New Obesity Drug Shows Superior Weight Loss to Zepbound Ingredient in Trial

A new obesity drug developed by Novo Nordisk, known as CagriSema, has shown potential for greater weight loss than tirzepatide, the active ingredient in popular medications like Mounjaro and Zepbound. The findings come from the late-stage REIMAGINE 5 clinical trial, which compared CagriSema to tirzepatide in individuals with type 2 diabetes.

In the trial, participants receiving a 1mg weekly dose of CagriSema experienced an average weight loss of 12.4 percent over 60 weeks. In comparison, those on a 5mg weekly dose of tirzepatide achieved an average weight loss of nine percent during the same period. CagriSema also demonstrated superior blood sugar control among the diabetic participants.

In a separate Phase 3 trial focused on adults who were overweight or obese but did not have diabetes, CagriSema resulted in a 21 percent weight loss over 68 weeks when compared to a placebo.

CagriSema is a once-weekly injectable medication that combines two active drugs: cagrilintide and semaglutide. Semaglutide, also the active ingredient in Novo Nordisk's Ozempic and Wegovy, mimics a natural gut hormone (GLP-1) that helps regulate appetite and promotes a feeling of fullness by slowing stomach emptying. Cagrilintide is a synthetic, long-acting analog of amylin, a hormone involved in regulating blood sugar and body weight, which acts on brain regions controlling hunger and satiety.

"The results from CagriSema are very encouraging, demonstrating the strong potency of the combination of semaglutide and cagrilintide," said Martin Holst Lange, Novo's Chief Scientific Officer. "With only 1.0 mg/1.0 mg, CagriSema shows superior weight loss versus tirzepatide 5 mg as well as strong results across obesity and type 2 diabetes."

It is noted that the dosage of tirzepatide can be increased to 10 mg or 15 mg, which may lead to greater weight loss than observed in the trial's comparison. Novo Nordisk has filed for FDA approval for CagriSema, with a decision anticipated later this year. The company is targeting an early next year market launch for the drug.

CagriSema is positioned as a successor to Novo Nordisk's Wegovy, whose patent is set to expire in 2030. GLP-1 drugs are increasingly prevalent, with approximately 12 percent of U.S. adults currently using one for weight loss, diabetes, or other conditions, according to a KFF poll. Another Gallup survey indicated that 11 percent of U.S. adults are using these drugs specifically for weight loss.

Wegovy prescriptions have seen significant volume, with around 100,000 prescriptions written weekly in 2024, peaking at 200,000 in mid-2024 and early 2025. The oral version of Wegovy, launched earlier this year, now accounts for 30 percent of all Wegovy prescriptions. Zepbound, launched in 2023, became the most prescribed branded weight-management medication in the U.S. by 2025.