Summary
- The obesity rate in the U.S. has been rising, with about 40% of adults considered obese between 2021 and 2023, but new medications have helped decrease the rate to 37% by 2025.
- GLP-1s and similar drugs, originally developed for diabetes, are now approved and widely used for obesity treatment; notable options include Saxenda, Wegovy (including a new oral version), and Zepbound, which have demonstrated significant sales and effectiveness.
- These medications work by mimicking hormones that regulate hunger and blood sugar, and ongoing developments promise to further impact obesity rates and the U.S. healthcare system.
What’s ahead in the GLP-1 and similar market in 2026
The obesity rate has been increasing over time in the U.S. From August 2021 to August 2023, about 40% of American adults were considered obese. A recent study shows that without intervention and advances, these rates could continue to rise for another 20 years. Complications related to obesity can include heart disease, high cholesterol, sleep apnea, diabetes, and certain cancers.
Enter glucagon-like peptide-1s (GLP-1s) and similar drugs which have transformed obesity treatment and have bent the curve, bringing the obesity rate down by almost 3%. In 2025, the obesity rate was estimated to be 37%. Originally developed to treat diabetes, GLP-1s and similar drugs are now on the market to treat obesity (and other conditions like sleep apnea and metabolic dysfunction-associated steatohepatitis [MASH]). GLP-1s and similar drugs mimic the hormone glucagon and slow down the speed in which food moves through the system, making people feel full more quickly.
In this blog, we look at where GLP-1s and similar drugs for the obesity market currently stand, where the market is headed, and what this could mean both for Americans and the U.S. healthcare system.
Currently approved GLP-1s and similar for obesity
These GLP-1s and similar drugs are currently approved for weight loss:
- Novo Nordisk’s Saxenda® (liragutide) was approved in December 2014. As of June 2025, Saxenda had annual sales of $165 million. A generic version of Saxenda was approved in August 2025.
- Novo Nordisk’s Wegovy® (semaglutide) was initially approved in June 2021. In 2024, sales of Wegovy were about $8 billion. In December 2025, an oral version of Wegovy was approved, making it the first oral GLP-1 to treat obesity. The starting 1.5 mg dose costs $149 a month for patients paying cash, and the 4 mg dose is expected to be $149 a month through April 15. After that date, the cost is expected to increase to $199 a month. The 9 mg and 25 mg doses are $299 a month. Patients who pay in cash can also get the starting dose for $149 a month on TrumpRx under a deal made in November 2025. The Wegovy pill is also now available nationwide.
- Eli Lilly & Co.’s Zepbound® (tirzepatide) was approved in November 2023 and is currently shown to be the most effective GLP-1. It exhibits up to 22.5% average weight loss in trials. Zepbound had sales of about $4.9 billion in 2024. Tirzepatide is a dual agonist—it mimics both a GLP-1 and a glucose-dependent insulinotropic polypeptide (GIP).
GIP is a hormone naturally produced in the small intestine which plays a role in food processing and energy storage, helping to control levels of blood sugar and regulating the perception of hunger.
In the pipeline
Drugmakers are searching for the perfect magic bullet—that combination of hormones that will best trigger weight loss, maintain muscle mass, and result in the least amount of side effects.
There are many new drugs in the pipeline with some offering an oral version rather than an injection.
The most anticipated include:
- An oral, “non-peptide” GLP-1 receptor agonist, orforglipron from Eli Lilly & Co. This is a once daily small molecule pill with less dosing restrictions than oral Wegovy. In December 2025, the company announced positive results in maintaining weight loss after switching from injectable drugs. The company is expected to sell it competitively for near $149 a month for starting doses and up to $399 per month for higher doses. In November 2025, the FDA granted the drug its Commissioner’s National Priority Voucher, meaning review time would be one to two months instead of the standard 10 to 12 months. In December 2025, Eli Lilly said it filed an application with the FDA and expects an action date of April 10, 2026.
- CagriSema from Novo Nordisk. This is an injectable, once-weekly combination of cagrilintide (an amylin analog) and semaglutide. Amylin is a pancreatic hormone secreted with insulin. Amylin analogs can help with glycemic control by increasing feelings of fullness and slowing stomach emptying. CagriSema was submitted to the FDA in December 2025 and approval is expected late this year.
- Amycretin from Novo Nordisk. This is being developed in both injection and oral forms. Amycretin is a GLP-1 and an amylin receptor co-agonist, meaning it activates amylin receptors and another metabolic receptor (in this case, GLP-1). The projected approval date is in 2030.
- Retatrutide from Eli Lilly. An injection and a triple-receptor agonist (nicknamed “Triple G”), it targets GLP-1, GIP, and glucagon. Lilly’s triple agonist, retatrutide, delivered weigh loss of up to an average of 71.2 lbs. along with substantial relief from osteoarthritis pain in the first successful Phase 3 trial. Phase 3 trials should end early this year. It may be approved and available in late 2026 or early 2027.
Most recent changes
- Zepbound KwikPen is a Eli Lilly product that is newly launched. This is a new form of its blockbuster obesity drug, Zepbound, that offers a month’s worth of doses in a single pen.
- Novo Nordisk on Tuesday said it plans to slash the monthly list prices of its popular obesity and diabetes drugs in the U.S. by up to 50% starting in 2027.
