Much is being highlighted regarding Eli Lilly’s superior weight loss results in studies.
I have personally wondered at what point a weight loss drug becomes too effective. In weight loss, it is important to preserve muscle and other vital components. Eli Lilly and Novo emphasize the importance of diet and exercise in the guidelines they provide when starting a weight loss medication. In the real world, this is not what happens; instead, patients take the medication and eat less, but the quality of the food hardly improves significantly.
Will we have significantly more frail elderly patients in the future? Will treatment recommendations start to favor “not so effective” weight loss drugs?
The core of the thesis is that with Eli’s pill, the use of various oral contraceptives becomes more difficult or even impossible. This creates friction between the user and the product, which in turn would play into the hands of Novo, where no such restriction exists.
My own competence isn’t enough to compare all the features of new, old, and developing drugs, and I wouldn’t want to get into that, but I guess I opened this can of worms myself
I assume most pharmacists and doctors don’t know the latest research results and every drug’s side effects. Eli Lilly and Novo Nordisk are repeatedly pumping out new announcements about how drug X or Y has performed, while competitors are only just bringing their numerous different products to market. The situation is by no means helped by the fact that some drugs are officially weight loss drugs and some are officially diabetes drugs, which have similar effects (i.e., causing weight loss).
If we look at official weight loss drugs, Novo has the Wegovy tablet and Eli Lilly has Foundayo.
Storing Foundayo is easier and more flexible than Wegovy (Eli Lilly > Novo)
Apparently, statistically, Wegovy has been discontinued due to side effects less often than the Eli Lilly product, but to my eye, the listed side effects and percentages would suggest Wegovy is worse (Novo <=> Eli Lilly, depending on what you look at or what lens you’re looking through)
Well, when looking purely at weight loss percentages, things are surprisingly complicated since there are quite few impartial, sensible tests. In Novo’s tests, they are better, but in Eli Lilly’s tests, they themselves were better.
Eli Lilly’s Zepbound is currently the most effective injectable weight loss drug on the market.
Zepbound (Tirzepatide): Average weight loss is about 20–22% of starting weight (at 72 weeks). It affects two hormones (GLP-1 and GIP), which boosts metabolism and the feeling of satiety more.
Wegovy (Semaglutide): Average weight loss is about 15% of starting weight. It affects only one hormone (GLP-1).
Tolerability: Studies (such as SURMOUNT-5) suggest that Zepbound is slightly better tolerated for many, even though it is more potent. Wegovy statistically causes more vomiting and severe nausea in the early stages of treatment.
There are hardly any differences regarding storage, eating, or drinking.
Just a quick comment. In my opinion, Ummon’s latest comparisons seemed to be made through Eli Lilly-tinted glasses. A couple of points:
“Foundayo can be taken more freely vs Wegovy’s restrictions on eating and drinking (Eli Lilly > Novo)“…
What about restrictions on, for example, sexual life? It seems that Foundayo requires women to stop taking birth control pills, whereas Wegovy does not. Novo > Eli Lilly, right?
“Well, looking just at weight loss percentages, things are surprisingly complicated since there are very few sensible, independent tests. In Novo’s tests, they are better, but in Eli Lilly’s tests, they were better themselves”…
In Eli Lilly’s study, Wegovy was used at a 14 mg dose, while Foundayo was at a 36 mg dose, which naturally skews the results in Eli Lilly’s favor, as the Wegovy dosage should be 25 mg. Also, why leave Ummon’s own source drugs.com uncommented – it seems to be an independent test, results:
“The headline result: In OASIS 4, oral Wegovy 25 mg led to 13.6% (31.7 lbs) average weight loss at 64 weeks, compared with 2.4% with placebo. Responder rates were also strong: 76.3% of patients lost at least 5% of body weight, 59.8% lost at least 10%, 47.0% lost at least 15%, and 27.9% lost at least 20%. By comparison, Trial 1 Foundayo 17.2 mg dose patients achieved 11.1% (25.2 lbs) average weight loss at 72 weeks, compared with 2.1% with placebo. In that group, 71.5% lost at least 5% of body weight, 54.5% lost at least 10%, 35.9% lost at least 15%, and 18.4% lost at least 20%.” – In other words, in every respect, Novo > Eli L.
What about the benefits regarding cardiovascular diseases? Etc.
I got a similar feeling from Ummon’s writing. If one has sought information using AI, a problem with colored glasses might arise. AI is by no means an impartial information gatherer, because AI seeks these different views from a large mass of writings, the impartiality of which is not guaranteed.
By this, I don’t mean that there are no differences in products and that both products have their side effects.
However, at the moment and with the information I have, I would not claim one to be better than the other. People are different, so it’s clear that one might suit some better than others.
The article below explains that Novo will begin selling its current diabetes medication in the United States as tablets under the name Ozempic.
The drug contains semaglutide, just like Rybelsus, which is still sold elsewhere. According to the article, the change is related to the competition against Lilly and the company’s investment in new drug formulations as well as more direct-to-consumer sales.
The move comes as Novo Nordisk works to regain market share from Eli Lilly & Co. (NYSE:LLY). The company is focusing on new formulations of its medicines and a more direct-to-consumer approach.
A Wegovy pill introduced in January recorded the strongest launch of any obesity drug to date. Novo Nordisk also introduced a subscription program offering lower monthly prices for the drug.
