"Era of Obesity Drugs That Cut Body Weight by 30%... Set a 'Target Weight' for Each Patient"

Eli Lilly Senior Vice President Thomas Sek
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"For diabetes, there are blood sugar targets, and for hypertension, blood pressure targets, but there are still no targets for obesity. Now that we have entered an era in which medication can reduce body weight by as much as 30%, we need to establish criteria for how much weight each patient should lose."

Thomas Seck, Eli Lilly's senior vice president overseeing clinical development for cardiovascular and metabolic diseases, made the remarks during his keynote address at the 2026 KoNECT International Conference on Clinical Trials, held at The Grand Lotte Seoul in Jung-gu, Seoul, on October 14.

His assessment is that treatment goals must now be set for individual patients, given the greater degree of weight loss achievable. For example, for hypertension and diabetes, medication is adjusted until blood pressure and blood sugar targets are reached, and then maintained. Obesity, however, has no such benchmarks, so treatment is often escalated to the maximum dose a patient can tolerate. "Until now, medications could reduce body weight by only around 5%, leaving little room to consider targets," Seck said. "Now that weight loss can reach 20% to 30%, data showing how much weight different patients should lose have become important."

Thomas Seck, Eli Lilly's senior vice president overseeing clinical development for cardiovascular and metabolic diseases, delivers a keynote address at the 2026 KoNECT International Conference on Clinical Trials, held at The Grand Lotte Seoul in Jung-gu, Seoul, on the 14th. Photo by Park Jeongyeon.

Without targets, it is also difficult to determine the course of treatment after weight loss, he said. According to Seck, in a maintenance trial of tirzepatide (brand name Mounjaro), patients who remained on the maximum dose maintained weight loss of about 22%, while those whose dose was reduced to 5 mg maintained weight loss of about 17%. The dose to which treatment can be lowered may vary from patient to patient, but there are not yet criteria for making that determination. "We need to build data linking target weight and body mass index (BMI) to actual health outcomes," he said, emphasizing that "awareness among healthcare professionals, patients, and policymakers must change together to curb the spread of obesity."

He identified treatment burden, tolerability, degree of weight loss, and muscle loss as challenges that obesity drugs have yet to resolve. He said that more than 400 obesity drug trials currently underway worldwide are targeting these issues.

At the conference, Seck introduced Lilly's next-generation candidates as potential solutions to each challenge. To reduce the burden of treatment, he cited orforglipron (U.S. brand name Foundayo), an oral obesity drug. Existing oral semaglutide has an absorption rate of around 1%, and patients must avoid eating for 30 minutes after taking it. Orforglipron is a small-molecule compound with high absorption and no restrictions on when it can be taken. In a Phase 3 trial, it reduced body weight by 12.4% at the highest dose.

He said the triple agonist retatrutide could increase the degree of weight loss. It is a once-weekly injectable that stimulates the glucagon receptor in addition to glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). In a Phase 3 trial whose results were announced this year, it reduced body weight by about 28% over 80 weeks and about 30% over two years. "This is enough for a considerable number of patients to move out of the obesity range and even the overweight range," Seck said.

As a candidate to improve tolerability, he cited the amylin receptor agonist eloralintide, which reduced body weight by 15% to 16% in a Phase 2 trial. "It appears to cause fewer gastrointestinal side effects than existing GLP-1 drugs, but this needs to be confirmed in the ongoing Phase 3 trial," Seck said.

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