Utilization and uptake of weight loss medications
GLP-1 and similar utilization has soared since 2021. In 2025, the market size of GLP-1s and similar was expected to be over $70.08 billion. By 2034, the market size for GLP-1s and similar could grow as large as $322.85 billion.
Up to 12% of American adults have used a GLP-1 for weight loss. Use is highest in women age 50 to 64. And for those who have not taken a GLP-1, 22% said they would be interested in taking one for weight loss.
As the use of GLP‑1 and similar medications continues to grow—and is expected to keep rising— drug spend increases as well.
Traditional drugs have historically not been the main drivers of drug spend—specialty drugs often account for the bulk of drug spend. But a 2025 report from Evernorth Research Institute shows that with the increasing use of GLP-1s, traditional drug spend now surpasses specialty spend. Weight loss therapy contributed to a 46.8% increase in drug spend in 2024, and GLP-1s were the main reason. By the end of 2025, the increase in utilization of GLP-1s for weight loss was expected to be 73.1%.
As utilization increases, employers are grappling with how to respond to the surge in care costs. WTW’s Best Practices in Healthcare 2025 survey said that 57% of employers are currently covering GLP-1s for weight loss, but that 9% are thinking about removing this coverage. Seventy-three percent of employers say they are dealing with more cost pressure than ever in the past 10 years. And nearly 80% of employers would cover GLP-1s if the costs for doing so were lower.
Price changes
The cost of weight loss drugs has fluctuated since they came onto the market. In 2025, there were many changes related to direct-to-consumer (DTC) pricing. The government also introduced new pricing strategies for weight loss drugs.
In November 2025, Novo Nordisk and Eli Lilly entered into pricing agreements with the government under TrumpRx and lowered the cost of several weight loss drugs. If bought through TrumpRx, the monthly price of Ozempic® and Wegovy is roughly $350—this is down from $1000 for Ozempic and $1350 for Wegovy. The TrumpRx price is for cash pay, commercial, and various other government-sponsored, insured products. The price of Zepbound is expected to average $346 monthly, down from $1086. People on Medicare/Medicaid will get an even lower price via TrumpRx for these drugs than those paying the previously mentioned cash prices. People on Medicare can use TrumpRx prices as a comparison tool when reviewing drug coverage options.
Also in November 2025, Novo Nordisk announced that it was decreasing the DTC price of Wegovy and Ozempic for existing patients paying cash. In a November 17, 2025, announcement, Novo Nordisk said that Wegovy will cost $349 a month for cash payers and that the same cash price would apply to Ozempic (except the 2 mg highest dose, which would stay at $499 per month). In December 2025, Eli Lilly announced additional price cutting for Zepbound under its DTC platform. Beginning on December 1, 2025, people paying in cash could receive the starting dose of Zepbound for as little as $299 a month. The next dose up (5 mg) will be $399 a month and other doses will be $449 a month, provided patients refill within 45 days for those other doses.
While it’s unclear what else may happen with pricing in 2026, these developments help to increase access to these drugs.
Final thoughts
GLP-1s and similar have shifted from being known as diabetes drugs to playing a large role in obesity treatment. The increased uptake of these drugs is already affecting healthcare in the U.S. With the addition of more therapies for weight loss, there could be additional profound effects. We are already seeing improved access, greater adherence, and the expansion of patients being treated with these drugs. In 2026 and beyond, there is tremendous opportunity—but also comes the continued challenges of cost and disparity in treatment. By combining innovation, expanded coverage, and additional healthcare support, we may see a major shift in the overall health and well-being of those living with obesity.
References
Witters, Dan and James, Mary Page. Obesity Rate Declining in U.S. Gallup. October 28, 2025.
Saxenda FDA Approval History. Drugs.com.
Wegovy FDA Approval History. Drugs.com.
Zepbound FDA Approval History. Drugs.com.
Will Retatrutide Be Available in 2026–2027? Heally. October 14, 2025.
Cubanski, Juliette. Recent Trends in GLP-1 Use and Spending in Medicare. KFF.com. January 30, 2026.
2025 Pharmacy in Focus Report. Evernorth Health Services.
Healthcare cost pressures drive employers to consider disruptive changes. WTW. October 10, 2025.
The Challenges of Healthcare Logistics Through the Lens of GLP-1 Medications. DKSH.
GLP-1 Receptor Agonist Market (2026 – 2033) Size, Share & Trends Analysis Report By Product (Trulicity, Wegovy, Ozempic, Mounjaro), By Application (Diabetes, Obesity), By Route Of Administration, By Region, And Segment Forecasts) Grandview Research.com
https://www.lilly.com/news/stories/what-to-know-about-orforglipron
Lilly Investors. December 11, 2025.
Manalac, Tristan. FDA Delays Decision for Lilly’s Obesity Pill Orforglipron, Other Priority Voucher Awardees: Report. Biospace.com. January 15, 2026.
The Challenges of Healthcare Logistics Through the Lens of GLP-1 Medications. DKSH.com. December 19, 2025.
https://www.rand.org/pubs/research_reports/RRA4153-1.html
Eli Lilly launches new form of obesity drug Zepbound with a month’s worth of doses in one pen