Eli Lilly winning the GLP1 game over Novo Nordisk.

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We invented being obese. Hey Denmark, get the f-ck out of here!

The weight loss drug giants are going in opposite directions

Novo Nordisk invented the modern weight loss drug market with Ozempic. But it's Eli Lilly that is now best positioned to scale that market profitably

By Catherine Baab

Published 6 minutes ago

It’s a tale of two weight loss drug giants: The best of times for some, the worst for others.

Shares of Novo Nordisk have fallen roughly 17% this week, after the pharma giant forecast a sales drop in 2026. At the same time, Eli Lilly $LLY -3.90% stock was gaining by double digits ahead of Wednesday’s market open, with futures up 8%.

Here's what to know.

Eli Lilly earnings show big growth

First, the good news. Eli Lilly, maker of the weight loss drugs Mounjaro and Zepbound, saw sales rise 43% in its fourth quarter. Profits rose even faster, with earnings per share up 51% and net income rocketing 50%.

Sales growth was broad-based, with revenues increasing both domestically and abroad, and vast volumes making up for a slight decline in prices. Even with a drop in price, margins remained enviable. Per the release: “Gross margin as a percent of revenue was 82.5%, an increase of 0.3 percentage points. The increase in gross margin percent was primarily driven by favorable product mix and improved cost of production, partially offset by lower realized prices.”

Unsurprisingly, Mounjaro and Zepbound were the primary growth drivers, Lilly’s wide drug portfolio notwithstanding. Worldwide revenues for Mounjaro “increased 110% to $7.4 billion.” In the U.S., sales totaled over $4 billion for a near-60% increase. Outside the U.S., sales grew to top $3.3 billion, up from $900 million this time last year. Zepbound revenues showed a similar trajectory, albeit U.S. only, climbing 122% to over $4 billion on a similar mix of exponential demand amid slightly lower prices.

Novo Nordisk results show a very different picture

The Danish pharma giant, the maker of Ozempic, ended 2025 with solid underlying growth, albeit skewed by one-off costs and currency effects. Stripped of those effects and costs, operating profit rose 13%. Unsurprisingly again, weight loss drugs remained the clear engine — with sales jumping more than 26%, again stripped of currency effects.

Novo did pick up a major win late in the year with FDA approval of the first oral GLP-1 for obesity, the Wegovy pill, which is already seeing strong early uptake in the "self-pay market," with some 50,000 prescriptions and counting. But the drugmaker’s outlook for 2026 is cautious to actively negative, with management guiding to declining sales and profit and lower realized prices amid U.S. health policy changes. Add to this how Novo's patents are expiring in some markets, while the competition for core markets only seems to be increasing—not least, of course, from Eli Lilly.

Wall Street's view is clear

Put together, the earnings crystallize a narrative that’s been building for years. Novo may have invented the modern weight loss drug market, but its early-mover advantage has evaporated. Lilly now looks like the company best positioned to scale the market profitably. With the stock movements on Wednesday morning, Wall Street's view could hardly be clearer.