GLP-1 prescriptions for weight loss climb sharply, despite persistent barriers
Key Takeaways:
- GLP-1 prescriptions for weight loss have increased by nearly 2,000% among people without diabetes between 2019 and 2024, according to Fair Health data.
- Drugmakers face criticism and logistical challenges, including high costs, shortages, and concerns about replacing behavioural and surgical interventions.
- Government resistance to subsidising obesity medications and rising public scrutiny may slow broader uptake, despite clinical success and commercial demand.
Background: GLP-1 Receptor Agonists and Rising Obesity Treatment Demand
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a class of drugs that simulate a gut-derived hormone responsible for lowering blood glucose levels and suppressing appetite. Initially approved for the treatment of type 2 diabetes, these medications have more recently demonstrated efficacy in supporting weight loss. Their expansion into the field of obesity care has transformed both patient outcomes and the commercial pharmaceutical landscape.
Fair Health, a U.S.-based non-profit organisation, analysed over 51 billion commercial claims to identify trends related to GLP-1 prescriptions and obesity care. The data show a significant rise in GLP-1 prescriptions, particularly for weight loss purposes rather than diabetes management.
Explosive Uptake in Weight Loss Prescriptions
Among individuals prescribed GLP-1 medications in the past year, approximately half received the prescription for weight management, not for diabetes. When people living with type 2 diabetes were excluded from the dataset, the data revealed a 1,961% increase between 2019 and 2024 in prescriptions to individuals with overweight or obesity but without diabetes.
This staggering growth reflects both public demand and shifting clinical practice. GLP-1 RAs are increasingly viewed not only as antidiabetic medications, but as a frontline treatment option for obesity—a chronic and often intractable condition.
An Expanding Market and the Role of Industry
The commercial implications have been profound. Industry analysts project the anti-obesity drug market could exceed $100 billion globally by 2030. At present, three GLP-1 drugs are approved by the U.S. Food and Drug Administration (FDA) specifically for weight management:
- Saxenda (liraglutide) – Novo Nordisk
- Wegovy (semaglutide) – Novo Nordisk
- Zepbound (tirzepatide) – Eli Lilly
Although Saxenda received approval in 2014, it was not until Wegovy’s launch in 2021 that the weight loss potential of GLP-1s gained widespread public attention. Eli Lilly’s Zepbound followed and quickly contributed to $4.9 billion in sales in its first full year. In 2023, Novo Nordisk reported $9.9 billion in combined sales from Saxenda and Wegovy.
Shortages, Substitutes, and Setbacks
Rapid uptake led to supply shortages, during which telehealth companies partnered with compounding pharmacies to distribute non-branded formulations. Although these shortages have since resolved—restoring market exclusivity to the original manufacturers—the episode dented both projected 2025 revenues and investor confidence. It also contributed to leadership changes at Novo Nordisk.
Affordability and Access Barriers
The high cost of GLP-1 drugs remains a critical issue, with monthly list prices reported as follows:
- Wegovy: $1,350
- Zepbound: $1,060
(Source: Institute for Clinical and Economic Review)
Because long-term use is generally required to maintain weight loss, the financial burden on health plans is substantial. In 2024, fewer than 20% of employer-sponsored insurance plans covered GLP-1s for weight loss, largely due to cost constraints.
To address this, manufacturers have sought partnerships with major pharmacy benefit managers. Recent collaborations include:
- Novo Nordisk and Eli Lilly with Cigna’s health services subsidiary to offer discounts and cap out-of-pocket costs
- Novo Nordisk with CVS Caremark, granting Wegovy preferred formulary status
Policy Resistance and Political Backdrop
Obesity remains a public health emergency in the United States. According to the Centers for Disease Control and Prevention (CDC), over 40% of adults are currently living with obesity, a figure projected to reach 50% by 2030. Yet federal support for pharmacological obesity treatment remains limited.
Earlier this year, the Trump administration rejected a proposal to expand Medicare coverage to include anti-obesity drugs, a move that would have added $40 billion to taxpayer expenditures over ten years.
The decision coincides with political and cultural scrutiny of pharmaceutical interventions. Health and Human Services Secretary Robert F. Kennedy Jr. has been vocal in his opposition to pharmacological weight loss treatments, attributing rising obesity rates to poor dietary choices. He has argued that medication should not replace healthier food and lifestyle interventions.
“We cannot medicate our way out of a nutrition crisis,” Kennedy stated in a White House report released last week.
Impact on Other Forms of Obesity Care
Fair Health’s findings suggest that the rise in GLP-1 prescribing has coincided with a decline in bariatric surgery rates. This supports prior research indicating that patients are increasingly turning to pharmacotherapy instead of more invasive interventions.
However, the trend has also been linked to a reduction in behavioural health interventions, which raises significant clinical concerns. GLP-1s have been associated with increased risks of depression, anxiety, and suicidal ideation in some individuals, making ongoing psychological support an essential component of care.
Looking Ahead
While new partnerships and forthcoming price negotiations under the U.S. Inflation Reduction Act (effective 2027) may improve affordability—particularly for Medicare recipients—current dynamics underscore the complex interplay of clinical promise, economic burden, and political ideology.The rapid growth of GLP-1 prescribing marks a new chapter in the treatment of obesity. Yet its future success will depend not only on drug efficacy, but also on ensuring equitable access, maintaining comprehensive care, and fostering public trust in what remains a deeply politicised health issue.
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GLP-1 receptor agonists show early promise in reducing BMI among children with severe obesity, study finds
Key Takeaways:
- GLP-1 receptor agonists appear to enhance treatment outcomes for children with severe obesity when added to existing intensive behavioural and lifestyle interventions.
- Clinically meaningful BMI reductions were observed in a higher proportion of children following the integration of GLP-1 medications into their care plans.
- Families reported additional benefits beyond weight loss, including reduced conflict around food and improved ability to follow lifestyle recommendations.
Background: Addressing Severe Obesity in Children
Children living with severe obesity face considerable health challenges and are at increased risk of metabolic and psychological complications. While glucagon-like peptide-1 (GLP-1) receptor agonists are now widely used to treat obesity in adults, their use in paediatric care remains a developing area.
These medications mimic the hormone GLP-1, which helps reduce appetite, prolong satiety, and slow gastric emptying. When prescribed as part of a holistic care plan, they may support young people in achieving clinically significant improvements in weight and health outcomes.
At the 2025 European Congress on Obesity (ECO), new data were presented suggesting that incorporating GLP-1 receptor agonists into childhood obesity treatment regimens could enhance the likelihood of meaningful BMI reduction.
The Study: Real-World Outcomes from Sweden’s National Childhood Obesity Centre
Dr Annika Janson and her research team at the National Childhood Obesity Centre, Karolinska University Hospital, Stockholm, investigated the real-world effects of GLP-1 receptor agonists when used in conjunction with intensive health behaviour and lifestyle treatment (IHBLT).
The retrospective study included 1,126 children aged 0–16 years (51.6% boys), all living with severe obesity as defined by the International Obesity Task Force criteria. Each participant was enrolled in the IHBLT programme, which involves a multidisciplinary approach to support children and their families in modifying lifestyle behaviours, such as:
- Healthy eating and nutrition education
- Managing meal portions and timing
- Reducing screen time
- Promoting physical activity
- Supporting psychological wellbeing
This intensive intervention is tailored in collaboration with families, schools, and other community stakeholders.
