The battle for weight loss drugs is going to be huge

Mounjaro, already on the market to treat Type 2 diabetes in the U.S., is going head to head with Novo’s drug. The stakes are enormous in need, expected to be over $30 billion by 2030, according to analysts at Cowen Inc. Novo Nordisk was projected to capture the largest share, with Wegovy sales topping $7 billion, but if Lilly’s head-to-head trials turn out well Mounjaro, and Lilly, could be huge winners.

The hype says, “Mounjaro helped a typical person with obesity who weighed 230 pounds lose up to 50 pounds during a test period of nearly 17 months”. What’s not mentioned is whether these people also included diet and exercise to lose those pounds.

There is a tremendous amount of money to be made for whoever captures the market lead, but there are still several obstacles. First, insurers are reluctant to cover the drugs for weight loss because of the high cost. Second, we need to understand what the long-term use of these drugs does to patients. Finally, most patients regain their weight when they stop using these drugs.

I’ve been talking with physicians about these drugs, and their opinions vary. Some are worried about the side effects and potential costs to patients, but when I probe more deeply, they are concerned that these drugs don’t change patient behavior.

As for side effects, the NY Times published an article that suggests there may be other issues. According to the report.” some people taking Ozempic can experience such intense lack of appetite that they become malnourished.”

No standard nutritional guidelines have yet been established for patients taking Ozempic or other medications that work similarly, like Wegovy and Mounjaro. Doctors usually give similar dietary recommendations to people taking drugs like Ozempic and other patients trying to lose weight or who have diabetes, said Dr. Robert Gabbay, the chief scientific and medical officer of the American Diabetes Association. That means following a diet high in fruits, vegetables, and fiber, like the Mediterranean diet, said Dr. Janice Jin Hwang, the division chief of endocrinology and metabolism at the University of North Carolina School of Medicine.

A Reality Check?

Based on what I’m hearing and reading, I believe the market for weight loss drugs may be exaggerated. I have talked to many people who tried one of the drugs and were almost bedridden by the side effects, that she said she spent a lot of time in the bathroom. She also said she ate a tiny doughnut and immediately was struck with diarrhea. As she said, “Yes, I want to lose weight, but in my family, an evening dinner is a social event, plus I love to cook”.

What I believe will happen is that drug makers will spend more on research into diet drugs and come up with products that don’t have the nasty side effects of the injectables. The golden carrot is dangling, and Wall Street is betting on Lilly as the potential winner.