What experts are saying about the future of obesity treatments

Obesity impacts roughly 40% of U.S. adults and 16% globally, and it’s associated with an estimated $173 billion in annual U.S. medical costs and $2 trillion across the world. As obesity-related mortality and downstream comorbidities place sustained pressure on the health system, forecasts project that more than 250 million Americans—including more than 43 million children and adolescents—may be overweight or obese by 2050.  

Yet the same scale that makes obesity “the opportunity of the decade” is precisely what will force the market to evolve beyond today’s playbook.  

In May 2026, Guidehouse convened an obesity roundtable with industry leaders and key opinion leaders to test what’s changing in obesity care and what it will take for the next wave of pharmaceutical manufacturers to address the market’s greatest unmet needs. Here are a few takeaways about some emerging trends and how they may impact new entrants. 

The future of the obesity market is in more tailored approaches to treatment

Roundtable participants emphasized that obesity will become more commoditized over time—and as more therapies enter, incremental improvements won’t be enough. Winning brands will be those that embed differentiation in evidence, positioning, and go-to-market design. Innovation is already moving toward multi-target approaches and personalization, shifting from “one-size-fits-all” obesity management to more tailored treatment goals such as muscle preservation, visceral fat reduction, and comorbidity-specific benefits.  

Participants also highlighted a strategic “flip” that may unlock new prescribers. Brands that lead with non-obesity indications such as cardiovascular risk reduction and position weight loss as an additional benefit may be able to better engage cardiologists and other specialist prescribers beyond primary care. 

What this means for new entrants: Success will come from choosing a clear lane: phenotype/segment focus, combination strategy, and a positioning narrative that creates stakeholder belief along with clinical differentiation. 

Access will expand, but brands will need to work more intently with employers and payers 

Even if category pricing declines with competition, broad payer coverage of most obesity drugs remains structurally difficult because obesity is highly prevalent, chronic, and budget-impacting at scale. Coverage restrictions, prior authorization, and step edits are pushing patients toward cash-pay and other channels. In a recent Lilly earnings call, analysts suggested that roughly 55% of new-to-brand prescriptions for obesity GLP-1s were self-pay. 

Participants discussed the employer as the emerging connection point that can meaningfully improve coverage, especially for self-insured populations. If the value story is compelling, measurable, and relevant to near-term costs, employers can decide to fund coverage as a highly valued employee benefit. 

As a result of these trends, self-pay is likely to become a structurally embedded channel alongside insurance coverage rather than a temporary workaround. In parallel, policy-driven change may incrementally widen public coverage over time, such as through the CMS BALANCE model. That may be challenging to implement, though, as the model has been indefinitely paused due to insufficient plan participation.  

What this means for new entrants: Winning access will require an employer-forward strategy and a payer-ready evidence plan that can survive budget-impact scrutiny. 

Persistence is the new battleground 

Leaders agreed that sustained use of obesity drugs across patient populations is challenged by affordability concerns, side-effect tolerability, and fatigue. Real-world tolerability is a leading driver of discontinuation for these drugs, while the next-gen drugs being developed now are explicitly focused on improving tolerability through alternative mechanisms, longer-acting formulations, and more gradual escalation strategies.  

Persistence isn’t only a clinical issue. It can challenge commercial performance because discontinuation undermines outcomes, weakens payer confidence, and reduces the credibility of long-term value claims. 

What this means for new entrants: Persistence should be treated as a launch KPI supported by design choices (e.g., route of administration, dosing frequency), patient support programs, and evidence that demonstrates durability beyond early weight-loss response. 

Reducing provider burden will become a core competency 

A rapidly growing treated population, frequent titration, and ongoing side-effect management are contributing to significant burden for providers. Many physicians are already operating at or beyond capacity, and the intense interaction required to stabilize patients early on may lead some of them to avoid certain drugs.  

The future implication is clear: treatment will increasingly be judged as a model of care, not just the drug innovation itself. Roundtable participants pointed to the need for a broader care team strategy to help absorb operational load, especially during initiation and escalation. That could include mid-level providers, dietitians, pharmacists, coaches, and digital support. 

Digital-enabled delivery models like Ro, Noom, and Lilly Direct are gaining traction because they offer perceived access, more frequent touchpoints, and a wraparound support system that looks and feels purpose-built for chronic titration. The obesity market is shifting from traditional rep-to-healthcare professional engagement toward a more integrated, ecosystem-based model where care delivery partners and digital stakeholders become central to outcomes.  

What this means for new entrants: Differentiation will increasingly come from tolerability strategies, simplified dosing, embedded services, and manufacturer-to-ecosystem business models that go beyond incremental efficacy to shrink provider workload. 

Brands will need to improve coordination across the healthcare ecosystem 

Manufacturers are increasingly concerned about delivery channel fragmentation. The broad set of intermediaries now sitting between manufacturers and patients complicate access, brand experience, and data visibility into adoption, adherence, switching, and satisfaction.  

Direct-to-consumer (DTC) platforms are evolving from competitors to partners as they help expand distribution reach while offering more personalized engagement—especially as scrutiny increases and branded distribution becomes more central. An increasingly fragmented delivery model will require manufacturers to synchronize efforts across payers, providers, employers, DTC platforms, and tech disruptors as a coordinated system.  

What this means for new entrants: Channel strategy and partner models are now a core brand strategy that must be designed as an integrated ecosystem from day one. 

How manufacturers approach health equity will shape their reputation and coverage 

Even with price declines, chronic affordability concerns will constrain access for marginalized populations with higher obesity prevalence and comorbidity burden, particularly in Medicaid and underinsured populations. This reinforces an uncomfortable truth: a market can grow rapidly while still deepening inequity. 

At the same time, the future market outlook includes massive growth in affected children and adolescents, amplifying the urgency to address early intervention and prevention, not just adult treatment.  

What this means for new entrants: Equity strategies—including access pathways, benefit design collaboration, community partnerships, and real-world evidence generation—will have a significant influence on policy, market penetration, and brand trust. 

What’s next 

New entrants that treat obesity like a traditional primary-care launch that’s focused narrowly on efficacy and sales force scale will be outpaced by competitors who build care pathways, data models, channel strategies, and value plans as integrated systems. Leaders must bridge clinical strategy, market access, patient support services, and digital enablement to define their lane, present differentiated evidence, and execute commercialization in an increasingly fragmented ecosystem.