Introduction of GLP-1 Agonists into the Programme
From 2023 onwards, GLP-1 receptor agonists – initially liraglutide, later including semaglutide – were prescribed to approximately one in four children within the programme. The study aimed to determine whether adding these medications led to improved BMI outcomes, acknowledging the complexities and inconsistencies of medication use in real-world settings.
“GLP-1 drugs are increasingly used to treat obesity in adults. They can also be used in children from the age of 12 and clinical trials have shown children lose 5–16% of their body weight after a year of treatment,” said Dr Janson.
She also highlighted that real-life application presents challenges absent in clinical trials:
“Children have varying degrees of obesity, co-morbidities and complications and may have faced problems in supply of the drug, financing it or taking it. As a consequence, it is difficult to isolate the effect of adding GLP-1 drugs to the plethora of treatments that are already available.”
Findings: BMI Improvements and Emerging Trends
The study compared outcomes from children treated prior to 2023 with those treated during and after 2023, when GLP-1 drugs were introduced. Prior to 2023, the average BMI reduction across patients was relatively stable. However, among those treated in 2023, 30% of children achieved a clinically significant BMI reduction – defined as at least a 0.25 standard deviation drop – compared with 27% in previous years.
While the difference is modest, researchers believe it reflects a positive early trend.
“Only a fraction of the children had GLP-1 drugs and most of those who did started on them 6–12 months into the treatment programme,” explained Dr Janson. “Longer-term treatment may lead to greater improvements in BMI.”
Moreover, a point prevalence estimate from January 2025 found that approximately one quarter of the 2023 cohort were actively taking GLP-1 medications at that time.
“These are just early indications but it does look as if the average effect of being a patient at our clinic has improved after adding GLP-1 drugs to the toolbox,” she added.
Beyond BMI: Family Experiences and Behavioural Shifts
Notably, Dr Janson reported that families described benefits that extended beyond measurable weight outcomes.
“Many children with severe obesity describe hunger and a strong appetite – both of which GLP-1 receptor agonists are known to help with,” she said.
“Results beyond obesity are also important. The families reported reduced conflicts around food and improved capacity for other lifestyle adaptations. It was easier to stick to meals and limit snacks. Portions could be down-sized. For some children, not being hungry all the time is a new feeling.”
Conclusion: A Valuable Tool with Cautious Optimism
While not a universal solution, GLP-1 receptor agonists appear to be a promising adjunct in the care of children living with severe obesity. The study’s findings support their wider use, particularly when integrated within a comprehensive treatment plan.
“GLP-1 receptor agonists are clearly beneficial to many children with severe obesity and while they won’t help in all cases, more children should have access to these important medications,” Dr Janson concluded.
CCH Insight:
This study is a great example of how GLP-1RAs are meant to work. They are not, as some people think, a ‘lazy way’ or an ‘easy way’ to lose weight. They are a tool which, when used as part of a holistic care plan and supported by a multidisciplinary team, enables people (in this case children with severe obesity) to follow a healthier diet and lifestyle. The children were able to achieve this because GLP-1 medications modified their appetites, so they were no longer constantly hungry or thinking about food.
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Weight-loss medications may halve risk of obesity-related cancers, landmark study reveals
Key Takeaways:
- GLP-1 receptor agonist medications may reduce the risk of obesity-related cancers by nearly 50%, rivalling the effects of bariatric surgery.
- The protective effects appear to extend beyond weight loss alone, potentially due to reductions in inflammation.
- Researchers and experts are calling for large-scale clinical trials to test weight-loss drugs as a new strategy for cancer prevention.
Introduction
A major new study suggests that weight-loss injections known as GLP-1 receptor agonists could nearly halve the risk of developing obesity-related cancers. Presented at the European Congress on Obesity in Málaga, Spain, and published in The Lancet’s eClinicalMedicine, the research has been described as “transformational” by leading cancer experts and may signal the beginning of a new era in preventive oncology.
Obesity, Cancer Risk, and Weight-Loss Interventions
Obesity is strongly linked with an increased risk of at least 13 different types of cancer. While losing weight is already known to reduce cancer risk, this study indicates that weight-loss medications may have protective effects that go beyond weight reduction alone.
The research, conducted by scientists in Israel, involved 6,000 adults with no previous cancer diagnoses. Participants had either undergone bariatric surgery or taken GLP-1 receptor agonists (GLP-1RAs), including liraglutide (Saxenda), exenatide (Byetta), or dulaglutide (Trulicity). These medications mimic the GLP-1 hormone, which plays a role in lowering blood sugar levels and promoting feelings of satiety.
Weight Loss vs Cancer Risk Reduction
Although participants who had undergone bariatric surgery lost approximately twice as much weight as those who used medication, both groups experienced a similar reduction in cancer risk. According to the study’s authors, bariatric surgery is associated with a 30–42% reduction in the risk of cancer. However, after adjusting for the greater weight loss associated with surgery, the protective effect of GLP-1 medications appeared stronger relative to the amount of weight lost.
Professor Dror Dicker, co-lead author of the study and head of internal medicine at Hasharon Hospital, Rabin Medical Center in Petah Tikva, Israel, commented:
“The protective effects of GLP-1RAs against obesity-related cancers likely arise from multiple mechanisms, including reducing inflammation.”
He also highlighted the potential of more advanced drugs:
“New generation, highly potent GLP-1RAs with higher efficacy in weight reduction may convey an even greater advantage in reducing the risk of obesity-related cancers, but future research is needed to make sure these drugs do not increase the risk for non-obesity-related cancers.”
Newer Medications Show Even Greater Promise
A second study, also presented at the European Congress on Obesity and published in the New England Journal of Medicine, compared different GLP-1 medications. It found that participants taking tirzepatide (sold as Mounjaro) lost around 50% more weight than those taking semaglutide (sold as Wegovy). Specifically, individuals using Mounjaro lost an average of 20.2% of their body weight, compared to 13.7% among those taking Wegovy.
Expert Reactions: A Transformational Moment
Professor Mark Lawler, an internationally recognised cancer researcher from Queen’s University Belfast, emphasised the significance of the findings:
“We already know bariatric surgery cuts obesity-related cancer risk by about a third; these data suggest target GLP-1s may cut that risk by nearly 50% – an approach that would be transformational in preventing obesity-related cancer.”
He continued:
“Biologically, this makes sense, as targeting GLP-1 dampens down inflammation, one of the hallmarks of cancer.
While further work is required on how it works, these data raise the intriguing possibility that a GLP-1 jab could prevent multiple cancers in the general population, including common cancers like breast and colorectal, and difficult to treat cancers like pancreatic and ovarian. This work could herald a whole new era of preventive cancer medicine.”
Professor Jason Halford, former president of the European Association for the Study of Obesity and head of psychology at the University of Leeds, proposed that GLP-1 drugs also be trialled in people with newly diagnosed cancer, to evaluate whether they could improve survival rates:
“The drugs have the potential to be a new dawn. And it’s not just prevention – weight management in people recently diagnosed with cancer is also critical in terms of outcomes. That would be the next thing to look at. More and more cancers are being associated with obesity.”
