News from Lilly about orforglipron this week points to what might be the next big development for GLP-1 medicines. The company announced topline results for a weight maintenance study of orforglipron and this first glimpse has us thinking that maintain might be the magic word in obesity care next year.

The topline come from the ATTAIN-MAINTAIN study, which aimed to show that people who successfully lost weight with either tirzepatide or semaglutide could maintain that lower body weight – and potentially better health – with orforglipron. Orofo, as many many people are calling it, is a new GLP-1 in the form of a daily oral tablet.

Overall, it appears that orfo is pretty good for helping people maintain the lower weight they reach with either semaglutide or tirzepatide.

At the same time Lilly announced these topline results, the company announced it had submitted an application to FDA for approval to market orfo to treat obesity and overweight. The submission was done with a Commissioner’s National Priority Voucher, which could reduce its review time to just one or two months.

Maintaining a Healthier Weight

We’ve seen tremendous progress in obesity care with new obesity medicines, mainly because they are highly effective for losing weight. Where the real world results are falling short is in the longer term. These medicines don’t keep working after people stop taking them (duh). But about half of the people who take GLP-1s stop taking them in the first year after they start. The reasons are many, but one reason is that the medicines we have now are expensive injectables. Orforglipron will be an oral tablet and may people are speculating that the price point will be lower for it.

So these new results point to the potential for a new approach to clinical obesity care, says obesity medicine physician Michael Albert:

“We are moving toward a sequencing model where injectables drive induction (maximal weight loss) and oral agents support long-term maintenance.

“Obesity is a chronic disease, not a 72-week experiment. For the first time, we have Phase 3 data supporting a real-world sequencing strategy that addresses what happens after injectable therapy.”

This totally makes sense.

These Are Only Toplines

But there’s just one caveat. These are only topline results. We will not know the full story until Lilly publishes the detailed results in a medical journal with peer review. And we won’t know how well this works in the real world until FDA approves orfo and Lilly launches it.

On top of all this is the expectation of an imminent approval of oral semaglutide for obesity and overweight. With two oral GLP-1s for obesity in 2026, maintain might indeed become the magic word in this obesity care.

Click here for Lilly’s announcement of all this, here, here, and here for further perspective.

The Magic Word, illustration created for ConscienHealth with Gemini image generation