The next major competition in obesity treatment is moving from weekly injections to oral medications. For many patients, a tablet could offer a simpler alternative to injectable therapy, potentially improving convenience and expanding access.

The need is substantial. According to the U.S. CDC/NCHS, 40.3% of U.S. adults aged 20 and older had obesity in August 2021–August 2023, while another 31.7% were overweight. Severe obesity affected 9.7% of adults.

This large patient population is encouraging pharmaceutical companies to invest heavily in oral GLP-1 and next-generation oral incretin therapies.

Novo Nordisk and Eli Lilly Are Leading the Race

Two companies currently stand out most clearly: Novo Nordisk and Eli Lilly.

Novo Nordisk: Oral Wegovy

Novo Nordisk has taken a major step toward oral obesity treatment with its tablet version of Wegovy (semaglutide).

FDA labeling records show Wegovy is now available in both tablet and injectable forms in the U.S.

Towards Healthcare’s analysis reports that the oral segment has become an important competitive area, with oral Wegovy capturing approximately 90% of the U.S. weight-loss-pill segment shortly after its early-2026 launch.

Novo is also continuing to test lower maintenance doses of oral Wegovy. A newly registered trial is evaluating lower doses in approximately 450 overweight participants, with the study expected to continue through 2028.

This suggests Novo is looking beyond simply launching a tablet it is also exploring how dosing and affordability could broaden patient access.

Eli Lilly: Orforglipron

Eli Lilly has become Novo Nordisk’s most important competitor in oral obesity treatment.

The FDA approved Foundayo (orforglipron) on April 1, 2026, for adults with obesity or adults who are overweight with at least one weight-related comorbidity, alongside a reduced-calorie diet and increased physical activity.

Unlike oral semaglutide, orforglipron is designed as a small-molecule oral GLP-1 receptor agonist and does not require patients to take it on an empty stomach.

That could be an important practical advantage for patients.

Why Orforglipron Matters

The FDA approval was supported by two randomized, double-blind, placebo-controlled trials involving adults with obesity or overweight plus weight-related comorbidities. At 72 weeks, the Foundayo groups achieved statistically significant and clinically meaningful weight reduction compared with placebo.

Eli Lilly is therefore competing not only on efficacy but also on ease of administration.

Pfizer: Oral GLP-1 Development Has Faced Setbacks

Pfizer has also invested heavily in oral obesity drugs, although its path has been more challenging.

The company discontinued danuglipron, one of its oral GLP-1 candidates, in 2025. Towards Healthcare identifies this discontinuation as an important development in the competitive oral GLP-1 landscape.

This illustrates an important point for buyers and investors:

A large obesity pipeline does not automatically translate into a successful oral product.

Companies need to demonstrate a combination of:

• Weight-loss efficacy
• Tolerability
• Convenient dosing
• Long-term safety
• Manufacturing scalability
• Competitive pricing

Why Oral GLP-1 Drugs Are Becoming So Important

The biggest advantage is convenience.

An injectable GLP-1 requires a patient to administer medication through an injection, while an oral formulation can potentially fit more easily into an existing medication routine.

That could be particularly important for people who:

• Dislike needles
• Prefer tablets
• Want simpler treatment routines
• Are considering obesity treatment for the first time
• Need long-term maintenance therapy

The FDA itself describes obesity as a chronic disease associated with significant health risks, including type 2 diabetes, hypertension, cardiovascular disease, dyslipidemia, sleep apnea, osteoarthritis, and some cancers.

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Government Data Shows the Size of the Obesity Challenge

The latest CDC/NCHS data show how large the potential treatment population is.

U.S. adults

40.3% of adults aged 20+ had obesity.

Severe obesity

9.7% had severe obesity.

Overweight including obesity

72.4% of adults aged 20+ were overweight, including those with obesity.

The prevalence is also particularly high among middle-aged adults. CDC data show obesity affected 46.4% of adults aged 40–59, compared with 35.5% among adults aged 20–39 and 38.9% among adults aged 60 and older.

These numbers explain why pharmaceutical companies see oral obesity medicines as a potentially important next step in expanding treatment options.

Oral Wegovy vs. Orforglipron

The competition can be summarized simply.

Novo Nordisk’s oral Wegovy brings the company’s established semaglutide platform into tablet-based obesity treatment.

Eli Lilly’s orforglipron introduces a small-molecule oral GLP-1 approach designed around convenient daily administration.

The key difference is not simply Novo vs. Lilly.

It is:

Established semaglutide efficacy and brand recognition vs. a new oral molecule designed for convenience.

For patients, physicians, payers, and healthcare systems, factors such as efficacy, safety, adherence, pricing, supply, and reimbursement will ultimately determine which products gain the greatest adoption.

Towards Healthcare’s View

Towards Healthcare identifies oral GLP-1 therapy as one of the most important competitive developments in the obesity-treatment landscape.

Its U.S. semaglutide analysis highlights the rapid evolution of the oral segment and notes that Novo Nordisk’s oral Wegovy became the dominant oral weight-loss product shortly after launch, while Eli Lilly’s orforglipron emerged as the most credible near-term competitor.

The broader competitive landscape is therefore shifting from a two-product injectable battle toward a much wider ecosystem involving:

Oral GLP-1s → Injectable GLP-1s → Dual agonists → Next-generation incretins → Lower-dose maintenance therapies

This creates opportunities not only for pharmaceutical companies but also for CDMOs, clinical research organizations, drug-delivery companies, digital-health providers, pharmacies, and healthcare systems supporting obesity treatment.

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What Buyers Will Look For in Oral GLP-1 Drugs

For physicians, payers, healthcare providers, and patients, the most important factors are likely to be:

1. Clinical effectiveness

How much meaningful and sustained weight loss does the medicine provide?

2. Tolerability

Can patients remain on treatment long term?

3. Convenience

Does the tablet fit easily into everyday routines?

4. Pricing

Can patients and healthcare systems afford long-term treatment?

5. Supply

Can manufacturers reliably produce enough tablets to meet demand?

6. Cardiometabolic benefits

Can the medicine provide benefits beyond weight reduction?

7. Long-term evidence

Does the therapy demonstrate safety and effectiveness over extended treatment periods?

The Next Phase of the Obesity Drug Race

The approval of Foundayo has changed the competitive landscape.

There are now two important oral obesity options from the industry’s leading companies, with Novo Nordisk’s oral Wegovy and Eli Lilly’s orforglipron competing for patients who prefer a tablet.

At the same time, other pharmaceutical companies continue to investigate oral incretin approaches and next-generation obesity medicines.

For the industry, the goal is becoming broader than simply developing a drug that produces weight loss.

The bigger opportunity is to create a treatment that combines:

Strong efficacy + convenient administration + tolerability + affordability + reliable supply

Expert View by Payal Rabde – highlighting the trends shaping the future of healthcare.

About Us

Pharma Geek is a part of Towards Healthcare Research & Consulting which is a global healthcare market research and consulting firm dedicated to helping businesses make informed decisions through reliable market intelligence and strategic insights. We serve pharmaceutical, biotechnology, medical device, AI in healthcare, cell and gene therapy, digital health, and life sciences organizations with in-depth market research, custom consulting, competitive analysis, and growth forecasts. Our team combines industry expertise with rigorous research to deliver clear, actionable insights that support market expansion, product strategy, investment decisions, and long-term business growth. From emerging innovations to established healthcare markets, we help organizations understand where the industry is today and where it’s headed tomorrow.

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