Novo CEO sees obesity market beyond winner-take-all as 100 million untreated

Novo Nordisk CEO Mike Doustdar said the obesity market won't be winner-take-all, citing 100 million eligible Americans and oral pill demand.

"I could see a future where actually this market is, to a large extent, a pill market," Doustdar said, arguing that investors are underestimating demand for differentiation among obesity treatments.

More than 100 million people in the U.S. live with obesity, yet only 10 to 15 percent have used a GLP-1 medication, Doustdar said. Novo's oral Wegovy pill, launched in January, has surpassed 5 million U.S. prescriptions, while Lilly's competing pill Foundayo generated $98 million in its first quarter on the market after FDA approval on April 1. Lilly's Q2 revenue jumped 48 percent to $22.974 billion, driven by Mounjaro sales of $9.943 billion and Zepbound revenue of $4.928 billion.

The comments come as Novo and Lilly escalate competition across the GLP-1 market. Novo filed a lawsuit in July alleging Lilly's advertising for Zepbound misleads consumers by comparing against an older, lower-dose version of Wegovy rather than the newer 7.2 mg formulation approved in March. Lilly has said it stands "firmly behind our advertising," citing head-to-head trial data showing Zepbound delivered 20.2 percent average weight loss versus 13.7 percent for the older Wegovy dose. Since the suit was filed, Novo shares have fallen 6 percent while Eli Lilly has climbed nearly 4 percent.

Foundayo won U.K. approval this week, marking the first approval outside the U.S. and setting up a direct pill-to-pill contest with the Wegovy pill in Europe. The U.K.'s Medicines and Healthcare products Regulatory Agency authorized orforglipron for weight management and type 2 diabetes, with National Health Service access pending a cost-effectiveness review. Novo launched the Wegovy pill in the U.K. two months earlier, with an estimated 300,000 patients starting the treatment in its first three weeks.

Lilly raised its 2026 revenue guidance to $85 billion to $87 billion, while Novo's injectable Wegovy sales grew just 1 percent year over year to DKK 19.484 billion ($3.013 billion). Oral Wegovy generated DKK 3.218 billion (about $498 million) in its first quarter on the U.S. market. Doustdar acknowledged Lilly has gained market share in injectables but said the oral segment represents a new competitive frontier where differentiation matters.

The market's trajectory hinges on whether oral GLP-1s expand the addressable patient pool or simply cannibalize injectable sales. Novo's Wegovy pill has a head start with 5 million prescriptions, but Lilly's Foundayo offers the advantage of no food restrictions, a key differentiator that could drive adoption. Investors will watch Foundayo's U.K. rollout and whether Novo can sustain Wegovy pill momentum through the second half of 2026.

This article is for informational purposes only and does not constitute investment advice.