Who will dominate obesity treatments? Ranking the top 10 pharma players

The company remains the undisputed leader of the obesity drug market. Its tirzepatide franchise became the world’s best-selling drug in 2025, overtaking Merck’s hugely successful Keytruda and generating more than $36 billion in annual revenue. Eli Lilly has a strong late-stage pipeline that will help it maintain its lead, though Novo Nordisk’s Wegovy Pill appears to have some edge in efficacy.

Having successfully taken the lead in the obesity drug market with semaglutide, the company ran into trouble in 2025 and issued a negative annual sales forecast for the first time since its blockbuster launch. Novo now relies on a successful launch of the injectable Wegovy 7.2 mg, Wegovy tablets and CagriSema to stabilise its US market share and restore investor confidence.

After acquiring Metsera for $10 billion and signing a licensing agreement with YaoPharma in 2025, Pfizer has moved up significantly in the competitor ranking. Although the company previously faced numerous setbacks in obesity drug development — including the discontinuation of danuglipron and lotiglipron — it now appears to have built a viable pipeline and can fully leverage its commercial and manufacturing infrastructure.

Despite historically limited presence in the cardiometabolic space, the company has publicly emphasised its ambition to become a top-three player in obesity treatment. Phase II results for CT-388 are encouraging, and data from Phase II trials of petrelintide — developed jointly with Zealand Pharma — are expected soon.

The company quietly advanced an extensive mid-stage pipeline throughout 2025, and with several Phase II/III results expected in 2026, its licensing deal with CSPC Pharmaceuticals — which added a monthly dual agonist to AstraZeneca’s arsenal — further strengthens its position.

The company is betting on an extended dosing regimen for MariTide as its key competitive advantage in the obesity drug market. While quarterly maintenance dosing is a distinctive feature of the drug, it remains to be seen whether Amgen can overcome tolerability issues that emerged during Phase II trials.

Phase III trial data for survodutide is expected to begin rolling in during the first half of 2026, positioning Boehringer Ingelheim as the first serious contender to take on current leaders Lilly and Novo. Even with positive Phase III data for survodutide, Boehringer will likely need to expand its pipeline beyond its Phase II triple agonist to become a long-term competitive player in the space.

Regeneron was seen as a secondary player in the obesity treatment market, focusing on developing drugs that preserve muscle mass. Its licensing of olatorepib in June 2025 demonstrated the company’s ambitions in the space. However, like Boehringer Ingelheim and Amgen, Regeneron likely needs to further diversify its portfolio to become a leader in this segment.

Driven by CEO Adam Steensberg’s ambition to end what he calls the “weight-loss Olympics”, Zealand is betting that amylin will become the next obesity drug class. Following Zealand’s partnership with Roche on petrelintide, the upcoming Phase II ZUPREME-1 trial results will help assess whether the drug meets expectations under the TPP programme.

After licensing the GLP-1/GIP dual agonist ribupatide from China’s Hengrui — which has already shown high weight-loss efficacy in late-stage trials — Kailera launched its own Phase III programme, evaluating higher doses (>6 mg) over a longer treatment period.