Weight loss drugmakers race to make muscle retention treatments

For now, Novo Nordisk’s Ozempic and Wegovy and Eli Lilly’s Zepbound are the leading therapies in a weight-loss market that could grow to $100bn (€92bn) by 2030, according to Goldman Sachs estimates.

The new blockbuster weight loss shots can help patients trim more pounds than any medicines have before. Now drugmakers are rushing to solve another problem — making sure people keep their muscle even as they shed fat.

The race for potential treatments is picking up pace. Regeneron Pharmaceuticals released data recently showing that its antibody cocktail boosted muscle in a small group of volunteers. Eli Lilly & Co agreed to shell out as much as $2bn (€1.8bn) last year for a startup with an experimental drug that aims to decrease fat while maintaining muscle.

Some doctors are sceptical, saying that for many obese patients shedding pounds is of paramount importance, even if they lose muscle alongside fat. Yet preserving muscle is an alluring goal for drugmakers that missed the first generation of obesity treatments and are seeking a foothold in the fast-growing and lucrative field.

For now, Novo Nordisk’s Ozempic and Wegovy and Eli Lilly & Co’s Zepbound are the leading therapies in a weight-loss market that could grow to $100bn by 2030, according to Goldman Sachs estimates. 

However, both companies are also studying treatments to help patients retain muscle while slimming down.

“We can make people lose weight — now it’s the next step,” said Jennifer Linge, a lead scientist at AMRA Medical, a Swedish company that uses body scans to study muscle composition. “The muscle piece will be an important one for the next phase.”

Like obesity, sarcopenia — the loss of skeletal muscle mass and function — was long an ignored disorder, Ms Linge said. It’s usually linked with ageing, though chronic diseases such as cancer, HIV, and diabetes can also cause the condition.

Some doctors say that, for many obese patients, shedding pounds is of paramount importance, even if they lose muscle alongside fat.

When people drop weight very quickly, whether via obesity drugs or bariatric surgery, they may face a higher risk of an unhealthy loss of muscle. And if they stop using the drugs and regain weight, they risk adding back a higher proportion of fat, an effect that can weaken the body over time.

The phenomenon is rooted in the body’s ability to raid its own muscles to survive periods of starvation, said George Yancopoulos, chief scientific officer of Regeneron. Severe caloric restriction helps spur the production of myostatin, a protein that impedes the growth of muscle.

To move more quickly, some companies are turning to medicines originally developed for other disorders.

Swiss drugmaker Roche Holding has said it sees potential to combine an experimental muscular dystrophy drug with a weight-loss compound it acquired in the $3.1bn Carmot Therapeutics deal.

Eli Lilly & Co is testing a similar hypothesis. The company plans to study its weight-loss drug Zepbound in combination with a treatment that has shown promise preventing muscle atrophy in older adults.

Novo is doing its own early work on compounds that could preserve muscle, development chief Martin Holst Lange said this week. Yet Novo has also pushed back against the idea that the muscle loss seen with Wegovy is unhealthy.

• Bloomberg