Las Vegas – – September 15, 2026 -- The obesity therapeutics market across the seven major markets was valued at approximately USD 16 billion in 2025 and is projected to grow at a 27% CAGR through 2036, according to DelveInsight, as a wave of next-generation candidates threatens to disrupt the Eli Lilly-Novo Nordisk duopoly.
Oral GLP-1 Therapies Accelerate Patient Uptake
Novo Nordisk's oral WEGOVY surpassed 5 million cumulative U.S. prescriptions within 30 weeks of launch, while Eli Lilly's oral FOUNDAYO (orforglipron) gained significant traction among patients initiating obesity treatment by mid-2026. Aparna Thakur, Project Manager of Forecasting & Analytics at DelveInsight, said FOUNDAYO's once-daily oral formulation positions it for rapid uptake as a more convenient alternative to injectable therapies.
Discontinuation Rates Expose Real-World Treatment Gap
Despite strong demand, 65-68% of patients discontinue GLP-1 treatment within 12 months, with discontinuation climbing to as high as 85% by 24 months. High out-of-pocket costs, loss of insurance coverage, gastrointestinal side effects, and supply constraints drive the gap between real-world persistence and the lower discontinuation rates reported in Phase III trials.
Novo Nordisk's CagriSema Awaits Q4 2026 FDA Decision
Novo Nordisk has filed CagriSema, a once-weekly injectable combining cagrilintide 2.4 mg with semaglutide 2.4 mg, for U.S. approval in weight management, with an FDA decision expected in Q4 2026. In the Phase III REDEFINE 1 trial, CagriSema delivered 22.7% mean weight reduction at 68 weeks versus 16.1% for WEGOVY and 11.8% for cagrilintide alone. REDEFINE 2, in patients with obesity or overweight plus type 2 diabetes, showed 15.7% mean weight loss. Novo Nordisk plans a Phase III high-dose study combining cagrilintide with semaglutide 7.2 mg in the second half of 2026, while REDEFINE 11 results are expected in H1 2027.
Lilly's Retatrutide Targets Q1 2027 FDA Submission
Eli Lilly's triple GIP/GLP-1/glucagon receptor agonist retatrutide met primary endpoints in the Phase III TRIUMPH-2 and TRIUMPH-3 trials reported in July 2026. TRIUMPH-2 (n=1,152) showed mean weight reductions of 12.7%, 19.1%, and 20.8% at 4 mg, 8 mg, and 12 mg doses respectively at week 80, versus 4.0% for placebo. Across its development program, retatrutide has produced mean weight loss of up to approximately 22.6% in adults with severe obesity, supporting a planned FDA submission in Q1 2027.
Roche's Enicepatide Posts 22.5% Placebo-Adjusted Weight Loss
Roche/Carmot Therapeutics' once-weekly dual GLP-1/GIP agonist enicepatide (CT-388) achieved 22.5% placebo-adjusted weight loss at 48 weeks in Phase II at the 24 mg dose, with no plateau observed; 54% of participants reached a BMI below 30 kg/m2 versus 13% on placebo.
AstraZeneca, Boehringer Ingelheim Advance Late-Stage Candidates
AstraZeneca has moved its oral GLP-1 agonist elecoglipron into an extensive Phase III program following positive Phase IIb data, evaluating it as monotherapy and in combination regimens. Boehringer Ingelheim and Zealand Pharma's dual glucagon/GLP-1 agonist survodutide remains in Phase III, with safety and efficacy not yet established. Additional pipeline assets including RGT-075 (Regor Therapeutics) and MET-002o (D&D Pharmatech) are also advancing toward potential near-term market entry.