade.

What began as a medical breakthrough has now become a global business war — one that’s redefining how the world approaches weight, health, and longevity.