A Global Call to Action
In light of the findings, a coalition of 54 international experts from 12 countries released a joint statement at the conference urging that GLP-1 drugs be trialled urgently for cancer prevention. In response, a team of researchers at the University of Manchester, funded by Cancer Research UK, are planning a major clinical trial involving tens of thousands of participants. The study is anticipated to begin within the next three to five years.
Dr Matthew Harris, from the Manchester Cancer Research Centre, commented:
“Weight-loss jabs provide genuinely fantastic weight loss, and may provide an intervention that could be delivered on a population-scale, where we have not been able to achieve this before.”
Conclusion
This growing body of evidence suggests that GLP-1 receptor agonists may offer far more than just weight loss benefits. With their potential to dramatically reduce cancer risk, these medications could form the basis of a proactive, large-scale approach to cancer prevention, particularly for people living with obesity. Further clinical research will be critical to confirm these findings and determine the full scope of benefits—and risks—associated with long-term use.
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NHS plans free weight-loss injections at community pharmacies
Key Takeaways:
- The NHS is preparing a trial to offer the weight-loss medication Mounjaro at community pharmacies, aiming to improve access and reduce waiting times.
- Pharmacies like Boots and Superdrug, which already sell these medications privately, may soon provide them free of charge under NHS schemes, particularly in deprived areas with high obesity rates.
- Experts stress the need for comprehensive support, including psychological and nutritional counselling, alongside the rollout of these powerful medications to ensure safe and effective use.
Weight-loss medications such as Mounjaro and Wegovy may soon be available free of charge at high street pharmacies as part of the NHS’s expanding efforts to address obesity in the United Kingdom.
At present, these medications are accessible only through specialist NHS weight-management clinics, which are hospital-run and face waiting lists extending up to two years. Consequently, although approximately 15 million people in Britain are classified as living with obesity and meet the eligibility criteria, only around 50,000 have been able to access these treatments through the NHS.
Currently, numerous pharmacy chains — including Boots and Superdrug — offer these medications privately at a cost of roughly £150 per month, but they are not available to NHS patients via this route.
In a move designed to speed up access, the government is preparing to launch a trial in which Mounjaro, the brand name for tirzepatide (manufactured by the US pharmaceutical company Eli Lilly), will be made available through NHS community pharmacies. The programme is expected to focus on deprived areas, where high unemployment and elevated rates of obesity intersect, with the broader goal of boosting economic growth by improving public health.
Due to the high workload already faced by general practitioners (GPs), community pharmacies are increasingly involved in prescribing medications — such as antibiotics — following brief consultations. A similar model is likely to be applied for dispensing weight-loss injections.
Clinical trials have shown that Mounjaro can help people lose, on average, 20 per cent of their body weight. In December of last year, the National Institute for Health and Care Excellence (Nice), the UK’s health watchdog, approved the medication for NHS use, explicitly stating that it could be administered not only in hospital clinics but also within GP surgeries or pharmacies.
The NHS is expected to release details in the coming weeks about how Mounjaro will be incorporated into community care pathways.
Dr Kath McCullough, NHS England’s national speciality adviser for obesity, described the move as an “exciting opportunity” and emphasised that the initiative is likely to concentrate on regions with the “greatest clinical need”. Speaking after the publication of the Nice guidelines, Dr McCullough stated:
“Community pharmacies already provide a range of care — some pharmacists who will go through, for example, your blood pressure medication with you and manage that. But it’s still early days and pharmacists prescribing weight-loss injections is one of several potential models that NHS England is exploring, and ultimately it will be down to each local ICB [integrated care board] to consider. The exciting thing here is that it’s pretty much uncharted territory.”
The Tony Blair Institute for Global Change, a think tank that holds significant influence with the Labour government, released a report last year arguing that the government’s prevention agenda would be “doomed to fail” unless weight-loss medications were delivered at scale. The report advocated for NHS partnerships with online pharmacies, rather than relying solely on specialist clinics, to expand access.
In addition, the UK government has partnered with Eli Lilly to conduct a five-year trial in Manchester, aiming to evaluate whether Mounjaro can support individuals in returning to work and in preventing obesity-related diseases, thereby alleviating strain on NHS resources.
Analysis conducted by Nice suggests that widespread use of the drug can result in substantial cost savings for the NHS, particularly by preventing conditions such as type 2 diabetes, which currently costs the health service £11.4 billion annually.
Prime Minister Sir Keir Starmer has previously remarked that weight-loss medications “could be very important for our economy and for health”. Health Secretary Wes Streeting has similarly commented that the new class of drugs could have a “monumental” impact on Britain’s productivity by reducing levels of worklessness.
While access to these medications on the NHS has been limited, more than half a million individuals in the United Kingdom are currently purchasing Mounjaro and Wegovy privately from online pharmacies.
Professor Jason Halford, representing the European Association for the Study of Obesity, expressed cautious optimism about the plans, stating:
“I welcome efforts to increase availability of these drugs, and pharmacies could certainly play a part in that.
The concern is getting enough support. People need close monitoring, psychological support and advice on nutrition.
Potentially this is certainly work that pharmacies could expand into, but these are powerful drugs and they do have side-effects. I would definitely welcome efforts to trial new ways to roll out the drugs.”
As this trial advances, experts, policymakers, and healthcare providers alike will need to ensure that access to these medications is paired with comprehensive support structures, helping individuals achieve sustainable, long-term health improvements.
CCH Insights:
This sounds like a great idea, to improve access to GLP-1RAs, particularly in areas of high deprivation. However, it needs to also provide the right kind of support for patients, and the necessary funding and training to deliver it. If you are spending taxpayers’ money on GLP-1 therapy, you need to make sure it is part of an integrated approach which optimises the safety of the patient and the likelihood the treatment will be successful. This means providing an integrated approach with things like nutrition advice, psychological support and monitoring of side effects. Pharmacists would require appropriate training and referral options to be able to deliver this kind of service.
This sounds like a great idea, to improve access to GLP-1RAs, particularlyin areas of high deprivation. However, it needs to also provide the right kind of support for patients, and the necessary funding and training to deliver it. If you are spending taxpayers’ money on GLP-1 therapy, you need to make sure it is part of an integrated approach which optimises the safety of the patient and the likelihood the treatment will be successful. This means providing an integrated approach with things like nutrition advice, psychological support and monitoring of side effects. Pharmacists would require appropriate training and referral options to beable to deliver this kind of service.
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Antibiotic exposure before age two linked to increased risk of overweight and obesity in children
Key Takeaways:
- Antibiotic use within the first two years of life is associated with higher body mass index (BMI) and a significantly increased risk of overweight and obesity by age twelve.
- Antibiotic exposure before pregnancy, during pregnancy, or around the time of birth shows no statistically significant association with later childhood weight outcomes.
- Findings underscore the importance of careful antibiotic prescribing in early childhood, particularly avoiding unnecessary prescriptions for self-limiting conditions.
Children exposed to antibiotics during their first two years of life may face a heightened risk of developing overweight or obesity later in childhood, according to new research presented at the 2025 Paediatric Academic Societies (PAS) Meeting in Honolulu, Hawai‘i.
The study, led by investigators from the University of Oulu in Finland, specifically examined whether the timing of antibiotic exposure — ranging from before conception to early childhood — influenced weight outcomes in children. Researchers analysed data from 33,095 vaginally born children, drawing upon national health registers, medical records, and electronic growth charts to track weight development over time.
