In their race to own the weight-loss market, pharmaceutical companies are innovating at breakneck speed.

The inception of so-called GLP-1 drugs — a shorthand for glucagon-like peptide-1 agonists — which can help users rapidly lose up to 20 percent of their total weight has created a veritable arms race amongst the world’s leading drug makers. All want to create the most effective and widely-adopted iteration. While Novo Nordisk’s Ozempic may be the best-known, competitors like Eli Lilly and now Pfizer are quickly catching up. On Sept. 22, the latter acquired obesity startup Metsera for $7.3 billion after facing slowing demand for its Covid-19 vaccine and treatments.

The competition is no surprise: GLP-1s could be the most consequential medical development since penicillin.

“I have not seen something as revolutionary as GLP-1 weight loss drugs within my lifetime,” said Marc Ronert, a board-certified plastic surgeon based in Frankfurt and the co-owner of clinical beauty company Image Skincare. GLP-1s help to lower blood sugar and promote weight loss by affecting slower digestion and quieting “food noise” in the brain. They’ve also been observed to help patients lower their risk of liver or heart disease.

Patient demand is hot, but after years of shortages, drugmakers now have to contend with copycat compounded formulas and increased regulatory scrutiny. There’s a lot to play for; Investment bank Morgan Stanley estimated the value of the weight loss market at $15 billion in 2024, and expects it to hit a peak of $150 billion in 2035, with the US comprising half of all sales. This summer, the World Health Organisation classed four GLP-1 drugs as essential medicines, and they’ve already suffused conversations about public health, wellness, longevity and beauty.

“People on my feed are, in their own way, rebranding GLP-1s,” said Julia Bellary, a marketer and co-host of the beauty-themed Glowjob podcast. “It’s going from weight loss to ‘longevity care.’ They’re losing that vanity weight, but tying it into biohacking.”

Pharma’s GLP-1 Players

Since Novo Nordisk’s Ozempic initially broke onto the scene in 2017, it has fast become a catch-all term for all weight-loss drugs — despite being initially conceived and licensed as a diabetes medication. The company followed up quickly by launching a higher concentration under the brand name Wegovy, specifically for weight loss.

Competitors immediately began chomping at its heels. US pharma giant Eli Lilly released its next-generation GLP-1 drug tirzepatide under the brand name Mounjaro for diabetes in 2022 and Zepbound for weight loss in 2023, siphoning Novo’s market share by partnering with telehealth firms and online marketplaces — a strategy it’s repeating in global markets like China and the EU.

Trials show that Lilly’s Zepbound, of all GLP-1 medicines, causes the most dramatic weight loss, helping patients shed up to 20 percent of their body weight against a placebo, compared to around 12 percent for Wegovy and 4 percent for Novo’s first-generation diabetes GLP-1 Saxenda. (Lilly is also in trials for its next injection, retratrutide, which has shown weight loss of up to 25 percent.)

Tirzepatide also captures the most consumer spend, according to sales data from insights firm Guidepoint Qsight. Consumers at medspas pay an average of $485 per month for tirzepatide compared to $350 per month for semaglutide.

The original cohort now have to contend with a rising number of companies bringing their own proprietary GLP-1s to market — like China’s Innovent, and its drug Xinermei (generic name mazutide) — or acquiring them, like Pfizer and Metsera or British firm Astrazeneca, which licensed Chinese firm Eccogene’s pill for around $2 billion in 2023.

Another competitor in the space are pharmaceutical compounders, which gained traction after the FDA declared shortages of semaglutide and tirzepatide and allowed pharmacies to make cheaper versions of the medicines. Now those shortages are lifted, government agencies and the companies themselves are cracking down on copycat products. Novo Nordisk had an early in with Hims & Hers, but terminated their agreement to prescribe Wegovy in June 2025 over the telehealth firm’s prescription of compounded semaglutide.

These regulatory headaches are expected to ease as companies begin launching their GLP-1 weight loss pills, which are easier to manufacture and don’t require cold-chain distribution like their injectable counterparts. Novo and Lilly are neck-and-neck to be first, with their stock prices rising and falling as late-stage trial results eke out. Novo’s semaglutide pill awaits an FDA decision that could see it launching in the US in early 2026, but is closely followed by Lilly’s forthcoming pill orforglipron.

Experts say it’s just the beginning. “We know that the demand overall is very strong,” said Erika Sheyn, senior vice president of aesthetics at insights firm Guidepoint Qsight, “so the market keeps adapting to it.”

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