Can NVO Maintain Obesity Leadership With Next-Generation Candidates?

Novo Nordisk NVO has achieved tremendous commercial success with its blockbuster semaglutide products, Wegovy (for obesity) and Ozempic (for diabetes). However, the company’s growth trajectory has suffered recently.

In July 2025, the company revised its sales and profit outlook for the year, reflecting slower-than-expected uptake for Wegovy and Ozempic, due to intensifying competition from arch-rival Eli Lilly LLY and compounded semaglutide alternatives in its largest obesity market, the United States. Eli Lilly’s tirzepatide-based drugs, Mounjaro (diabetes) and Zepbound (obesity), have captured rapid demand and market share, pressuring NVO’s position in both obesity and diabetes markets.

To tackle the same, Novo Nordisk is developing several next-generation obesity candidates, especially targeting the lucrative U.S. market, to solidify its leadership position.

The most advanced candidate in Novo Nordisk’s pipeline is CagriSema injection, a fixed-dose combination of a next-generation long-acting amylin analogue, cagrilintide, and Wegovy. CagriSema met the primary endpoint of statistically significant weight loss in two late-stage studies, REDEFINE 1 and REDEFINE 2, in obesity or overweight patients with one or more obesity-related comorbidities. However, the candidate demonstrated a lower-than-expected reduction in body weight in both studies. NVO is planning CagriSema’s regulatory submission in 2026.

Novo Nordisk recently reported superior weight loss from a sub-analysis of its phase III REDEFINE 1 study, which tested cagrilintide, a once-weekly amylin analogue injection as a monotherapy in obese adults, but without diabetes. The data strengthen Novo Nordisk’s obesity pipeline expansion strategy, with a dedicated phase III RENEW program planned to start in late 2025. NVO is also developing oral and subcutaneous formulations of an early-stage candidate, amycretin, a unimolecular GLP-1 and amylin receptor agonist, which had outperformed Wegovy in a phase I study.

Novo Nordisk has also been pursuing licensing deals and acquisitions to expand its obesity pipeline further. In 2023, it acquired Inversago Pharmaceuticals, which added a small-molecule oral CB1 inverse agonist, monlunabant, to its pipeline. Novo Nordisk signed a $2.2 billion deal with Septerna for the development and commercialization of oral small-molecule medicines for treating obesity, diabetes, and other cardiometabolic diseases.

NVO’s strategic push into next-generation obesity candidates alongside targeted acquisitions demonstrates a calculated approach to sustaining its market lead. While near-term growth faces pressure from slower uptake of Wegovy and Ozempic and rising Eli Lilly competition, NVO’s diversified pipeline and innovative therapies position it to reinforce U.S. obesity dominance and support long-term value creation. 

Competition Heating Up in the Obesity Space

Eli Lilly is Novo Nordisk’s fierce competitor in the obesity space, which markets its tirzepatide medicines as Mounjaro for diabetes and Zepbound for obesity. Like NVO, Lilly is investing broadly in obesity and has several new molecules currently in clinical development with a range of oral and injectable medications with different mechanisms of action. These include two late-stage candidates, orforglipron, a once-daily oral GLP-1 small molecule, and retatrutide, a GGG tri-agonist and some mid-stage candidates, bimagrumab, eloralintide and mazdutide. Lilly plans regulatory filings for orforglipron oral pill for obesity and diabetes indications by the end of 2025.

Several other companies, like Viking Therapeutics VKTX, are also making rapid progress in the development of GLP-1-based candidates in their clinical pipeline. Viking Therapeutics’ dual GIPR/GLP-1 RA, VK2735, is being developed both as oral and subcutaneous formulations for the treatment of obesity. In August 2025, VKTX announced mixed top-line results from a mid-stage study evaluating the safety and efficacy of the oral formulation of VK2735, which caused the stock to drop significantly. Phase III obesity studies with the subcutaneous formulation of VK2735 have also been initiated.

Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free report

This article originally published on Zacks Investment Research (zacks.com).

Zacks Investment Research