Ozempic and the class of weight loss drugs it now represents have left their mark everywhere: in the lives of millions who’ve experienced unprecedented weight loss, on grocery store shelves with products tailored for those on medication, and even in insurance company calculations that
investigate the effects of medication on mortality
.
(Yes, there’s even an
Ozempic Thanksgiving Guide
.)
Despite all of these societal changes brought about by GLP-1 drugs, their high price limits access. Many patients discontinue medications due to adverse side effects, and others who could benefit are deterred by the need for injections.
Weight Loss Injections: Tablets, More Effective Injections, and New Active Ingredients Arrive
Table of Contents
- Weight Loss Injections: Tablets, More Effective Injections, and New Active Ingredients Arrive
- Natural Alternative to Weight Loss Injections: 10 Foods for More GLP-1 Production
- Next Generation Pills – Like Henry Ford and the Car
- Weight Loss Tablets Tested So Far Don’t Work as Well as the Injection
- More Weight Loss, Fewer Side Effects?
- Molecules Suppress Appetite to Produce a Stronger Effect
- A Monthly Dose of a Weight Loss Medication?
- Will Anyone Still Be Taking Ozempic in Five Years?
A new wave of drugs is on the horizon, potentially transforming human health: tablets, more effective injections, and new active ingredients that may have fewer side effects or require only monthly administration. “With this new generation of drugs, we’re not just focusing on weight loss,” said David Lau, an endocrinologist and professor emeritus at the University of Calgary Cumming School of Medicine. “We’re talking about changes that go beyond what you see on the scale.”
Whether these next-generation treatments can deliver on this promise remains uncertain. The Food and Drug Administration has not yet approved them, and the agency has warned consumers about unapproved versions advertised online. It’s also common for the FDA to identify new risks after drug approval, as seen with current GLP-1 blockbusters.
Next Generation Pills – Like Henry Ford and the Car
The potential of these future products is so great that Eli Lilly reached a stock market value exceeding $1 trillion on Friday, November 21 – the first healthcare company to achieve this milestone. Here’s a look into the future, with analysis from obesity researchers involved in key clinical trials.
Novo Nordisk and Eli Lilly are preparing to launch once-daily weight-loss pills next year, pending FDA approval. This would eliminate the need for injections with tiny needles. “Some people are afraid of needles and of injecting themselves,” Lau said. Pills don’t require refrigeration – simplifying shipping and storage – and may be more affordable.
“What Henry Ford did with cars wasn’t make a better car. He just built more of them and made them more accessible,” said Sean Wharton, a doctor and researcher in Toronto and lead author of two articles published in September in the New England Journal of Medicine. By increasing convenience and lowering costs, these pills could have a similar impact on weight loss.
Weight Loss Tablets Tested So Far Don’t Work as Well as the Injection
The downside is that tablets tested to date haven’t been as effective. In year-long clinical trials, participants lost an average of 11 to 14 percent of their body weight. In comparison, the most effective injectable medications result in 15 to 20 percent weight loss.
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Novo Nordisk’s Wegovy tablet is likely to be the first available. The company anticipates an FDA decision before year-end and potential market launch in early 2026. Eli Lilly promotes its GLP-1 tablet, Orforglipron, as more convenient because it doesn’t impose dietary restrictions.
Anticipation for the pills is so high that they’ve already been included in drug pricing negotiations with the White House. Novo Nordisk and Eli Lilly reached agreements with the administration earlier this month to offer certain drugs at a discount, gaining access to Medicare, which previously didn’t cover weight-loss medications. Both companies will offer the lowest dose of their new pills, if approved, for $150 per month.
More Weight Loss, Fewer Side Effects?
Today’s weight loss drugs act like keys, unlocking the body’s natural processes and instructing it to produce more gut hormones that signal the brain to stop eating. Existing medications target one or two of these hormones. Eli Lilly is developing a drug targeting three hormones, potentially leading to even greater weight loss.
Clinical trial participants taking the highest dose of this drug lost an average of 24.2 percent of their body weight within 48 weeks, according to a 2023 publication. Researchers believe this effect could be even larger over a longer period.
“There are patients with severe obesity who need stronger agents,” said Ania Jastreboff, director of the Yale Obesity Research Center and lead author of the 2023 study. She is also co-writing a forthcoming book on obesity with Oprah Winfrey.
Before Eli Lilly seeks FDA approval, the company awaits results from several large clinical trials of the drug retatruide, expected by the end of next year. A potential risk for some patients is excessive weight or muscle mass loss.
Molecules Suppress Appetite to Produce a Stronger Effect
Drugmakers are also combining molecules known to suppress appetite for a more potent effect. Novo Nordisk’s experimental drug CagriSema combines semaglutide, the active ingredient in Ozempic and Wegovy, with a compound mimicking another gut hormone, amylin. A clinical trial showed the combination increased average weight loss to about 20 percent of body weight – 5 percent more than semaglutide alone. The company expects to seek FDA approval for CagriSema next year. Eli Lilly released clinical trial data for a drug stimulating amylin earlier this month.
“We have been studying amylin for weight loss for over 20 years,” said Louis Aronne, director of the Comprehensive Weight Control Center at Weill Cornell Medicine. “In some ways, it might be a better drug,” he said, adding that it appears to result in less lean muscle mass loss and fewer stomach side effects.
A Monthly Dose of a Weight Loss Medication?
While many consider a daily pill more convenient than a weekly injection, drugmakers are exploring another frontier: a drug producing weight loss comparable to current best-in-class options, requiring only monthly injection.
Earlier this month, Pfizer outbid Novo Nordisk in a bidding war to acquire biotech Metsera, whose leading once-monthly weight-loss products are in development. Amgen’s experimental drug MariTide showed up to 16 percent average weight loss over a year, though data on side effects has raised analyst concerns. Jastreboff, the MariTide study lead author, envisions a future where “monthly or less frequent” injections will be an option for patients.
Will Anyone Still Be Taking Ozempic in Five Years?
Eli Lilly’s tirzepatide-based drugs, Mounjaro and Zepbound, generated approximately $25 billion in the first nine months of the year, making them the world’s best-selling drugs. Novo Nordisk’s Ozempic and Wegovy aren’t far behind, with sales equivalent to $23.5 billion during this period. But with patients having a choice between a weight-loss pill, a more effective injectable, or a drug with fewer side effects, what’s the appeal of the current blockbusters?
These drugs could be long-lasting, researchers say. Years of data on the safety of GLP-1 drugs exist outside of clinical trials. The FDA has approved Wegovy not only for weight loss but also for reducing cardiovascular risk, while Zepbound is also approved as
treatment for sleep apnea
.
However, it’s uncertain whether other drugs coming to market, however promising, will offer the same benefits.
“This is the hurdle that every other class has to overcome to show that it can reduce the risk of heart attack, stroke, and death,” Aronne said. Market competition and government policy also drive down prices, meaning any new drug must be superior to justify a higher price than today’s GLP-1 drugs. “More choices also create more competition,” Jastreboff said, hoping it will lower costs and increase accessibility.
Semaglutide, Wharton said, is “a really beautiful molecule” with potential long-term benefits for conditions like coronary heart disease and osteoarthritis. Looking ahead to next-generation treatments, he offered a technological metaphor. “Nobody uses the iPhone 1 anymore, right?” he said. “But sometimes I wish I had my Blackberry back.”
Daniel Gilbert writes about the business of medicine. He was previously an investigative reporter for The Seattle Times and previously covered economics for The Wall Street Journal. For confidential information, he can be reached on the encrypted messaging app Signal at (773) 350-6933.
This article was first published in English on November 27, 2025.
