By Asif Dhar, Global Life Sciences and Health Care Consulting Services Industry Leader, and Jay Bhatt, Managing Director of the Deloitte Health Equity Institute and the Deloitte Center for Health Solutions

Initially approved for type 2 diabetes treatment, GLP-1s (glucagon-like peptide-1 agonists) have emerged as game-changers in the treatment and management of obesity. GLP-1s are also showing early promise as a treatment for addiction, sleep apnoea, neurological, psychiatric, cardiovascular and kidney diseases. This could help move us closer to Deloitte’s vision for The Future of Health,^TM which predicts a monumental pivot from sick-care to well-care, early detection, and prevention. This week’s blog, which first appeared as a Center for Health Solution’s Health Forward blog, explores the emergence of GLP-1s as a potential catalyst for a more preventative health ecosystem, examining the weight loss market’s, potential to support patients in their weight loss journey and what improvements are needed to counteract the side-effects of these drugs.

What are GLP-1s?

GLP-1s appear to be reshaping the way patients, clinicians, and pharmaceutical companies approach weight loss. Along with helping to redefine the emerging obesity-health ecosystem, GLP-1s are also being evaluated for their ability to treat or prevent a wide range of diseases.¹ 

GLP-1s, formally known as glucagon-like peptide-1 receptor agonists, mimic a hormone that helps control insulin and blood glucose levels and promotes feelings of being full. The drugs have proven to be effective in reducing obesity, a condition that can reduce life expectancy by as much as 10 years.² And their ability to regulate blood glucose and insulin levels makes GLP-1s a candidate for treating diseases linked to metabolic dysfunction, such as kidney and liver diseases.³ Some studies suggest that GLP-1s may be a viable therapeutic approach for treating non-alcoholic fatty liver disease (NAFLD) or steatohepatitis (NASH). In addition, GLP-1s are being assessed for a range of other health issues including the treatment of addiction, sleep apnea, Alzheimer’s disease, and mental health.

The most effective treatments will likely pair a GLP-1 with personalized care, which can include diet, exercise, digital monitoring, and side-effect management. Such a lifestyle transformation could help some patients extend their health span. Health span is the average number of healthy years between birth and death, also known as quality of life or health-adjusted life expectancy (see Employers can spark healthy aging).

If GLP-1s are effective at treating and preventing certain diseases, some consumers might feel empowered to take a more active role in their well-being. It also could prompt the health care sector to redesign services around condition-management. Even if prescription drug costs increase in the short-term, there could be a significant and long-term reduction in care costs. However, GLP-1s are expensive and might not be accessible or affordable to everyone who could benefit from them. Some leaders in Congress are encouraging generic pharmaceutical companies to sell lower-cost alternative products.⁵ If this issue isn’t addressed, it could further widen the health-equity gap.

GLP-1s have been around for years as a treatment for type 2 diabetes, but demand began to surge once the drugs were proven to be effective for weight loss.⁶ More than 55 million GLP-1 prescriptions were filled in 2023—triple the number filled in 2020; global sales are expected to reach $150 billion by the early 2030s—up from $24 billion in 2023.⁷ The potential to prevent or treat a broad range of illnesses could encourage some pharmaceutical companies to enter the market. And existing GLP-1 manufacturers might opt to ramp up production. Some large drug manufacturers are investing billions to strengthen supply chains to keep up with anticipated demand.⁸

The potential downstream effect of GLP-1s

The weight-loss ecosystem is likely to expand to include new drugs, complementary products, and periphery markets. Here’s a look some possible growth areas:

• Supplements:The global weight-loss supplement market is expected to more than triple over the next 10 years—from 28.6 billion in 2023 to $101 billion by 2033. Some supplements are being promoted as complementary to GLP-1s, while others are touted as alternatives.^{9, 10} 
• New weight-loss drugs:The success of GLP-1s has prompted some pharmaceutical companies to invest in research and development. Between 2022 and 2023, the number of clinical trials for obesity drugs increased nearly 70%. About 125 drugs are in development, 40% of which are agonists of either the GLP-1 or glucose-dependent insulinotropic peptide receptors.¹¹
• Medical devices: Spending on medical devices, such as pumps that eliminate food from the stomach, is expected to increase by more than 40% over the next decade.¹²However, sales of glucose monitors, insulin pumps, and other medical devices that help patients manage diabetes could decline if GLP-1s can keep people from developing type 2 diabetes.¹³
• Restaurants and grocery stores:GLP-1s cause a decrease in appetite, which translates to lower calorie intake. This could have an impact on the food choices people make—from grocery stores to restaurants. People who take weight-loss drugs often reduce their consumption of sugary drinks, alcohol, confections, and salty snacks.¹⁴ Some restaurants might decide to revamp their menus to include healthier food options.¹⁵
• Wearables and fitness trackers: Medical devices and wearables that monitor health metrics and metabolic function are becoming increasingly integrated with treatment regimens. In some cases, GLP-1s are being paired with fitness devices, dietary supplements, and products that help track goals and compliance.¹⁶
• Gyms and weight-loss companies:As individuals lose weight, there also could be an uptick in new gym memberships. Some gym operators are working with the medical community to create GLP-1 programs for their members.¹⁷ Weight-loss companies could help members get prescriptions and combine GLP-1s with lifestyle changes.¹⁸

Beyond diabetes and weight loss

A few pharmaceutical companies are exploring ways to promote existing products, or develop new ones, that could help mitigate side-effects or enhance the effectiveness of GLP-1s.¹⁹ A recent study found that a majority of patients who use the drugs for weight management stay on their prescribed treatment regimen for fewer than 12 weeks, which makes it difficult to achieve meaningful weight loss.²⁰ Nausea is among the most frequently cited side effects and a major reason some patients stop taking GLP-1s. Nausea is also a common side effect for some chemotherapies. Drugs used to prevent or treat nausea in cancer patients might be paired with GLP-1 treatments to reduce side effects and help improve compliance.²¹ Some companies are evaluating formulas that would make it possible to move from weekly injections to monthly ones; oral formulations are also being evaluated.²²

The use of GLP-1s could signify a broader shift toward more accessible and less invasive weight-loss treatments. The potential reduction in the need for surgeries like gastric bypass could not only change individual patient care but also significantly impact the economics of obesity treatment.