Below is an article about how the strong start of Novo’s Wegovy tablet has reportedly revolutionized the weight-loss drug market, while challenging Lilly’s previous dominance in this field. Oral GLP-1 drugs are expanding the market significantly by attracting new user groups with their affordability and ease of use compared to traditional injections.
According to the article, this development is “forcing” investors to re-evaluate the market situation; even though Lilly brought its own Foundayo pill to the market, Novo’s head start and aggressive marketing have surprised analysts.
And while the pills are important to both Novo and Lilly, analysts say they won’t define either company.
“Yes it’s shaking things up, but I still think Lilly has enough components to excel,” BMO’s Seigerman said. “And while Novo may win with this, they need more than one win to be the champion.”
In my opinion, Novo’s pill launch is a major success, and we will soon know how it affects the company’s figures. Sentiment regarding Novo is currently so poor that the Q1 earnings report could turn it around. Hopefully, Novo can regain market share with the pill and win this round. It will also be interesting to see if there are any changes to the guidance. Currently, the sentiment for Eli Lilly is much more bullish, and for good reason, but hopefully Novo gets a bit of a lift from the Q1 report.
Q1 2026 reported sales increased by 32% at CER, positively impacted by a provision reversal related to the 340B Drug Pricing Program in the US.
Q1 2026 adjusted sales, excluding the 340B provision reversal, decreased by 4% at CER, driven by lower realised prices, partly offset by GLP-1 volume growth across geographies. Q1 2026 adjusted Obesity care sales increased by 22% at CER.
US Operations adjusted sales decreased by 11% at CER in Q1 2026, driven by lower realised prices, partly offset by volume growth across the Wegovy® product portfolio.
International Operations sales increased by 6% at CER in Q1 2026, driven by higher volumes.
Q1 2026 adjusted operating profit decreased by 6% at CER, while reported operating profit increased by 65% at CER, driven by a provision reversal related to the 340B Drug Pricing Program in the US.
Commercial highlights
Wegovy® pill was launched in the US on 5 January 2026, and for the week ending 17 April, total weekly prescriptions exceeded 200,000. Coupled with total prescriptions for Q1 2026 of around 1.3 million and now more than 2 million since launch, it marks the strongest-ever GLP-1 volume launch in the US. Q1 2026 sales for Wegovy® pill reached DKK 2,256 million, impacted by pre-launch pipeline fill with wholesalers and telehealth partners.
Pending regulatory decisions, the first Wegovy® pill launches outside the US are expected during the second half of 2026.
Pipeline progress
Within obesity, Wegovy® HD (injectable semaglutide 7.2 mg) was approved by the FDA in March and subsequently launched in the US on 7 April. In the STEP UP trial, Wegovy® HD provided 20.7% mean weight loss.
Within obesity, the zenagamtide AMAZE phase 3 programme was initiated.
Within diabetes, Awiqli®, the first-ever once-weekly basal insulin for type 2 diabetes, was approved by the FDA.
In sickle cell disease, etavopivat successfully met both co-primary endpoints in the HIBISCUS phase 3 trial.
Outlook
The 2026 outlook is raised, driven by increased expectations for GLP-1 product sales.
Adjusted sales growth for 2026, which excludes the 340B provision reversal, is now expected to be -4 to -12% at CER.
Adjusted operating profit growth, also excluding the 340B provision reversal, is now expected to be -4 to -12% at CER.
Prices are heading for a race to the bottom. Investments have been made in production facilities, and they should be in top shape. One-off items improving the bottom line are coming in, so on paper, things look good.
I wasn’t originally the biggest fan of the Nokia comparison, but there certainly is a lot in common with Nokia circa 2005-2015.
One could think that there is plenty of room for a rise today, as the bitter pill is selling well.
It’s a bit strange to compare Novo to Nokia, as you’d really have to scramble to find any similarities.
Nokia killed its mobile business all on its own through the actions of its own leaders. The company’s management had completely lost their understanding of the market and focused on defending short-term results at the expense of future competitiveness. In my opinion, there is no such thing on the horizon for Novo, and the company is ready to put in the work for the continuous development of its products’ competitiveness.
Defensive victory. I am officially declaring the end of my Novo-bearishness here. Based on the opening rounds, Wegovy vs Foundayo looks to be a win for Denmark.
Early responders (15% or more weight loss after 24 weeks) to the higher dose of Wegovy® (semaglutide 7.2 mg) achieved on average 27.7% mean weight loss at week 72 in the STEP UP trial1
Participants treated with the higher dose of Wegovy® reached weight loss goals faster as compared to semaglutide 2.4 mg1
The majority of the weight loss comes from losing body fat: 84% of weight loss with Wegovy® (semaglutide 2.4 and 7.2 mg) can be attributed to reductions in fat mass, while preserving muscle function and improving muscle health2
Novo Nordisk A/S: Wegovy® delivered substantial weight loss in women across all menopause stages, plus heart and migraine protection, shown in new Novo Nordisk data at the European Congress on Obesity
Wegovy® showed an average 22.6% weight loss for premenopausal women with obesity, with more than 4 in 10 (41.4%) achieving 25% or more weight loss1.
Substantial weight loss was consistent across all menopausal stages, as well as major reductions in waist circumference, a key indicator of metabolic health1.
Women taking Wegovy® had an average 42–45% lower risk of migraine starting six months after initiation, and a 25% lower risk of depression, compared with menopausal hormone therapy alone2.
