Blink And You Miss It
Did you know that the average person blinks about 17,000 times a day?
Well, if you blinked during the American Diabetes Association conference, you might have missed Eli Lilly (LLY) delivering some of the most impressive clinical data I’ve seen in years.
While their competitors stumbled through disappointing presentations, Lilly quietly demonstrated why they’re positioning themselves to dominate the obesity market for the next decade.
So, what happened during the conference? Lilly presented results for two experimental drugs that could reshape how we think about weight loss treatments.
The first one, bimagrumab, is an anti-myostatin antibody they picked up when they acquired Versanis Bio in 2023.
Now, I’ve been following biotech long enough to know that most combination therapies promise big results and deliver mediocre outcomes. But this one actually delivered.
When they combined bimagrumab with semaglutide – that’s Novo Nordisk’s (NVO) blockbuster Ozempic – patients lost over 20% of their body weight in 48 weeks.
And this is how it sets itself apart: 92-95% of that weight loss came from fat, not muscle.
Compare that to semaglutide alone, where only 72% of weight loss comes from fat mass, and you start to understand why this matters.
We’re talking about preserving lean muscle mass while burning fat, which is exactly what doctors and patients want to see.
The side effects were manageable – some acne and muscle spasms – but nothing that would derail the program. More importantly, there were no additional gastrointestinal problems beyond what you’d expect from semaglutide alone.
Then there’s eloralintide, Lilly’s amylin analog that’s designed completely differently from competing drugs in this class. While other companies are trying to hit multiple hormone receptors simultaneously, Lilly focused exclusively on the amylin receptor.
The early results look promising: patients lost up to 11.3% of their body weight in just 12 weeks with very few side effects.
What really caught my attention was how well these results compared to the competition.
Zealand Pharma (ZLDPF) and Roche’s (RHHBY) petrelintide managed 8.6% weight loss after 16 weeks, so Lilly’s achieving better results in less time. That’s the kind of data that gets regulators and doctors excited.
Meanwhile, the competition had a rough conference.
Amgen’s (AMGN) MariTide showed vomiting rates up to 92%, which isn’t exactly the kind of tolerability profile you want for a weight loss drug.
Novo Nordisk’s amycretin had its own tolerability issues, though they’re pushing ahead with Phase 3 trials anyway.
What strikes me most about Lilly’s position is how they’re building a comprehensive portfolio across different mechanisms of action.
They already dominate with tirzepatide in the injectable market. They’ve got orforglipron coming as the first oral GLP-1 that can be manufactured at scale. Their triple hormone agonist retatrutide should start reporting Phase 3 data next year.
And now they’re showing leadership in muscle-preserving therapies and amylin modulation.
This isn’t just about having multiple shots on goal. Each of these approaches targets different patient populations and clinical scenarios.
Bimagrumab could be particularly valuable for older patients who need to lose weight while preserving muscle mass. The fitness community would probably line up around the block for access to something that burns fat while building lean mass.
I’m not saying Lilly will own the obesity market forever. Nobody does in pharma. One minute you’re on top, the next you’re staring down a patent cliff.
But right now? Lilly isn’t just leading. They’ve actually changed the game entirely.
While Novo Nordisk plays defense and Amgen tries to explain away 92% vomiting rates, Lilly is steadily assembling what looks a lot like an obesity treatment empire.
This market is barreling toward 100 billion dollars a year, and at this conference, Lilly made it clear they intend to lead it.
Every bull market has its generals. In obesity drugs, Lilly just took command.
