Lilly lays out a five-molecule obesity strategy at ADA

Eli Lilly executives used the American Diabetes Association's 86th Scientific Sessions to lay out where its cardiometabolic drug pipeline stands, framing tirzepatide, orforglipron (brand name Foundayo), retatrutide and eloralintide as four complementary medicines meant to serve different patients ^[1]. Ken Custer, who leads Lilly's Cardiometabolic Health division, said an estimated 100 million or more people in the U.S. live with obesity, with roughly 2 billion worldwide, but fewer than one in 10 who could benefit from incretin-based medicines are currently taking them ^[1].

For tirzepatide, sold as Mounjaro and Zepbound, Lilly pointed to new data since last year's ADA meeting, including results from the SURPASS-CVOT cardiovascular outcomes study and the SURMOUNT-MAINTAIN study, which looked at switching patients to alternative doses for long-term weight management ^[1]. The company also cited earlier data showing tirzepatide outperformed 2.4 mg of Wegovy in a head-to-head trial ^[1].

Orforglipron, an oral pill marketed as Foundayo, received U.S. marketing authorization for weight management in April 2026, followed shortly by approval in the United Arab Emirates ^[1]. Lilly's Thomas Seck, senior vice president of product development, said the drug's program includes seven completed phase 3 studies with more than 10,000 patients and six more studies underway ^[1]. In the ACHIEVE-3 trial, a 1,700-patient study comparing Foundayo to oral semaglutide (Rybelsus) in people with type 2 diabetes, the higher dose of Foundayo produced weight loss of up to 9.2%, versus up to 5.3% for the approved doses of oral semaglutide, a difference Lilly said was statistically significant ^[1]. In the ATTAIN-1 trial, which enrolled more than 3,000 people without diabetes, Foundayo produced weight loss of up to 12.4% from baseline; in ATTAIN-2, in people with type 2 diabetes, weight loss reached 10.5% ^[1]. Separate MAINTAIN studies found that patients who lost weight on injectable Wegovy or Zepbound and then switched to Foundayo kept 95% and about 76% of that weight loss, respectively, after a year on the pill ^[1]. Discontinuation rates across the Foundayo studies ranged from about 4% to 12%, with gastrointestinal side effects being the most common and typically mild, moderate and temporary ^[1].

Retatrutide, described as Lilly's third obesity medicine, had new data from the TRANSCEND-T2D-1 and TRIUMPH-1 studies presented the same day, though specific numbers from those trials were not detailed in the portion of the transcript reviewed ^[1]. Eloralintide, introduced only last year, is now in five phase 3 studies, and Lilly said it delivers weight-loss efficacy similar to incretin drugs but with more placebo-like gastrointestinal tolerability; data on how it works when combined with tirzepatide are expected later this year ^[1].

Why it matters for patients

Lilly's message is that no single drug fits everyone with obesity, and it is building a menu of medicines with different delivery methods, side-effect profiles and, potentially, different effects on weight maintenance ^[1]. The MAINTAIN data suggest that people who lose weight on an injectable drug may be able to preserve much of that loss by switching to a pill like Foundayo, which could matter for patients who want to move off injections without regaining weight ^[1]. At the same time, Lilly's own numbers show that fewer than one in 10 eligible Americans currently take these medicines, underscoring that access and cost remain separate from any scientific progress ^[1].

What happens next

Lilly said it completed the U.S. submission process for Foundayo in type 2 diabetes in the second quarter of 2026 and has submitted approvals for type 2 diabetes and weight management in 45 countries ^[1]. Additional studies are planned to test Foundayo for obstructive sleep apnea, hypertension, osteoarthritis pain, stress urinary incontinence and peripheral artery disease, along with a large outcomes study, ATTAIN, examining cardiovascular effects ^[1]. Further eloralintide combination data with tirzepatide are expected later in 2026 ^[1].