Early-Life Antibiotic Use Tied to Higher BMI and Obesity Risk
The research revealed that antibiotic use within the first 24 months of life was associated with significantly higher body mass index-for-age z-scores (zBMI) at two years of age. Children who received antibiotics during this window exhibited an average zBMI increase of 0.067 (95% confidence interval [CI]: 0.041 to 0.094) compared to children who were not exposed.
Long-term follow-up of these children up to the age of twelve showed that those who had received antibiotics in early life faced a 20% increased risk of developing obesity (adjusted hazard ratio [HR] 1.20; 95% CI, 1.10 to 1.31). Additionally, early antibiotic exposure was linked to a 9% increased risk of becoming overweight by age twelve. These associations persisted even after the researchers adjusted for several potential confounding variables, underscoring the robustness of the findings.
“Antibiotic exposure in the first two years of life has a stronger association with childhood weight gain than exposure during pregnancy stages or other early ages,” stated Sofia Ainonen, MD, PhD, a medical doctor at the University of Oulu and the study’s presenting author.
No Association Found from Maternal or Perinatal Exposure
The investigators also explored whether antibiotic exposure before conception, during pregnancy, or in the perinatal period influenced the likelihood of overweight or obesity in children. Their analysis indicated no statistically significant associations in these cases.
Within the study population, 39% of mothers had used antibiotics during the year preceding pregnancy, 27% during pregnancy itself, and 21% of children had been exposed during the perinatal period. However, none of these exposures were linked to higher BMI or weight-related outcomes later in childhood. This finding suggests that the critical window of influence may be limited to the early postnatal period.
Antibiotic Prescribing in Young Children Remains Widespread
Notably, the study found that 68% of the participating children had been prescribed antibiotics within their first two years of life, reflecting how common such early exposure remains. While antibiotics are essential for treating certain bacterial infections, they are frequently prescribed for conditions such as upper respiratory tract infections, where their clinical benefit may be minimal.
“Providers need to be cautious about prescribing antibiotics for young toddlers, especially unnecessary antibiotics for upper respiratory tract infections,” Ainonen emphasised.
Clinical and Research Implications
The findings contribute to a growing body of evidence indicating that the early postnatal period may represent a sensitive window during which antibiotic exposure can shape long-term health outcomes, including body weight regulation.
The study authors highlighted that future research aiming to uncover the biological mechanisms linking early antibiotic use to later obesity risk should concentrate specifically on the first two years of life, given the lack of associations found for exposures occurring before or during pregnancy.
Childhood obesity remains a critical global health challenge. As of 2022, more than 159 million school-aged children worldwide were diagnosed with obesity. The present study underscores the importance of antibiotic stewardship in early childhood as a potentially modifiable factor that could help reduce the long-term risk of overweight and obesity.
By focusing on appropriate prescribing practices and minimising unnecessary antibiotic use, especially during the crucial early years, healthcare providers may help support healthier long-term outcomes for children.
CCH Insight:
The results of this study are consistent with the increasing body of evidence that the gut microbiota plays a major role in metabolic health and conditions like obesity. A baby’s gut is sterile at birth, and then becomes populated with micro-organisms from its food and environment. This study supports the theory that oral ingestion of antibiotics during the first two years of life disrupts the establishment of a healthy gut microbiota and increases the risk of metabolic dysfunction and obesity.
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Novo Nordisk introduces Wegovy to Thailand, marking first launch in Southeast Asia
Novo Nordisk has announced the launch of its highly popular weight management medication, Wegovy, in Thailand, according to an executive from the Danish pharmaceutical company’s local subsidiary. This development marks Wegovy’s first introduction into the Southeast Asian market.
Initially launched in 2021, Wegovy has significantly contributed to Novo Nordisk’s growth, propelling the company to become Europe’s most valuable publicly listed firm, reaching a peak valuation of $615 billion.
The medication, which is administered via injection, is now available in over a dozen countries, including the United States, Japan, and China. Thailand is the latest addition to this expanding list of markets.
“We actually received the Thai FDA approval already in 2023,” stated Enrico Canal Bruland, Vice President and General Manager of Novo Nordisk’s Thai subsidiary. He emphasised that Novo Nordisk had introduced Wegovy in Thailand ahead of the anticipated arrival of rival Eli Lilly’s weight management medication, Zepbound.
Bruland declined to disclose the pricing strategy for Wegovy within Thailand, a nation with an estimated population of approximately 66 million people. He also did not provide details regarding the company’s broader plans for expansion into additional Southeast Asian countries.
Currently, Wegovy is available for prescription at private hospitals across Thailand. Bruland confirmed that access would soon be extended to public hospitals, enhancing availability for a broader segment of the population.
“Over the last four years, we have invested approximately 500 million Thai baht in clinical trials in Thailand,” he noted, underscoring Novo Nordisk’s long-term commitment to the Thai healthcare landscape.
In addition to Wegovy, Novo Nordisk’s diabetes medication Ozempic, which contains the same active ingredient as Wegovy (semaglutide), is already accessible within Thailand’s healthcare system.
According to data from Thailand’s Ministry of Public Health, approximately 42% of adults in the country are living with obesity. The prevalence of obesity among school-aged children has also risen dramatically, increasing from 5.8% to 15% over the past two decades.
Reflecting on the economic burden of obesity, Bruland commented, “If we then look at the economic impact that this has, approximately 1 percent of GDP is used for health-related costs that come with obesity and productivity loss.”
He expressed optimism about Wegovy’s potential impact in Thailand, stating, “We believe with this innovation, we can make a big difference and hopefully bend this curve.”
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Diabetes drug metformin reduces knee pain in people with overweight or obesity clinical trial shows
A widely prescribed diabetes medication may offer relief for people living with knee osteoarthritis (OA) and overweight or obesity, potentially delaying the need for knee replacement surgery, according to new research led by Monash University.
The clinical trial, published in the Journal of the American Medical Association (JAMA), found that metformin, a drug commonly used in the treatment of type 2 diabetes, significantly reduced knee arthritis pain over a six-month period.
The randomised, placebo-controlled study investigated whether metformin, compared to a placebo, could alleviate knee pain in individuals experiencing symptomatic knee osteoarthritis and who were living with overweight or obesity. Importantly, none of the participants had diabetes.
The research was conducted entirely within the community through telehealth consultations, making it accessible to participants across a range of locations. A total of 107 individuals (73 women and 34 men), with an average age of 60, were enrolled. Participants were randomised to receive either up to 2,000 mg of metformin daily or a placebo for six months.
Pain was assessed using a 0–100 scale, where 100 represents the worst imaginable pain. After six months, those in the metformin group reported an average reduction of 31.3 points, compared with an 18.9-point reduction in the placebo group—a difference considered to represent a moderate effect on pain.
“These results support use of metformin for treatment of symptomatic knee osteoarthritis in people with overweight or obesity,” the researchers concluded. “Because of the modest sample size, confirmation in a larger clinical trial is warranted.”
A New, Affordable Treatment Option
Professor Flavia Cicuttini, lead researcher and Head of Monash University’s Musculoskeletal Unit as well as Head of Rheumatology at The Alfred Hospital, described the findings as highly promising. She highlighted that metformin could represent an affordable, novel approach to improving knee pain in people living with knee osteoarthritis and overweight or obesity.