As the market for GLP-1s grows, some pharmaceutical companies are reevaluating their product lines and research directions. The integration of real-world evidence and adjustments in clinical-trial designs to better reflect diverse patient responses to GLP-1s could just be the beginning. There is a potential opportunity for these companies to lead in innovation, both in developing new formulations of GLP-1s and in creating products that address their side effects or enhance their benefits.

In medical school, we had limited training in nutrition, weight loss, health span, and disease prevention. We were taught how to treat illness. The burgeoning market around GLP-1s, and an increased focus on healthy lifestyles, could help transform the lives of individuals who are struggling with obesity. It could also help launch a wave of innovation across the health care and pharmaceutical sectors that could move us closer to Deloitte’s vision for the Future of Health.

Asif Dhar - Consulting Services Life Sciences and Healthcare Leader - Global

Dr. Asif Dhar is the Deloitte Global Consulting Services Life Sciences and Health Care Industry Leader, guiding the overall strategic direction for Deloitte's global consulting services in the life sciences and health care sectors. With over two decades of experience, Dr. Dhar has been a trusted strategic advisor to senior leaders across governments, life sciences and health care clients, as well as technology and consumer firms, reinventing wellness, addressing disease, responding to pandemics and tackling health inequities. He is an executive sponsor for Deloitte’s Health Equity Institute, promoting longevity and health equity to patients and families around the world. Dr. Dhar serves on the board of the American Cancer Society and collaborates with numerous organizations dedicated to ending cancer as we know it. Dr. Dhar holds an MD from the University of Illinois and an MBA from the University of Chicago Booth School of Business.

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Jay Bhatt - Managing Director, R&I

Jay Bhatt, D.O., MPH, MPA is a physician executive, public health innovator and is board certified in Internal Medicine and Geriatrics. As Executive Director of the Center for Health Solutions and the Health Equity Institute, Dr. Bhatt directs the research, insights and eminence agenda across the life sciences and health care industry while driving high impact collaborations to advance health equity. Prior to Deloitte, Dr. Bhatt was Sr VP & CMO at the American Hospital Association. He also practiced at Erie Family Health Center, sat on faculty at Northwestern Medicine, CHO of the IL Health and Hospital Assoc and was managing deputy commissioner and CIO for the Chicago Dept of Public Health. Jay has a B.A. from the Univ of Chicago; D.O. from Philadelphia College of Osteopathic Medicine; MPH in public health from the Univ of Illinois at Chicago; and MPA from the Harvard Kennedy School of Government. Dr. Bhatt currently serves on the UNIDOSUS and National Forum for Heart Disease and Stroke Prevention Boards.

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¹Five unexpected new uses for GLP-1s, Pharmacy Times, May 23, 2024

²The weight-loss drug market outlook, Morgan Stanley, May 7, 2024

³GLP1 agonists: current and future landscape of clinical trials for patients with metabolic dysfunction, Nature, September 6, 2024

⁴Beyond weight loss: Companies look to expand GLP-1 pipelines, BioSpace, July 22, 2024

⁵Sanders issues dire warning about projected GLP-1 spending, FiercePharma, May 16, 2024

⁶Reflections on the discovery GLP-1s, European Journal of Clinical Nutrition, June 18, 2024

⁷Weight-loss drug forecasts jump to $150 billion as supply grows, May 28, 2024

⁸Lilly increases manufacturing investment to $9 Billion, press release, May 24, 2024

⁹Global weight-loss supplement market, yahoo!finance, June 28, 2024

¹⁰Supplements companies are cashing In on the GLP-1 wave, WIRED, August 14, 2024

¹¹Global trends in R&D 2024, IQVIA, February 22, 2024

¹²Global weight-loss stomach pump market size to exceed $541 million, yahoo!finance, June 29, 2024

¹³Will GLP-1 medications affect the diabetic devices market?, Medical Device Network, February 29, 2024

¹⁴Appetite for reduction: GLP-1 drugs fuel grocery decrease, The Food Institute, February 23, 2024

¹⁵Could obesity drugs take a bite out of the food industry?, Morgan Stanley, September 5, 2023

¹⁶Life Time stock slides. Could a push Into weight-loss drugs help?, Athletech News, October 31

¹⁷WeightWatchers debuts new creative as it navigates weight-loss drug boom, MarketingDive, August 12, 2024

¹⁸Cleveland Clinic launches wellness and diet coaching app, June 27, 2024

¹⁹The golden era of GLP-1 drugs: Where we are and what comes next, BiopharmaDIVE, September 23, 2024

²⁰Real-world trends in GLP-1 treatment persistence and prescribing for weight management, Blue Health Intelligence, May 2024

²¹How anti-obesity drugs cause nausea: finding offers hope for better drugs, Nature, July 10, 2024

²²Tern oral GLP-1 shows 5% weight loss at 1 month at highest dose, FierceBiotech, September 9, 2024