Obesity drugs generated $66 billion in list-price sales in 2025, and IQVIA expects that figure to reach $92 billion this year.
The forecast, published by IQVIA in April, puts annual sales somewhere between $105 billion and $200 billion from 2027 onward, enough to make obesity one of the five most valuable therapy classes in the world by 2030. For investors, the next dollar earns a very different return depending on the size of the company writing the check.
Leen Kawas, CEO of EIT Pharma and managing general partner of the life sciences investment firm Propel Bio Partners, has spent years arguing that drug development succeeds or fails on execution, efficiency and the patient’s experience. Those three filters, applied to the GLP-1 market, sort the boom into a crowded top tier and a set of gaps that remain wide open.
How Big the GLP-1 Market Has Become
J.P. Morgan Global Research estimates that U.S. GLP-1 users grew from 5 million in 2023 to about 10 million in 2025, and projects 25 to 30 million by 2030. The bank sees the global incretin market reaching $200 billion by the end of the decade.
Even so, J.P. Morgan puts GLP-1 use at roughly 2% of the world’s population living with obesity and 7% of people with diabetes. Much of that gap is explained by cost and delivery. Injectable drugs need refrigerated supply chains, and prices have kept coverage patchy even in wealthy markets: 55% of U.S. commercial employers cover GLP-1s for obesity, and 15% of those have since dropped coverage over cost.
Pills are starting to loosen those limits. Novo Nordisk’s oral Wegovy became widely available in January, and IQVIA found it captured about a third of new-to-brand prescriptions within eight weeks of its U.S. launch. Eli Lilly’s Foundayo (orforglipron), the first small-molecule oral GLP-1 approved for weight management, followed on April 1.
Where Obesity Drug Investment Is Flowing
The largest checks are coming from pharma’s biggest balance sheets. IQVIA put Pfizer’s acquisition of Metsera at $10 billion. Roche committed up to $5.3 billion to a partnership with Zealand Pharma on petrelintide, a long-acting amylin analog. AbbVie agreed to pay up to $2.225 billion for Gubra’s amylin program, and Novo Nordisk signed a $2.2 billion deal with Septerna for oral small molecules, according to Labiotech’s roundup of 2025 obesity deals. Regeneron, Lilly and Novo added further deals worth roughly $1.3 billion to $2 billion each.
Most of that money chases what comes after first-generation GLP-1 monotherapy: amylin analogs, triple agonists, and pills that can be made and shipped at scale. Life Science Daily News counted more than 193 obesity assets in active development as of October 2025. Lilly’s triple agonist retatrutide produced 28.3% average weight loss at 80 weeks in its TRIUMPH-1 trial, results announced in May.
Biotech startups raised $9.1 billion in the first half of 2026, the strongest first half since 2022, but 76% of it arrived in megarounds of $100 million or more, and about two-thirds of rounds went to companies already testing drugs in people, BioPharma Dive reported in July. Immune and cancer companies took more than 40% of those rounds. Obesity developers have pulled in some big sums, including the $747.5 million public offering that Structure Therapeutics, a developer of oral obesity drugs, closed in December, but the early-stage field is thin, and it’s the incumbents who set the pace.
Leen Kawas on Capital Efficiency in a Crowded Field
A startup building one more injectable incretin now competes against Lilly and Novo on potency, manufacturing and price all at once. That’s a tough spot for a company that needs its next financing to survive.
Leen Kawas has pushed founders to look for a different edge. Speaking on Enterprise Radio, she said much of drug development still runs on habit. “There’s a lot of redundancies in our industry,” she said, describing established ways of working that are “expensive and capital intensive.” Her advice was to keep what works and cut the rest. Technology, AI included, can make development workstreams more efficient without lowering quality, she said.
She has also urged entrepreneurs to “look at the long term and find investors that understand the complexity of our technology and the timeframe of our industry.” In a guest post for Life Science Daily News this summer, she wrote that biotech’s real bottleneck is operational and that founders and investors need to settle operational fundamentals well before a trial reads out.
For obesity, that framework favors companies with a cheaper or faster path to a differentiated product over companies trying to outspend the market leaders. Pricing pressure makes the math tighter each year. IQVIA said semaglutide lost exclusivity in early 2026 in India, China, Brazil, Turkey and Canada, markets home to 38% of adults living with obesity worldwide. J.P. Morgan expects Medicare recipients to face a $50 monthly out-of-pocket cap under a pilot program. A late entrant with high production costs won’t have much room to move.
The Gaps the First Wave Left Behind
Weight loss numbers get the headlines, and they’re big. Keeping patients on the drug is a different story.
Nearly 65% of U.S. adults with obesity but no diabetes stopped their GLP-1 within a year, according to a study of more than 125,000 patients in JAMA Network Open. Pharmacy benefit manager Prime Therapeutics found that three years out, only 1 in 12 people who started a GLP-1 for obesity were still taking one. Even on the newest, most potent drugs, just 14% made it that far.
A January BMJ analysis of 37 studies found that patients who stopped semaglutide or tirzepatide regained their lost weight within about 18 months. Across all the weight-loss drugs studied, regain ran almost four times faster than after diet-and-exercise programs. Blood pressure, blood sugar and cholesterol drifted back with it.
Side effects explain part of the exodus. The same retatrutide trial that posted 28.3% weight loss reported nausea in 42.4% of participants, diarrhea in 32% and constipation in 26.1%, according to Life Science Daily News. The JAMA researchers found that moderate or severe gastrointestinal problems made patients more likely to stop, and that side effects and cost were the reasons most often recorded in clinical notes. A drug that delivers slightly less weight loss with far fewer side effects could keep more people on treatment, and in a market this large, better persistence could be worth billions.
Leen Kawas has built much of her career around that kind of patient-level detail. “If you design clinical trials that have the patient’s voice in them, patient retention will increase (which is a problem in our industry),” she has said. In obesity, the same logic applies after approval, when a patient decides each week whether to keep taking a drug that upsets her stomach.
Oral formulations remove the cold chain, and generic semaglutide is arriving in large markets, but most of the world’s patients still aren’t being treated. Leen Kawas has said her goal as an investor is to back “technologies that can help human health,” adding, “I would love it to be accessible globally.” Cheaper manufacturing, simpler dosing and pricing that employers and public payers can absorb are each business opportunities in their own right.
Developers are also testing GLP-1-based drugs in fatty liver disease (MASH), chronic kidney disease, cardiovascular events and obstructive sleep apnea. Each new indication brings a different patient population with its own side-effect tolerance and its own trial design problems, which is where operational discipline pays off.
What the Boom Means for Everything Else
Capital that flows toward obesity flows away from somewhere. Earlier-stage fields with long timelines, from rare disease to women’s health, compete for the same finite pool of venture dollars and investor attention. Silicon Valley Bank has found women’s health startups repositioning themselves as metabolic companies to catch the current, and W Group’s first women’s health investment report singled out SheMed’s $50 million Series A for a GLP-1 business among the year’s rounds.
The GLP-1 wave has proved that metabolic medicine can support blockbuster economics. The next winners will likely look less like the first ones. For Leen Kawas, a biotech investor who has backed a patient-first approach to drug development throughout her career, they are more likely to be the companies that make these drugs easier to tolerate, cheaper to produce and available to the large majority of patients the first wave hasn’t reached.