Current treatments for knee OA primarily focus on lifestyle modifications such as exercise and weight management, interventions that many patients find challenging to maintain. Medications such as paracetamol, topical anti-inflammatory creams, and oral anti-inflammatory drugs are also used; however, they often provide limited benefit and may not be suitable for everyone due to safety concerns.
Notably, no new drugs for osteoarthritis have been approved in Australia since the late 1990s, with the approvals of Celebrex (celecoxib) and Vioxx (rofecoxib).
Professor Cicuttini emphasised that treatment options for managing knee pain in osteoarthritis remain scarce. She noted that this scarcity often drives both patients and their doctors to consider surgical options prematurely.
This has led to a growing issue both within Australia and internationally, with rising rates of knee replacements being performed for earlier stages of osteoarthritis. This trend is underpinned by the belief that effective non-surgical treatments are lacking and that prosthetic knees have long lifespans.
“At first glance this may seem reasonable, but it is a major problem because patient dissatisfaction with knee replacements is already high at between 20–30%, even when the operation is technically perfect,” Professor Cicuttini explained. “Dissatisfaction rates are highest when the operation is done for early knee OA.
“To go through the effort and cost of a big operation like a knee replacement, only to be unhappy with the results because of ongoing pain and symptoms, is definitely low-quality care. Doing a knee replacement earlier also increases the potential need for the procedure to be redone.
“This costs about 3.5 times as much, so about $70,000 compared to $20,000, and the results tend not to be as good as the first time. The best outcome for patients is to delay the knee replacements until it is absolutely needed.”
How Metformin Could Change Knee OA Care
Professor Cicuttini noted that metformin could now offer general practitioners (GPs) an alternative strategy to recommend alongside lifestyle measures such as weight management and increasing physical activity.
“Metformin works in a number of ways on the knee, including affecting low-grade inflammation and other metabolic pathways that are important in knee OA,” she said. “It is a different way to treat knee OA pain.
“GPs are very familiar with metformin, which is a low-cost, safe medication. It could be provided to patients in addition to other treatments they use and has the potential to delay people having knee replacements before they are absolutely needed. If people on metformin have less knee pain and are able to do more physical activity, then knee replacements can wait.”
The fact that metformin is already well known to GPs, affordable, and has a strong safety profile strengthens its potential as an adjunct therapy. Furthermore, if individuals experience reduced pain and can be more active, this may lead to additional benefits in joint health, functional capacity, and overall wellbeing.
Next Steps: Integrating Metformin into Knee OA Management
Professor Cicuttini and her team are now collaborating with patients, GPs, orthopaedic surgeons, and other healthcare professionals to explore how metformin can be incorporated into clinical care pathways for knee OA. The aim is to enhance patient outcomes and more effectively target surgical interventions when they are truly necessary.
Metformin could be prescribed ‘off label’ for this purpose, following thorough discussions between patients and their healthcare providers. This approach would allow for careful consideration of individual circumstances and potential benefits.
“Metformin is safe and well tolerated,” Professor Cicuttini stated. “It is used safely in other non-diabetes conditions such as polycystic ovarian syndrome. Metformin could be provided simply and safely using a telehealth approach, as we did in our study, meaning that it could be provided across the community, including in regional and remote areas.”
The study represents an important step forward in addressing the unmet needs of people living with knee osteoarthritis and overweight or obesity, offering a promising, accessible solution that may improve quality of life and reduce the reliance on invasive surgeries.
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Eli Lilly’s oral weight-loss drug matches Ozempic in trial results, signalling a shift in diabetes and obesity treatment
Eli Lilly’s experimental oral medication, orforglipron, has demonstrated weight-loss and blood sugar-lowering effects comparable to those of the blockbuster injectable drug Ozempic in a pivotal clinical trial involving individuals living with type 2 diabetes. The pharmaceutical company has announced its intention to seek regulatory approvals for orforglipron by the end of the year, aiming to introduce a new, more convenient option in a market currently dominated by injectable therapies.
News of the promising trial results sent Eli Lilly’s shares soaring by 16%, reflecting investor optimism around the drug’s commercial potential. Orforglipron is the first in a series of ongoing trials testing the oral treatment, and its success raises the prospect of a highly effective, user-friendly alternative to existing injectable weight-loss medications.
By contrast, shares of Novo Nordisk — the manufacturer of Ozempic — continued a downward trend, dropping by 7% on Thursday. Over the past year, Novo Nordisk’s U.S.-listed shares have fallen by more than 50%. In a research note, BMO Capital Markets analyst Evan Seigerman commented, “While Novo had the headstart… this first mover advantage has waned.”
The results from Lilly’s phase 3 clinical trial revealed that participants with type 2 diabetes taking orforglipron lost an average of 16 pounds — approximately 8% of their body weight — over a 40-week period. This surpasses outcomes observed with Ozempic, in which individuals on the highest dose typically lost around 6% of their body weight. Furthermore, Lilly indicated that weight loss had not plateaued by the end of the study period, suggesting that extended use could result in further weight reduction.
In terms of blood glucose control, orforglipron reduced haemoglobin A1c (HbA1c) levels — a key marker of long-term blood sugar — by an average of 1.3%. Although this falls short of Ozempic’s 2.1% reduction, the oral formulation’s overall benefits, including ease of use, are seen as significant.
Multiple pharmaceutical companies are currently in pursuit of effective oral weight-loss treatments, as global demand for such therapies accelerates. Forecasts estimate that the market for obesity drugs could exceed $150 billion in the coming years. With the publication of these results, Eli Lilly is now considered the frontrunner in the race to develop an oral alternative to injectable therapies.
Ozempic, which was first approved in 2017 for the treatment of type 2 diabetes, functions by mimicking the GLP-1 hormone — a naturally occurring hormone in the gut that helps regulate appetite and blood sugar. Eli Lilly’s existing injectable medication, tirzepatide, is marketed under the brand names Mounjaro (for diabetes) and Zepbound (for weight management). Tirzepatide mimics both GLP-1 and a second hormone, GIP, and has achieved weight reductions of up to 22% over 72 weeks in clinical studies.
Unlike tirzepatide, orforglipron targets only the GLP-1 pathway. However, its distinction lies in its composition: it is a synthetic small molecule, not a peptide-based drug. This molecular structure allows for simpler and more scalable manufacturing, which could enable broader access to effective weight-loss treatment.
“Readily manufactured” oral agents like orforglipron may dramatically expand access to treatment, particularly among individuals who face barriers to injectable therapies. Lilly also reported that orforglipron’s safety profile was consistent with other GLP-1 receptor agonists, easing concerns that side effects could hinder its commercial viability.
“The data is fantastic from an efficacy standpoint,” said Kevin Gade, Chief Operating Officer at investment firm Bahl & Gaynor, which holds shares in Lilly.
The company has also confirmed that it will publish results from another trial focused specifically on weight management later this year. Regulatory submissions for approval to treat obesity are expected before the year’s end, with an application for diabetes to follow in 2026.
“While this trial alone is very good, this just bodes extremely well for their trial in obesity patients,” Gade added.
Regarding side effects, the trial found that 13% to 18% of participants experienced nausea at varying doses, compared to 2% of those given a placebo. Diarrhoea occurred in 19% to 26% of individuals on orforglipron, and vomiting affected between 5% and 14%, depending on the dose.
“These results firmly validate the tolerable profile of orforglipron,” Seigerman noted in his analysis.
