Stepping back from the intense swirl of obesity care research at the ADA meeting just concluded, one thing stands out: People are having a very hard time following the thread of all this innovation.

If you have any doubt, just scan the reports of investment analysts at the meeting. On one hand, they know they are witnessing impressive innovation. Financial analysts, for example, were effusive about a new Novo Nordisk drug called amycretin. “Patients taking amycretin seem to have reached 24% weight loss faster than those on retatrutide,” writes Elizabeth Eaton for FirstWord Pharma.

And yet, Reuters reports: “Novo Nordisk shares fall as obesity pipeline faces investor scrutiny.”

Clearly, investors are having a hard time following the thread of obesity care innovation.

Clueless Myopia

At the heart of this difficulty in perception is a kind of clueless myopia that has people focused excessively on acute outcomes for a chronic disease. Weight loss seems to be the metric that many analysts seize upon to decide if a new medicine will be a hit or a miss.

But they are missing the point of further innovation in obesity care. Simply stated, people are not desperate for drugs that will deliver more weight loss faster. New drugs are already testing the limits of what patients can readily accept when it comes to the extent and speed of acute weight loss. Some patients and providers report issues with too quickly losing too much weight from some of these new drugs, such as retatrutide.

And yet, financial analysts pore over phase two research and declare that 23% weight loss is “less than hoped” for CagriSema.

Looking Toward the Long Term

If we want to understand what will perform well in the future of this still immature market for obesity care, we should extend our gaze beyond short-term outcomes. This is a chronic disease. None of the potent therapies for it will cure it once and for all. What they do is help people enjoy longer and healthier lives. Living with obesity is clearly a marathon, not a sprint.

Thus, the important dimensions become persistence on therapy, tolerability, affordability, and long-term health gains. These are factors that are not obvious for a drug that has only phase two results. Much fine tuning goes into the regimens for phase three studies. A good example would be the refined dosing for MariTide that Amgen hopes will significantly improve adherence to their innovative drug.

But long-term outcomes, obviously, take time to come into focus. So analysts will need to shift their focus from weight loss to health gains – and then be patient. It is the only way to see what those health gains really will be.

For additional perspectives on obesity from the ADA Scientific Sessions, click here and here.

The Thread, painting by Edouard Vuillard / WikiArt