Eli Lilly’s Obesity Pill Orforglipron Challenges Novo Nordisk’s Oral Wegovy in Weight-Loss Market Race
August 24, 2025
The obesity drug market, projected to surpass $73 billion by 2034, is witnessing a fierce competition between pharmaceutical giants Eli Lilly and Novo Nordisk. Eli Lilly’s oral GLP-1 receptor agonist, orforglipron, is emerging as a significant rival to Novo Nordisk’s oral semaglutide, the needle-free version of its blockbuster injectable Wegovy. While Novo Nordisk holds a first-mover advantage with its oral drug under FDA review, Lilly’s orforglipron brings unique advantages that could reshape the booming weight-loss treatment landscape.
Clinical Trial Results: A Close Race
Eli Lilly’s Phase III ATTAIN-1 trial results, released in August 2025, showed that orforglipron, taken daily at its highest 36-milligram dose, led to an average weight loss of 12.4% (about 27.3 pounds) over 72 weeks in over 3,000 adults with obesity or overweight with related health conditions. This fell short of Wall Street’s expectations of around 15% weight loss, causing a 13% drop in Lilly’s stock price on August 7, 2025. Meanwhile, Novo Nordisk’s oral semaglutide, currently under FDA review with a decision expected by Q4 2025, achieved an average weight loss of 15% in a late-stage trial over 68 weeks, with some patients reaching up to 16.6%. Posts on X reflected this sentiment, with @rebound_capital noting Novo’s 17.4% average weight loss compared to Lilly’s 12.4%, boosting Novo’s stock by 12% after the announcement.
Despite the efficacy gap, orforglipron’s results are still “clinically meaningful,” according to Dr. Jaime Almandoz of UT Southwestern Medical Center, who highlighted its potential as a needle-free alternative for patients averse to injections. Lilly’s pill also reduced cardiovascular risk factors like cholesterol, triglycerides, and blood pressure, aligning with benefits seen in Wegovy, which is FDA-approved for reducing heart events.
Orforglipron’s Competitive Edge
Orforglipron stands out due to its small-molecule structure, unlike Novo’s peptide-based oral semaglutide, which requires dietary restrictions (e.g., taking it on an empty stomach 30 minutes before eating or drinking). Orforglipron can be taken at any time without food or water restrictions, offering greater convenience. “This flexibility is a game-changer for patients with busy or unpredictable schedules,” said Dr. Rekha Kumar, an obesity medicine specialist, in a Healthline interview.
Additionally, orforglipron’s simpler manufacturing process could alleviate the supply shortages that have plagued injectable GLP-1 drugs like Wegovy and Lilly’s Zepbound. Lilly has already stockpiled $808.5 million in inventory, signaling readiness for a potential global launch by August 2026, pending FDA submission by year-end 2025. Analysts at Goldman Sachs predict orforglipron could capture a 60% share of the oral obesity drug market by 2030, equating to $13.6 billion, compared to Novo’s 21% share at $4 billion.
Novo Nordisk’s Head Start
Novo Nordisk’s oral semaglutide could reach the U.S. market by late 2025, potentially a year ahead of orforglipron, leveraging the company’s established dominance with Wegovy and Ozempic. Novo’s deal with CVS’s Caremark prioritizes Wegovy on formularies, which may extend to its oral version, enhancing insurance coverage. However, supply constraints for Wegovy and disappointing results from Novo’s next-generation drug CagriSema (16% weight loss vs. an expected 25%) have led to a 36% drop in its stock price in 2025, per CNBC.
Pricing and Accessibility
Both drugs are expected to be priced similarly to their injectable counterparts, around $1,000-$1,349 per month, though orforglipron’s lower production costs could allow for competitive pricing. Reuters reports that analysts see oral drugs as key to expanding access, especially in regions like South Africa, where cold-chain logistics for injectables are challenging. With only 8 million of the 170 million eligible U.S. patients currently using obesity drugs, oral options could bridge this gap, particularly if insurers expand coverage due to the drugs’ cardiovascular benefits.
Side Effects and Tolerability
Both drugs share similar side effect profiles, primarily mild-to-moderate gastrointestinal issues like nausea (33.7% for orforglipron, 10.4% for placebo) and vomiting (24% for orforglipron). However, orforglipron’s 10.3% dropout rate due to side effects at the highest dose exceeded analyst expectations, compared to Wegovy’s 7% in trials. Dr. Caroline Apovian of Brigham and Women’s Hospital cautioned that enthusiasm for orforglipron should be tempered, as “nobody can take it” if side effects drive discontinuations.
The Bigger Picture
The oral GLP-1 race is about more than weight loss—it’s about transforming obesity care. Orforglipron’s convenience and scalability position it to capture significant market share, especially for needle-averse patients or those in underserved regions. Novo’s first-mover status gives it an edge, but Lilly’s strategic investments and dual-agonist injectable Zepbound (which outperformed Wegovy with 20.2% vs. 13.7% weight loss in a head-to-head trial) suggest it could dominate long-term.
As both companies await regulatory milestones, the obesity drug market remains a dynamic battleground. “This isn’t a zero-sum game,” said UBS analyst Trung Huynh. “Both Lilly and Novo can thrive, but Lilly’s manufacturing advantage and patient-friendly design make orforglipron a serious contender.” With obesity rates rising globally, the winner of this rivalry could redefine healthcare access and outcomes for millions.
Sources: CNBC, Healthline, Verywell Health, The Independent, BioPharma Dive, Reuters, posts on X