Importantly, Lilly reported no signs of liver-related safety issues in its trial. This stands in contrast to Pfizer’s recent announcement that it would halt development of its experimental weight-loss pill, danuglipron, after a participant in one of its trials experienced potential drug-induced liver injury — a side effect which resolved after discontinuing the medication.
Lilly did state that 8% of patients on the highest orforglipron dose discontinued treatment due to adverse events. However, reductions in HbA1c across all tested doses ranged between 1.3% and 1.6%, reinforcing the drug’s effectiveness in managing blood glucose levels.
The trial’s multi-dose data revealed that individuals taking orforglipron daily achieved the following average reductions in body weight over 40 weeks:
- 4.7% reduction with a 3 mg dose
- 6.1% reduction with a 12 mg dose
- 7.9% reduction with a 36 mg dose
By comparison, individuals given a placebo experienced a 1.6% reduction in body weight.
Lilly has expressed confidence in its ability to meet global demand for orforglipron, should regulatory approvals be granted. The company noted that it recorded $550 million in drug-related inventory in its February financial statements, underscoring its readiness to launch the medication on a global scale.
If successful, orforglipron could become a landmark treatment option for people living with type 2 diabetes and obesity — offering meaningful weight loss in a daily oral format, with manufacturing and access advantages that may redefine the future of obesity care.
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Three-pronged approach helps preserve muscle mass during weight loss with GLP-1 medications, study finds
New findings to be presented at the European Congress on Obesity (ECO 2025) offer encouraging news for individuals living with overweight or obesity who are prescribed GLP-1 or dual GLP-1/GIP receptor agonists as part of their weight management plan. The six-month study involving 200 adults indicates that with the right support—specifically medical supervision, resistance training, and adequate protein intake—substantial fat loss can be achieved with only minimal reductions in lean muscle mass.
The research, conducted by a team of obesity specialists based in New York, reinforces a growing body of evidence supporting the efficacy of GLP-1-based therapies for treating obesity and highlights key strategies for protecting muscle mass during weight loss.
Understanding GLP-1 Receptor Agonists
GLP-1 (glucagon-like peptide-1) receptor agonists—such as semaglutide and liraglutide—were initially developed to treat type 2 diabetes but have also demonstrated significant benefits in supporting weight loss and managing obesity.
GLP-1 is a type of incretin hormone, produced in the gut, that helps regulate blood glucose levels. Medications in this class work by mimicking or enhancing the effects of the body’s own GLP-1, thereby:
- Stimulating insulin secretion in response to food,
- Inhibiting glucagon release (a hormone that raises blood sugar),
- Slowing gastric emptying,
- Suppressing appetite by promoting satiety.
More recently, medications such as tirzepatide, which activate both GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) receptors, have received approval for the treatment of type 2 diabetes and/or obesity. These dual agonists may offer even greater benefits by acting on multiple hormonal pathways involved in appetite and metabolism.
Why Body Composition Matters in Weight Management
While many treatments focus on reducing total body weight, experts stress the importance of maintaining lean muscle mass during weight loss. Muscle plays a vital role in metabolism, mobility, and long-term health. Excessive muscle loss during weight reduction can result in weakness, reduced physical function, and negative metabolic consequences.
To address this, the New York-based research team conducted a six-month prospective cohort study designed to monitor body composition changes in individuals prescribed GLP-1 or dual GLP-1/GIP receptor agonists.
Study Design and Methods
The study enrolled 200 adults aged 18 to 65 years, all of whom had a BMI of 25 kg/m² or higher—placing them in the overweight or obesity category. Participants were prescribed either semaglutide (a GLP-1 receptor agonist) or tirzepatide (a dual GLP-1/GIP receptor agonist). Sixty percent (n = 120) received tirzepatide, while the remaining 40% (n = 80) were given semaglutide.
All participants received care from a board-certified obesity medicine physician, who provided structured guidance on medication adherence, resistance training, and dietary protein intake. Body composition was assessed using the InBody 570—a medical-grade device employing multi-frequency bioelectrical impedance analysis (BIA)—at baseline, three months, and six months.
The InBody 570 measures a range of indicators including total body water, fat mass, skeletal muscle mass, visceral fat, and segmental muscle distribution. Researchers also collected data on medication adherence, physical activity, and dietary patterns throughout the study period.
Importantly, all 200 participants (99 men and 101 women) completed the full study duration.
Key Results: Fat Loss Outpaces Muscle Loss
The average participant age was 47 years, with a mean baseline BMI of 31.4 kg/m².
After six months:
- Women reduced their average body weight from 71 kg (156 pounds) to 62 kg (137 pounds)—a 12% decrease. On average, they lost 10.8 kg of fat mass while losing just 0.63 kg (1.4 pounds) of muscle.
- Men decreased their weight from 101 kg (223 pounds) to 88 kg (193 pounds)—a 13% reduction. Fat mass decreased by 12 kg (25 pounds), while muscle loss averaged just 1 kg (2.4 pounds).
Participants reported high adherence to medication protocols—95% at three months and 89% at six months. Qualitative feedback revealed that those who consistently followed resistance training and protein intake recommendations were more successful in retaining muscle mass and strength.
Comparing Semaglutide and Tirzepatide
While analysis is still underway to examine the comparative effects of semaglutide and tirzepatide on fat and muscle loss, early findings suggest both medications are highly effective in supporting body fat reduction in people living with obesity.
The researchers noted that although some muscle loss is expected during weight loss, targeted interventions—especially when supervised by a qualified obesity medicine specialist—can significantly reduce this loss.
Crucially, the combination of medication adherence, adequate dietary protein, and strength-based exercise emerged as a powerful trio for preserving muscle.
Expert Commentary: Insights and Cautions
Dr Dinabel Peralta-Reich and Dr Alexandra Filingeri, co-authors of the study, shared key insights with Medical News Today.
“This study measured body composition—specifically body fat mass (in pounds), muscle mass (in pounds), and total body weight (in pounds)—in patients at baseline, 3 months, and 6 months while taking GLP/GIP weight loss medications,” they explained.
“The results suggest that, with proper supervision, a protein-rich diet, regular resistance training, and guidance from a trained medical provider, patients can decrease fat mass while minimising muscle loss.”
Dr Peralta-Reich further emphasised:
“We found that, under close supervision and regular follow-up from an obesity medicine specialist, patients were able to lose fat mass with only a minimal decline in muscle mass.”
Commenting on the broader implications, Dr Mir Ali, a board-certified general and bariatric surgeon not involved in the study, added:
“This study was helpful to show that some muscle [loss] can occur with significant weight loss.”
“We see this in our surgical weight loss patients as well, and try to emphasise methods to minimise muscle loss.”
He continued:
“When patients are taking these weight loss medications, they should also implement measures to reduce muscle loss. Muscle loss can lead to weakness and other problems.”
“The main things patients can do is ensure adequate protein intake and exercise. Resistance-type exercises are helpful in maintaining and possibly even building muscle.”
Dr Filingeri noted that the research aimed to provide a clearer understanding of how incretin medications influence fat and muscle mass:
“We found that, under close supervision and regular follow-up from an obesity medicine specialist, patients were able to lose fat mass with only a minimal decline in muscle mass.”
