Nya insikter om semaglutid och viktnedgång

Semaglutid & Incretin mirakelmediciner

Weight loss has been for decades a very lucrative market. From diet companies to books describing magic solutions or food supplements supposed to activate the metabolism. Most of these “solutions” were snake oil at best and dangerous at worst. But this did not stop people from trying them anyway.

The growth of this market has been parallel with the increase in obesity worldwide. It concerns up to 650 million people today.

This is why the arrival of semaglutide as an anti-obesity treatment has been a healthcare revolution. Obesity is tightly linked to many other metabolic diseases and overall increases the death rate significantly.

The global obesity treatment market size was valued at $15.92B in 2024 and is projected to reach $60.53B by 2030, growing at a 22.31% CAGR.

Källa: Grand View Research

Semaglutide, commercialized under the brand name Wegovy by Novo Nordisk (NVO ), mimics a weight-related hormone called GLP-1 (glucagon-like peptide-1), but we are still not fully sure exactly what it does to our metabolism.

The same can be said for competing drugs like Eli Lilly’s (LLY ) Mounjaro (Tirzepatide- both a GLP-1 receptor agonist and a GIP-analog), with all these drugs grouped under the name “incretins”.

A new study observing people taking incretins in everyday life settings (and not in a hospital or other more controlled environment), taking semaglutide, reveals that not only does the drug affect our metabolism, but also our taste perception. This might be important in better understanding the effect of the drug and its impact on obesity and behavior.

The study was conducted by doctors and scientists in Austria at the Medical University of Vienna and the University of Graz. It was published in Diabetes, Obesity, and Metabolism¹, under the title “Real-world insights into incretin-based therapy: Associations between changes in taste perception and appetite regulation in individuals with obesity and overweight: A cross-sectional study”.

How Do Incretins Work?

Semaglutide (Wegovy) has been shown to reduce body weight by approximately 15% compared to placebo over a treatment period of 68 weeks.

Tirzepatide (Mounjaro) has been shown to result in even greater weight loss than semaglutide, particularly at higher doses.

Initially, this effect was mostly assumed to be due to the molecules belonging to the incretin hormone class, which decrease blood glucose levels (they were initially invented as a diabetes therapy).

But it has since appeared that these drugs also have an effect on several other organs, like the heart, kidneys, and central nervous system.

Källa: Frontiers In Molecular Biosciences

For the brain effects more specifically, GLP-1 drugs have been shown to influence food intake by targeting receptors located in multiple brain areas involved in taste perception, olfaction, and reward processing.

It seems that semaglutide not only reduces appetite but also affects dopamine-mediated reward signaling in the brain, which may explain the reduced food craving in patients.

Källa: Dr. Ulrike Hövelmann

Now, a new factor in the reaction to incretin is becoming apparent: direct change in taste perception not from affecting the brain, but the taste signals in the tongue themselves.

Changing Taste With Incretins

Who Was Studied?

Some studies had already pointed to possible effects of semaglutide and incretins on taste, like a reduction in taste detection. But the results were overall not clear yet, and sometimes contradicted each other.

The new study included people suffering from obesity, with an initial body mass index (BMI) ≥ 30, or BMI between 27 and 30. They also had at least one weight‑related comorbidity like prediabetes, type 2 diabetes mellitus, hypertension, dyslipidemia, obstructive sleep apnea, or cardiovascular disease.

All participants were required to be actively receiving treatment with a GLP‑1 or dual GIP/GLP‑1 receptor agonist and to have been on therapy for at least three consecutive months.

What Did the Study Find?

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Cirka 20 %–30 % av deltagarna rapporterade en ökad smakuppfattning för de söta, salta, bittra och sura smakerna.

Deltagarna med ökad intensitet i den söta och salta smaken var också de som upplevde starkare minskade begär eller tidigare mättnad (slutet på hungern).

Dock korrelerade denna starkare förändring i smak för vissa patienter inte med BMI-reduktion, efter justering för relevanta kovariater (andra faktorer, såsom högre initial vikt, till exempel).

Således indikerar studien att förändringar i smak från att ta semaglutid och andra incretiner är verkliga, men kanske inte har någon inverkan på viktnedgång.

En hypotes från forskarna för att förklara detta är att effekten på smakuppfattning är stark på kort sikt, men neutraliseras av kompensation i metabolismen eller matintagsvolymen på lång sikt.

New Possibilities For Obesity Therapies

New Hypothesis

These results could indicate a previously unknown link between taste perception and satiety, although the mechanism by which it works is still unknown.

Another possibility is that chemical sensors in the intestine, similar to taste buds, might also be affected, a previously unknown effect.

This opens the question that the difference in outcome between patients taking GLP-1 drugs might stem from differences in their genetic makeup and taste buds.

Further Research

New studies should focus on these new ideas, with, for example, a longer study from the start of incretin-based treatments, to study why the changes in taste stop impacting weight loss in the long run.

If this loss of effect could be addressed, it could significantly enhance the efficiency of all incretin drugs.

Figuring out why only some patients report a difference in taste perception could also help.

If this is due to genetic differences, this could help identify in advance which patients will benefit the most from semaglutide & incretin with a simple genomic test costing less than $1,000. If this is due to other factors, these too can be identified in advance to predict the pertinence of prescribing incretin better.

Investing In The Pharmaceutical Sector

While the initial lead in obesity treatment using incretin was held by Novo Nordisk, the approvals of more complex molecules, adding extra incretin effects, have upended the market in favor of other companies.

One of them is Eli Lilly, another prominent player in the diabetes drug market, with extensive experience working with incretin analogs, the class of molecules including GLP-1, glucagon, and GIP.

Eli Lilly is now the market leader in incretin analogs in the USA, with 53.3% of the market share of total prescriptions. This resulted in the company seeing a revenue growth of 45% year-to-year for its key products, which also include non-diabetes, non-obesity related drugs.

Källa: Eli Lilly

Mounjaro/Zepbound is only a step on the way, with the additional effect of glucagon to be added to a new product in the future, if the clinical trials go well.

Another potentially new important obesity drug is orforglipron, an oral version of GLP-1, which would be easier to take than the current ones, based on injections.

To answer the associated demand with these strong sales, the company is planning to drastically expand its US manufacturing capacities, with a total of $50B of investments planned. Eli Lilly is also planning to increase its R&D spending by 8%.

It should be noted that Eli Lilly is a more diversified company than Novo Nordisk, with a pipeline on Alzheimer’s, Parkinson’s, cancer, autoimmune diseases (Crohn’s, Rheumatoid Arthritis, Multiple Sclerosis), etc.

Källa: Eli Lilly

So while obesity drugs and diabetes are becoming the core of the company’s revenues, these segments should also be considered by potential investors.

(Du kan läsa en mer detaljerad analys av Eli Lillys verksamhet i vår dedikerade investeringsrapport.

Du kan också läsa vår artikel om “Toppföretag inom fetmabehandlingar”.)

Latest Eli Lilly (LLY) Stock News and Developments

Refererad studie

^{1. Ali Kapan, Othmar Moser, Richard Felsinger, Thomas Waldhoer, Sandra Haider. Verkliga insikter i incretinbaserad terapi: Samband mellan förändringar i smakuppfattning och aptitreglering hos individer med fetma och övervikt: En tvärsnittsstudie. Diabetes, Obesity, and Metabolism. 24 juni 2025. https://doi.org/10.1111/dom.16548}