Advancements in obesity treatment: Emerging therapies and future directions

Obesity drugs are advancing with over 100 drugs in development. New treatments combining GLP-1 with other hormones are being developed. Emerging therapies may also treat Parkinson's and Alzheimer's.

---

By Chantell Sell Reagan, PharmD | Original Article

There are over 100 drugs in the obesity pipeline, with two pending Food and Drug Administration (FDA) approvals this year. Novo's oral semaglutide, which is already approved for diabetes as Rybelsus, is expected to be approved for obesity in November. The drug may have some limits on how much you can take (like Rybelsus). You must take it first thing in the morning, without eating or drinking anything, and then wait 30 minutes before eating or drinking anything else or taking other medications.

Lilly’s oral orforglipron product may also receive approval by the end of 2025, and both are expected to launch in early 2026. Orforglipron is a non-peptide GLP-1 agonist, but won’t require refrigeration. Orforglipron isn't expected to have the same dosing restrictions as oral semaglutide, but gastrointestinal side effects are the most common for both drugs. IPD Analytics says the new oral products may cost the same as the existing injectable drugs, but that's not clear yet.

Pharmaceutical companies are now focusing on next-generation treatments that combine GLP-1 with other hormones (like GIP and glucagon) to improve outcomes, personalize care and address related health conditions such as diabetes, liver disease and heart disease. New drugs in development aim to increase fat loss while maintaining muscle, and some use artificial intelligence to accelerate innovation.

Emerging biotech partnerships and novel therapies, like multi-hormone drugs and metabolic gene silencers, are expected to shape the next wave of obesity care. Some advancements might be available within the next few years.

Obesity medications pipeline

Drug	Characteristics	Potential advantages
Retratrutide	GLP-1, GIP, Glucagon	More weight loss than tirzepatide and improved blood pressure, blood sugar lipids and liver function
Caraglutide	GLP-1, GIP and an antibody compound	Monthly injection, although trial showed less weight loss than semaglutide and tirzepatide
Amycretin	GLP-1 amylin	Large weight loss (in small trials so far)
Cagrisema	Semaglutide and an amylin analogue	Weight loss and improvement of blood sugar and HbA1C
Oral Semaglutide	GLP-1	Filed for FDA approval for weight loss; already marketed for diabetes
Orforglipron	GLP-1 small molecule	Requires no cold storage
Icosema (and others)	GLP-1 and insulin	Reduces injections for those with diabetes
Apitegromab (a drug added to GLP-1s and not of this class)	Myostatin inhibitor	Led to better preservation of lean muscle mass when added to tirzepatide

Other conditions now being evaluated for GLP-1 effectiveness include:

• Parkinson’s disease

• Alzheimer’s dementia

• Alcohol use disorder

  
  

These drugs are also being tested for obsessive-compulsive disorder, opioid use disorder, gambling and other mental health diagnoses, although these aren't mentioned in this review. This review also doesn’t mention that GLP-1 drugs are associated with decreases in many types of cancer when used to treat diabetes.