Eli Lilly's Foundayo and Retatrutide Could Bolster Lead Over Novo Nordisk in the Obesity-Drug Market

Novo Nordisk and Eli Lilly have been competing for dominance in the fast-growing anti-obesity drug market, with the rivalry shifting again as Eli Lilly prepares to launch its next oral option. Novo Nordisk’s Wegovy pill received approval in December, while Eli Lilly’s newly approved GLP-1 oral pill, Foundayo (orforglipron), is set to be available starting April 6.

Round two: oral GLP-1 pills enter the market

Novo Nordisk opened the oral GLP-1 market with its Wegovy pill, but Eli Lilly has moved quickly to close the gap in the U.S. The new product cycle is expected to intensify competition between the two companies as both pursue patients who prefer oral dosing over self-injection.

Early demand and a key dosing difference

Early demand for Novo Nordisk’s oral Wegovy suggests there is significant unmet appetite for anti-obesity drugs that do not require self-injection. Eli Lilly is second to market with orforglipron, but the article highlights a major practical advantage: orforglipron does not come with food or water restrictions.

By contrast, patients taking the Wegovy pill must take it on an empty stomach and avoid food or other medications for 30 minutes, because stomach enzymes can break down the drug if taken incorrectly. The article also notes that Novo Nordisk’s Rybelsus, a GLP-1 pill for diabetes, has similar restrictions and has not reached sales levels comparable to Ozempic.

Potential “knockout” follow-on: retatrutide in phase 3

The article argues that Eli Lilly’s longer-term competitive edge may depend on its next pipeline move. It points to retatrutide, described as a subcutaneous triple-hormone receptor agonist and the first of its kind, which is still in phase 3 trials.

In the first phase 3 trial cited, patients taking the 12 mg dose lost an average of 28.7% of body weight over 68 weeks. By comparison, Novo Nordisk’s next-generation subcutaneous drug, cagrilintide-semaglutide (CagriSema), achieved an average 23% reduction over 84 weeks in a recent trial, but failed to meet its primary endpoint of noninferiority versus Lilly’s tirzeputide (the drug sold as Mounjaro and Zepbound).

Impact and outlook for the companies

With orforglipron arriving after Wegovy, the article suggests Eli Lilly could still gain share in oral weight-loss therapy due to the absence of food and water restrictions. It also frames retatrutide as a potential longer-term differentiator, while noting that Novo Nordisk’s next potential winner remains further away because drug development takes years.

As a result, the article concludes that Eli Lilly may be able to maintain momentum with both orforglipron and retatrutide for the foreseeable future.