However, she stressed the importance of context when interpreting the findings:
“These results cannot be generalised to patients receiving medication via telemedicine without routine body composition analysis, nor can they be generalised to in-person visits without utilising body composition analysis.”
She concluded by highlighting the need for further studies:
“Further research should explore the roles that diet and exercise play in the success of these medications.”
Conclusion: A Pathway to Safer, Healthier Weight Loss
This six-month investigation provides meaningful insights for clinicians and individuals living with obesity who are using GLP-1 or dual GLP-1/GIP receptor agonists as part of their weight loss journey. By incorporating medical supervision, resistance training, and adequate protein intake, it is possible to minimise the loss of lean muscle and support long-term health outcomes.
As the obesity epidemic continues and these medications become more widely used, tailored, evidence-based strategies like those outlined in this study will be essential to ensuring that weight loss is both effective and sustainable.
CCH Insight:
One of the concerns about AOMs is that large amounts of muscle mass may be lost when people shed weight rapidly, so the results of this study are re-assuring, demonstrating that with the right diet and exercise, lean muscle loss can be minimised. The study is also an excellent reminder that these medications should be taken as an adjunct to lifestyle changes, including a healthy diet and physical activity. With appetite being significantly restricted, it is important to eat a nutrient-dense diet to ensure adequate intake of all essential nutrients, including protein.
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Pfizer halts development of promising oral obesity medication following safety concerns
Pfizer has announced the discontinuation of its once-daily oral obesity treatment, danuglipron, ahead of its transition to the most advanced and costly phase of clinical trials. The decision marks a significant shift in the pharmaceutical giant’s approach to tackling obesity, a therapeutic area that has rapidly gained prominence and commercial value.
The company revealed on Tuesday that it would cease development of the once-daily formulation of danuglipron after a participant in a clinical study experienced a potential drug-induced liver injury. The adverse effect resolved once the individual stopped taking the medication.
A Pfizer spokesperson explained that the once-daily pill was undergoing early-stage testing focused on determining the optimal dosage for people living with obesity. The original plan had been to progress into late-stage clinical trials, which typically serve as the final step before regulatory approval is sought.
Although this version of danuglipron will no longer be pursued, a company representative confirmed: “Pfizer still plans to develop other potential obesity treatments in earlier stages of testing.”
Obesity therapeutics have become one of the most dynamic and financially rewarding segments of pharmaceutical development. In 2024, Eli Lilly’s Zepbound, an injectable medication for obesity, generated close to $5 billion in its first full year on the market. Similarly, Novo Nordisk’s Wegovy has seen substantial commercial success. However, both of these leading therapies require injection, a delivery method that can be a barrier for some individuals.
As a result, there is growing industry interest in developing oral alternatives that offer greater convenience and are likely to be more acceptable to people reluctant to self-inject or attend frequent medical appointments. Eli Lilly is expected to release results later this year from clinical trials investigating several oral obesity treatments currently in development.
Despite the success of these medications, accessibility remains a major challenge. Many people face barriers to treatment due to recent supply shortages or inconsistent insurance coverage. Although both Lilly and Novo Nordisk have recently announced price reductions, the monthly cost of these treatments still runs into the hundreds of dollars, making them unaffordable for many individuals without adequate coverage.
Pfizer’s decision to halt development of the once-daily danuglipron follows an earlier move in late 2023, when the company discontinued its twice-daily formulation of the same drug. That version had advanced to mid-stage testing but was abandoned after more than half the participants in a clinical trial discontinued use.
As part of its latest announcement, a Pfizer spokesperson also confirmed that the company will no longer pursue trials of danuglipron in combination with other medications for obesity treatment.
While the company recalibrates its strategy in the obesity space, the market response remained muted. On Monday morning, shares of New York-based Pfizer Inc. rose by 12 cents to $22.03.
Pfizer’s withdrawal from the danuglipron programme underscores the complexity of developing safe and effective oral medications for obesity. The company’s ongoing commitment to researching new treatments may yet yield novel therapeutic options in a field of growing urgency and unmet need.
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Building minds in code: AI-based ‘digital twins’ of mouse brains open new frontiers in neuroscience
Much like a pilot might practise flight manoeuvres in a simulator, researchers may soon be able to conduct complex neuroscience experiments within a hyper-realistic digital model of a mouse brain. In a groundbreaking study, a team led by Stanford Medicine has developed an artificial intelligence (AI) system that acts as a “digital twin” of the mouse brain’s visual cortex – the region responsible for processing visual information.
This innovation brings us closer to a future in which scientists can explore brain function more safely, efficiently, and in far greater detail than ever before. By simulating how the brain reacts to real-world visual stimuli, these digital replicas allow researchers to investigate cognition and perception without invasive procedures.
A Digital Mirror of the Brain
To create the digital twin, the AI model was trained using vast datasets capturing the activity of real neurons in the visual cortex of mice as they watched clips from feature films. The model, informed by these data, was then able to accurately predict how tens of thousands of neurons would respond to entirely new images and videos.
“If you build a model of the brain and it’s very accurate, that means you can do a lot more experiments,” said Professor Andreas Tolias, PhD, from Stanford Medicine’s Department of Ophthalmology and senior author of the study, published in Nature on 9 April. “The ones that are the most promising you can then test in the real brain.”
Eric Wang, PhD, a medical student at Baylor College of Medicine, served as the lead author of the study.
Generalising Beyond the Known
This new model stands apart from earlier AI simulations of the brain, which were limited to predicting responses to stimuli similar to those in their training datasets. In contrast, the new model has demonstrated an ability to extrapolate and respond accurately to a much wider range of novel inputs. It can even infer physical characteristics of individual neurons, such as their anatomical locations and types.
The model belongs to a new class of AI systems known as foundation models — algorithms trained on extensive datasets that can then apply what they’ve learned to novel scenarios. ChatGPT, for example, is a language-based foundation model. In this case, the model applied foundational principles of neuroscience to visual processing.
“In many ways, the seed of intelligence is the ability to generalise robustly,” said Tolias. “The ultimate goal — the holy grail — is to generalise to scenarios outside your training distribution.”
Lights, Camera, Neural Action
Training the digital twin began with an ambitious experiment: recording over 900 minutes of neural activity from eight mice watching high-energy human films such as Mad Max. These action-packed movies were chosen deliberately. Mice have low-resolution vision — similar to the human peripheral visual field — and are primarily sensitive to movement rather than detail or colour.
“It’s very hard to sample a realistic movie for mice, because nobody makes Hollywood movies for mice,” Tolias quipped. “Mice like movement, which strongly activates their visual system, so we showed them movies that have a lot of action.”
As the mice watched, high-resolution recordings tracked the responses of their visual cortex, while cameras simultaneously monitored their eye movements and behaviours. This data was then used to build a foundational model, which, with a small amount of additional data, could be tailored to create a unique digital twin for any individual mouse.
Simulating the Brain in Silico
Once built, these digital brains responded to fresh images and videos with a high degree of accuracy, closely mirroring the behaviour of their real-world counterparts. This level of precision, according to Tolias, was due to the model being “trained on such large datasets.”
What is particularly remarkable is that the model, trained solely on functional data (neural activity), was also able to generalise to structural data. For one mouse, the AI model accurately predicted the anatomical locations, cell types, and synaptic connections between thousands of neurons in its visual cortex.
