How a single daily pill could soon be the future of losing weight
When Ian Strachan first started informing patients of how to secure weight-loss drugs at his pharmacies, he quickly realised that demand was strongest among one particular group.
“It was basically 50 and 60-year old women,” says Strachan, who runs a cluster of pharmacies in the north of England.
“They’d heard about the obesity injections through shows like Loose Women so they had a general idea about how they worked.”
Many of them viewed the treatments as a lifeline after years of struggling to shift the pounds. “They had tried everything,” says Strachan. “What they needed was a magic bullet.”
There was, however, one obvious deterrent. Despite Novo Nordisk’s Wegovy or Eli Lilly’s Mounjaro helping people lose between 15pc and 22.5pc of their body weight, some patients were steering clear of the drugs out of fear of weekly injections.
Now, optimism is growing that this barrier will be removed by the introduction of once-daily weight-loss pills and the surging investment for developing them.
While Novo Nordisk and Eli Lilly have dominated the weight-loss drug market with their existing jabs, experts believe more lucrative opportunities lie ahead with pills.
Up until now there has been limited progress on oral options, with companies struggling with a shortage of ingredients such as semaglutide.
However, if executives are able to roll out the treatment more broadly, mass market demand is expected to soar.
“The orals will play a very significant role,” said Pfizer chief executive Dr Albert Bourla last September. “Not everybody likes injections.”
Estimates suggest around a 10th of people are afraid of needles, although drug bosses believe the introduction of pills will hoover up far more customers than that. According to AstraZeneca chief Sir Pascal Soriot, at least 75pc of people would prefer to take pills over injections.
The British drugmaker is among a flurry of businesses racing to seize a slice of the market, alongside global giants including Pfizer, Roche and Boehringer Ingelheim, as well as biotechs such as Viking Therapeutics.
According to figures from industry group Airfinity, around 230 weight-loss drugs are currently progressing through studies and trials. A substantial chunk of these are thought to be oral pills. While many of these trials are in the very early stages, some companies are within shooting distance of bringing their pills to market.
Eli Lilly is among the frontrunners, having recently moved its experimental weight-loss pill into the last stage of clinical tests. Findings suggest the pill – which could also be taken with food – could help people lose an average of 24pc of their body weight.
However, it will not just come down to who is quickest to market.
Emily Field, an analyst from Barclays, says rivals will still be able to gain traction despite the head start secured by Novo Nordisk and Eli Lilly.
“That doesn’t mean companies like Roche and AstraZeneca can’t also have multibillion-dollar products,” she says. “Because the numbers are just so big.”
Goldman Sachs estimates that the weight-loss treatment industry will be worth around $130bn (£100bn) a year by 2030.
Others suggest it could end up being a similar market to female contraception, where patients ultimately work out which treatment is best for them.
Investors seem to be hedging their bets, as they back a range of different companies.
For years, Eli Lilly and Novo Nordisk have enjoyed eye-watering rallies in their share price – up 157pc and 122pc respectively since mid-2022.
However, when Roche set out results from its early-stage clinical trial last week, showing its daily obesity pill led to weight loss of 7pc in four weeks, shares jumped to their highest level in the past year.
Field says there is a clear sense of “obesity momentum” in the markets.
“I was talking to investors and they were saying, ‘I don’t like Roche, I don’t think Roche is that good a stock, but you have to own it because you can’t fight this momentum’. You’ve just got to get on the train or you’ll get run over.”
There is, equally, the argument that companies are developing better and better drugs, ones that help treat more than just people’s weight but also other conditions.
Zealand Pharma, which is working on weight-loss pills, said its focus is not purely on helping people shed more pounds.
Chief executive Adam Steensberg told the Financial Times that the plan was to design treatments with “similar degrees of weight loss but the potential to better address specific [illnesses that occur with] obesity”.
Meanwhile, AstraZeneca has suggested it is planning to use its weight-loss pill in combination with its other medicines to help people not just lose weight but also tackle things like cardiometabolic diseases.
A crucial aspect of this will be price. AstraZeneca’s Sir Pascal said the aim was to make weight-loss pills cheaper than injections.
Professor Naveed Sattar, who was appointed to helm Britain’s obesity-cutting programme last year, said this could be a game-changer.
He is expecting the next generation of weight-loss pills to be “substantially cheaper” after taking into account the lower cost of storing pills and the fact manufacturers would not require needles.
“We need to wait until we have the data but there could be an argument in using these to help prevent people from developing obesity in the first place,” Sattar says. “It’s becoming much harder for people to lead healthier lives without some conscious effort.
“There’s more food around and the opportunities to be physically active are less given we have cars – so people are struggling.”
He hopes at least one or two pills are approved in the next five years: “It would really widen how much they can be used.”
It is a view shared by Strachan, who says the pill version could send demand for weight-loss drugs into overdrive.
“People are generally frustrated with not being able to lose weight,” Strachan says. “We are only at the tip of the iceberg.”