Eli Lilly and Novo Nordisk are advancing a new generation of obesity and diabetes medications that target the amylin hormone pathway, which is distinct from but complementary to the widely used GLP-1 treatments. Amylin, produced alongside insulin in the pancreas, helps regulate appetite and fullness. These emerging therapies, including injections, pills, and combination regimens, aim to enhance weight loss outcomes either independently or in conjunction with existing drugs like tirzepatide, which is already a major player in this field.

Lilly’s experimental drug eloralintide demonstrated promising results in a Phase 2 trial when combined with tirzepatide, achieving an average body weight reduction of 23.3% at 48 weeks compared to 14.8% with tirzepatide alone in patients with obesity and Type 2 diabetes. The company plans to move into Phase 3 trials later this year and is developing eloralintide both as a standalone treatment and as part of a combo therapy, which analysts project could generate $23.2 billion in annual sales by 2035. However, Lilly faces challenges with side effects and patient tolerance in the combination treatment.

Novo Nordisk has also been pursuing amylin-based drugs, notably its late-stage candidate cagrilintide and the combination drug CagriSema with semaglutide, expected to launch next year. The company is developing amycretin (zenagamtide) to target both GLP-1 and amylin simultaneously, offering once-weekly injectable and daily oral tablet options. Early results show not only notable weight loss but also improvements in brain activity linked to cravings and self-control, suggesting additional benefits beyond fat reduction.

The move toward multi-hormone targeting drugs reflects a broader evolution in obesity therapeutics, where companies seek to provide individualized options by engaging multiple biological pathways. While these amylin-based treatments need to clear further trials and regulatory hurdles, they represent a significant potential advancement for patients who have not achieved sufficient benefit from GLP-1 therapies alone. Other companies, including Pfizer and AstraZeneca, are also exploring amylin as part of this expanding field.