6 things to know about the evolving market for obesity treatments

The U.S. obesity market is undergoing a fundamental transformation. 

Obesity treatment is quickly evolving from a narrow category to a dynamic, multi-indication therapeutic area—a shift fueled by expanding clinical evidence, rising patient demand, and heightened payer scrutiny.

This comes amid a radical change in societal perceptions about obesity and medical options to treat it. High-profile endorsements and mainstream care pathways are normalizing pharmacologic obesity care, and the product landscape is rapidly expanding. 

Next-generation assets will have greater and sustained efficacy. They’ll also feature combinations designed for “quality weight loss,” such as targeting visceral fat around organs and/or fat loss with lean muscle preservation. Label expansions will push beyond obesity-related cardiometabolic diseases and into inflammatory and neurodegenerative conditions. 

Major market shifts 

1. The stigma around obesity pharmacotherapy is eroding.
For decades, obesity treatment was seen as a failure of individual willpower rather than a medical necessity. That narrative is changing. A striking example came in 2025, when tennis icon Serena Williams partnered with telehealth provider Ro to promote GLP-1 based therapies. The campaign’s message, “It’s not a shortcut. It’s healthcare,” underscored a cultural pivot. Pharmacologic treatment is no longer viewed as only for those considered “morbidly obese” or lacking willpower. It’s being positioned as a legitimate tool for anyone—even professional athletes—seeking better health.

This cultural shift has been reinforced by regulatory milestones. In 2024, the FDA approved Wegovy (semaglutide) for cardiovascular risk reduction in adults with obesity and established cardiovascular disease. Zepbound (tirzepatide) became the first drug indicated for obstructive sleep apnea in adults with obesity. These types of label expansions elevate obesity drugs from weight-loss aids to disease-modifying therapies, strengthening the clinical and payer rationales for coverage.

2. The market will continue to expand beyond GLP-1s.
The U.S. market now offers a diverse portfolio of anti-obesity medications:

• GLP-1 and dual agonists: Semaglutide (Wegovy) and tirzepatide (Zepbound) dominate, with proven efficacy and expanding indications.
• Precision therapies: Setmelanotide (Imcivree) addresses rare genetic forms of obesity.
• Synthetic growth hormone (GHRH): Tesamorelin (Egrifta) reduces visceral fat for HIV-associated lipodystrophy.

The pipeline promises even greater disruption. Novo Nordisk’s CagriSema (a GLP-1 + amylin combination) and Lilly’s retatrutide (a GLP-1/GIP/glucagon tri-agonist) are setting new efficacy benchmarks, with retatrutide delivering up to 24% mean weight loss in phase 2 trials. Oral GLP-1 candidates like orforglipron could further expand access by eliminating the injection barrier. Boehringer Ingelheim’s survodutide (GLP-1/glucagon dual-agonist), Lilly’s bimagrumab (ActRII), and Regeneron’s trevogrumab (GDF8) are targeting higher-quality weight loss.

Analysts project that the global obesity drug market could exceed $95 billion by 2030, though this growth will be tempered by payer controls and price erosion as competition intensifies. 

3. An abundance of options is enabling personalized care. 
The growing number of approved therapies is a win for patients and providers. Today’s options span injectables, oral agents, adolescent indications, and rare-disease treatments—allowing clinicians to tailor therapy based on comorbidities, tolerability, and patient preferences. Label expansions into cardiovascular disease, obstructive sleep apnea, chronic kidney disease, and metabolic dysfunction-associated steatohepatitis (MASH) further support individualized care strategies.

This diversity also creates opportunities for manufacturers to differentiate beyond efficacy through durability, tolerability, convenience, and body-composition outcomes. 

4. Reimbursement decisions will narrow the market. 
As more drugs enter the market, payers are tightening control. Pharmacy benefit managers are already demonstrating a preference for certain GLP-1 brands.  Earlier this year,  CVS Caremark announced it would remove Zepbound from select formularies in favor of Wegovy, which could be attributed to increasingly competitive contracting and the release of additional real-world evidence. Non-coverage of Zepbound for commercial beneficiaries grew from 18% to 51% from 2024 to 2025. Expect more step therapy, reauthorization restrictions, and indication-based coverage policies.

The Inflation Reduction Act adds another layer of complexity, as it requires the federal government to renegotiate prices for certain drugs. Semaglutide is slated for Medicare price negotiation in 2027, a move that will ripple across commercial markets and accelerate net price compression. Goldman Sachs analysts now model annual U.S. price erosion of roughly 7% for obesity drugs—a stark contrast to the premium pricing seen at launch.

5. Consumer-centric business models will reshape access. 
Access to obesity care has been rapidly evolving. Telemedicine platforms like Ro and Found are mainstreaming virtual prescribing, while manufacturers are building direct-to-consumer (DTC) channels. LillyDirect, for example, offers Zepbound through a cash-pay model, bypassing insurance hurdles and ensuring supply continuity. These programs are no longer a differentiator—they are becoming table stakes for new entrants seeking to compete in a fragmented coverage environment.

With only about 39% of employer-sponsored plans covering GLP-1s for obesity, cash-pay and DTC strategies will remain critical to sustaining adoption. 

6. Products will eventually go beyond weight loss. 
The aesthetic implications of rapid weight loss alone, including skin laxity, facial volume loss, and muscle atrophy, are fueling demand for surgical and non-surgical cosmetic procedures as well as weight maintenance. This trend underscores the need for integrated care models that combine pharmacotherapy with nutrition, exercise, and aesthetic support.

But more transformative is how the growing efficacy of weight loss interventions will affect chronic disease management more broadly. Consider the implications for obese patients with chronic obstructive pulmonary disease. As treatments diminish weight’s role as a complicating factor, traditional care models may require recalibration. The roles of care management teams, once deeply embedded in obesity-related comorbidity coordination, may shift in scope or intensity. Provider specialties that were once central to multidisciplinary care may find their relevance redefined, while others rise in prominence.

This has significant ramifications for value-based care. The impressive value of avoided complications due to sustained weight loss demands a new framework for measurement. Current cost-avoidance models fall short in capturing the longitudinal impact of reduced disease burden, improved quality of life, and diminished reliance on acute interventions.

On the cusp of a revolution in obesity care

The obesity market is entering a platform era defined by scientific innovation, payer scrutiny, and consumer empowerment—and success will require more than launching a high-efficacy drug. Manufacturers must develop holistic commercialization strategies that address access, affordability, and comorbidity management while navigating a market that is becoming both more competitive and more commoditized.

The next five years will reward companies that can deliver not just more weight loss, but quality weight loss, safely and affordably—and at scale.