Novo Nordisk CEO says obesity drug market will not have a single winner

Novo Nordisk chief executive Mike Doustdar is telling investors that the market for obesity drugs will not be a winner-takes-all contest, with growth coming from treating more people and from new pill versions of existing medicines rather than from one company taking share from another ^[1][2].

Doustdar made the argument in an August 2026 interview with Reuters and in a Yahoo Finance interview published September 7, 2026 ^[1][2]. In the Reuters interview he said demand would be large enough for several global companies to thrive at once, and that physicians and patients would choose therapies based on efficacy, safety profiles, ease of use and overall treatment value, much as they do with insulin ^[1]. Novo's strategy, he said, extends beyond new molecules to expanding the market itself, particularly through oral therapies ^[1].

That push is already visible. Novo Nordisk has launched the tablet version of Wegovy in Germany and continues clinical development of oral semaglutide ^[1]. Oral treatment could bring in patients who are reluctant to use weekly injections, which would widen the market ^[1]. A specific patient target for oral semaglutide has not been disclosed.

The company's share numbers depend on what is being measured. In its 2025 annual report, Novo reported a 59.6% share of the global branded GLP-1 obesity market by volume, with revenue from its Obesity Care division up 31% at constant exchange rates to DKK 82.3 billion ^[1]. That share figure covers the annual report's reporting period and is a volume measure, not a current market-share estimate or a revenue share ^[1]. In the United States, Zepbound has overtaken injectable Wegovy in weekly prescriptions, but Novo said the broader Wegovy franchise, including the pill, led branded obesity medicines in new patient starts in its second-quarter 2026 update ^[1].

Doustdar has also acknowledged losing share. "It's not fun," he said in the Yahoo Finance interview. Market share loss, he said, "is not a numerical, graphical picture," but rather the people who could have been on a GLP-1 and were not ^[2]. He added that speed is a competitive advantage, but "maybe more important than speed is clarity" ^[2], and that he is convinced Novo has the better products ^[2].

Eli Lilly's commercial results show the scale of the competition. In the second quarter of 2026, Mounjaro generated $9.94 billion in revenue, up 91% from a year earlier, and Zepbound added $4.93 billion; together they accounted for 64.7% of Lilly's quarterly revenue, and the company raised its full-year 2026 revenue guidance to $85–87 billion ^[1]. Those combined product sales include diabetes and obesity indications, not obesity treatment alone ^[1]. In the head-to-head SURMOUNT-5 trial, tirzepatide produced greater average weight reduction than semaglutide after 72 weeks among adults with obesity but without diabetes ^[1]. Lilly's oral obesity drug Foundayo (orforglipron) received FDA approval on April 1, 2026, and became available in the United States on April 9 ^[1].

Forecasts for the category have been trimmed. Reuters reported in February 2026 that Goldman Sachs projected $105 billion in global obesity drug sales by 2030, down from an earlier estimate of $130 billion as expectations for prices weakened ^[1].

Novo has also had setbacks outside obesity. After the ZEUS cardiovascular trial failed, the company discontinued two additional ziltivekimab trials in patients with heart failure ^[1]. In company-reported initial results from STEP Young, an analysis that estimated outcomes if all participants adhered to treatment found that 40.4% of children aged six to under twelve taking semaglutide reached a BMI below the obesity threshold after 68 weeks, versus none on placebo; both groups also received a lifestyle intervention ^[1]. Those findings could support a future expansion of approved uses, subject to regulatory review ^[1].

Why it matters for patients

If Doustdar's view is right, the practical effect is more choice rather than one dominant drug: injections and pills, from more than one manufacturer, competing on results, side effects and convenience ^[1]. Oral semaglutide and Lilly's approved orforglipron ^[1] mean patients who avoid needles could have alternatives, though which drug a given patient can get still depends on insurance coverage and affordability ^[1].

More patients being treated does not automatically mean lower prices. Wider adoption can coexist with pressure on profit margins, because coverage and affordability shape access, while realized prices and manufacturing and distribution costs determine how much revenue becomes profit ^[1]. Whether competition in oral therapies changes what US patients pay out of pocket has not been established.

What happens next

Novo Nordisk says it will keep developing oral semaglutide and is awaiting regulatory review of the STEP Young findings ^[1]. Lilly is advancing retatrutide, an investigational treatment for obesity and metabolic disease, and investing in manufacturing capacity ^[1]. No dates for those milestones have been disclosed.