To validate these predictions, researchers compared the digital model against high-resolution electron microscopy images from the same mouse’s brain. These data were part of the MICrONS project — an ambitious effort to map the structure and function of the mouse visual cortex in unparalleled detail. The MICrONS findings were published simultaneously in Nature.
An Infinite Laboratory
The implications of this technology are profound. Because a digital twin can outlive the biological organism it models, researchers could theoretically run millions of experiments on a single virtual mouse. This approach could drastically reduce the time, cost, and ethical concerns associated with traditional animal research.
“We’re trying to open the black box, so to speak, to understand the brain at the level of individual neurons or populations of neurons and how they work together to encode information,” Tolias explained.
Already, these AI models are providing new insights. In another related study published simultaneously in Nature, researchers used a digital twin to uncover the mechanisms by which neurons in the visual cortex form connections. While it was previously known that neurons with similar properties tend to form connections, the digital model revealed a more nuanced rule.
The digital twin showed that neurons preferentially connect with others that respond to the same visual stimulus — such as the colour blue — over those located in the same spatial region of the visual field.
“It’s like someone selecting friends based on what they like and not where they are,” Tolias said. “We learned this more precise rule of how the brain is organised.”
What Comes Next?
Looking ahead, the team plans to expand this modelling approach to other areas of the brain and to other species, including non-human primates with more complex cognitive functions.
“Eventually, I believe it will be possible to build digital twins of at least parts of the human brain,” said Tolias. “This is just the tip of the iceberg.”
The project represents a collaborative effort involving researchers from Stanford Medicine, the University of Göttingen, and the Allen Institute for Brain Science.
Funding was provided by multiple institutions, including the Intelligence Advanced Research Projects Activity (IARPA), the National Science Foundation (NeuroNex grant), the National Institute of Mental Health, the National Institute of Neurological Disorders and Stroke (grant U19MH114830), the National Eye Institute (grant R01 EY026927 and Core Grant for Vision Research T32-EY-002520-37), the European Research Council, and the Deutsche Forschungsgemeinschaft.
As digital replicas of brains become more advanced, researchers hope that this technology will not only shed light on the mysteries of perception and learning but also pave the way for new therapeutic approaches to brain-related conditions — all while reducing reliance on live animal testing.
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Expanded access to anti-obesity medications could extend life and save society billions
A new white paper from the USC Schaeffer Center has found that broadening access to anti-obesity medications could significantly increase life expectancy and extend disease-free years for people living with obesity, all while delivering a substantial return on investment to society—even after accounting for treatment costs.
More than four in ten adults in the United States are living with obesity, a chronic health condition linked to over 200 diseases including cardiovascular disease, type 2 diabetes, cancer, and dementia. The financial toll of treating these associated conditions is immense, with annual societal costs reaching $260 billion. Despite the arrival of highly effective anti-obesity medications, fewer than one-third of health insurance plans cover them, largely due to concerns over initial expenditure.
According to the Schaeffer Center researchers, expanding access to these medications for all adults without diabetes who meet clinical eligibility criteria could generate as much as $10 trillion in social value. This value stems from improved longevity and health outcomes. Moreover, the societal return on this investment could exceed 13% annually—a figure on par with returns seen from high-impact policies such as early childhood education for disadvantaged populations, and nearly double the average return of the U.S. stock market over the 21st century.
“While the costs of anti-obesity medications have grabbed headlines, our analysis shows why it’s important to consider the lifetime value of treatment. Expanding access will prevent or delay obesity-related comorbidities, resulting in improved quality and quantity of life for many Americans,”
said Alison Sexton Ward, research scientist at the Schaeffer Center and co-author of the study.
The findings come at a pivotal time, as federal policymakers deliberate whether to expand Medicare and Medicaid coverage for anti-obesity medications—a decision that could also set the precedent for broader uptake among private insurers. The latest white paper builds upon a widely cited 2023 report from the Schaeffer Center, which projected that Medicare coverage alone could save the programme as much as $175 billion over the next decade through reduced demand for medical services.
Benefits Go Beyond the Sickest Individuals
To arrive at these conclusions, researchers employed the Future Adult Model, an economic-demographic microsimulation tool, to simulate the lifelong health trajectories, healthcare costs, and other economic outcomes for adults aged 25 and older who qualify for anti-obesity medication under current clinical guidelines, excluding those already diagnosed with diabetes. The analysis examined subgroups across age bands, body mass index (BMI) categories, and varying levels of diabetes risk.
Even though pharmaceutical competition often drives down net prices of high-cost drugs ahead of generic availability, researchers took a conservative stance, assuming stable net pricing until generic entrants are expected in 2032. The estimated net price, reflecting rebates and negotiated discounts, is approximately 55–65% below the list price, aligning with figures used by the U.S. Congressional Budget Office.
The study found that younger, healthier adults stand to gain the most from early treatment. For instance, people aged 25 to 34 who begin taking anti-obesity medications could gain up to 1.8 additional years of life and experience as many as 5.9 more years free from type 2 diabetes.
The researchers calculated the “social value” of expanded access by comparing the monetary worth of prolonged, healthier lives and lower healthcare costs to the price of medication.
Because early treatment yields more years of healthy life, its value is particularly high in younger age groups. For example, initiating treatment in a 25-year-old with low immediate diabetes risk could deliver nearly 30% more lifetime social value compared to beginning treatment in a 35-year-old with similar risk.
“Insurers often limit coverage of anti-obesity medications to sicker patients, such as those with prediabetes or diabetes, but our analysis shows they are likely missing out on a chance to prevent worse and more costly outcomes through early treatment,”
said co-author Darius Lakdawalla, chief scientific officer at the Schaeffer Center and professor at the USC Mann School of Pharmacy and Pharmaceutical Sciences and the USC Price School of Public Policy.
Importantly, the net lifetime social value of treatment was found to be positive for almost every group assessed in the study, not just the youngest or healthiest.
High Return on Investment Across Populations
The study also evaluated the long-term return on investment to society for each dollar spent on expanding access to anti-obesity medications, focusing on the internal rate of return (IRR). This metric reflects the projected annual benefit relative to the cost.
The IRR exceeded 13% across all subgroups with a BMI of 30 or higher, sustained over a 30-year horizon. This suggests that, across the board, investment in broader access to anti-obesity medication could deliver robust and consistent returns for society.
“Expanding access to anti-obesity medication is probably the single most effective policy to improve Americans’ public health,”
said Dana Goldman, co-director of the Schaeffer Center and founding director of the USC Schaeffer Institute for Public Policy & Government Service.
“The challenge will be to do it in a way that rewards innovators but keeps the public costs low.”
The report underscores that, despite the headline-grabbing costs of anti-obesity medications, their long-term benefits—in both health and economic terms—are substantial. As policymakers debate the future of healthcare coverage, the findings offer compelling evidence for the early and equitable use of these medications as a powerful tool in tackling one of today’s most widespread and consequential chronic health conditions.
CCH Insight:
This study makes a very strong case for access to anti-obesity medications for everyone who is eligible – there would be considerable financial and societal benefits. However, as long as these medications are delivered by self-injection ‘pens’, there are likely to be supply issues. Oral versions of these medications are under development, and the sooner they are available, the sooner we are likely to see a leap in accessibility and the possibility of the public health benefits suggested by this study. Our next news item about trials of oral AOM orforglipron provides hope that these oral medications may be available fairly soon.
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