People seeking powerful new obesity treatments like Ozempic have had little choice but to rely on injections. Now, pharma giant Eli Lilly says it has a pill that could offer the same benefits—minus the needle.

On Tuesday, the company unveiled results from a large international trial of its experimental drug, orforglipron. The pill helped people with both obesity and type 2 diabetes shed significant weight while improving blood sugar control, paving the way for Lilly to seek regulatory approval around the world.

A Pill That Mimics Blockbuster Injections

The study, known as ATTAIN-2, enrolled more than 1,600 adults across 10 countries. All were overweight or obese and living with type 2 diabetes, a condition that typically makes weight loss more difficult. Participants took either a placebo or daily doses of orforglipron, gradually increasing to their maximum level.

After 72 weeks, the results were striking. Patients on the highest dose lost an average of 10.5% of their body weight—about 10 kilograms (22.9 pounds), compared with just 2.2% for those on placebo. Blood sugar levels dropped as well. Most participants on the drug no longer met the clinical definition of type 2 diabetes by the trial’s end.

“It had ‘unprecedented efficacy’ in patients with obesity and Type 2 diabetes,” said Daniel Skovronsky, Eli Lilly’s chief scientific officer, in an interview, as per CNBC.

Patients also saw improvements in cardiometabolic risk factors, according to the company. Kenneth Custer, president of Lilly Cardiometabolic Health, said: “With these positive data in hand, we are moving with urgency toward global regulatory submissions to potentially meet the needs of patients who are waiting.”

Not Without Drawbacks

As promising as the results appear, orforglipron has its limits. In trials, the pill did not outperform Lilly’s own injectable tirzepatide (sold as Zepbound and Mounjaro) or Novo Nordisk’s Wegovy, which can deliver 14% or more weight loss.

Side effects were another hurdle. The most common complaints were nausea, diarrhea, constipation, and vomiting. About 10% of patients on the highest dose stopped treatment because of side effects, roughly double the rate of discontinuations among those taking a placebo.

If regulators approve orforglipron, it would become the first next-generation GLP-1 pill available for weight loss. GLP-1 drugs are a class of medications that mimic glucagon-like peptide-1 (GLP-1), a natural hormone the body releases after eating to help regulate blood sugar. They work by stimulating the pancreas to release insulin when glucose levels are high, slowing stomach emptying so food is absorbed more gradually, and signaling the brain to reduce appetite.

Right now, the only oral GLP-1 drug is Novo Nordisk’s Rybelsus, a pill form of semaglutide approved only for diabetes, not obesity. Novo is pursuing a higher-dose version aimed at weight loss, which could arrive in late 2025.

Convenience may give Lilly an edge. Unlike Rybelsus, which must be taken on an empty stomach with water and requires a half-hour wait before eating, orforglipron comes without dietary restrictions. For some patients, that alone could be decisive.

There are also supply concerns. Injectables like Wegovy and Mounjaro have faced years of shortages due to manufacturing limits and explosive demand. Pills are easier to mass-produce, potentially making them more widely available.

Analysts see staggering potential. Morgan Stanley projects that, if approved, orforglipron could generate as much as $40 billion annually by 2033.

Yet investors remain cautious. Earlier this month, Lilly released results from another trial of the drug that underwhelmed Wall Street, sending the company’s stock tumbling. Shares have since recovered.

The Road Ahead

Eli Lilly now has the full clinical package needed for regulatory submissions. CEO David Ricks told CNBC the company expects to launch the pill worldwide “this time next year.”

If that happens, millions of people with obesity and diabetes may soon face a new choice: stick with injections that work slightly better, or switch to a pill that is easier to take.

Either way, the competition between Lilly and Novo Nordisk is set to intensify. And for patients who have waited decades for more effective weight loss treatments, that competition could mean more options—and better access—than ever before.