Every pharmaceutical story has a moment when the numbers cease to feel like numbers and begin to feel like something completely different. That moment may have come for Novo Nordisk last week in San Diego at The Menopause Society 2026 Annual Meeting, a low-key but quietly important annual event.
In front of a group of medical professionals, the company’s researchers presented data on CagriSema, their next-generation obesity injection, demonstrating that over the course of 68 weeks, women in their Phase 3 trial lost an average of 25% of their body weight. Not twenty. Not the meticulously calculated headline figure that the larger trial had yielded. Twenty-five percent.
That distinction is important, and not only for the obvious reasons. The average weight loss of 22.7% was a soft thud when Novo first revealed the trial results for CagriSema earlier this year. The company had set a goal of 25%, and even slightly falling short of that benchmark wasn’t the moment of triumph that investors had hoped for. Shares dropped. Eli Lilly, whose tirzepatide has been gradually reducing Novo’s market share, appeared to exhale quietly as analysts recalibrated. Novo needed something quickly.
They were given a more detailed look at the specific individuals responsible for the defeat. Approximately two-thirds of trial participants were women, who reacted to CagriSema more strongly than the mixed-population headline implied. The average weight loss among premenopausal women was 26.7%. Given that 93.3% of women in the CagriSema arm lost at least 10% of their body weight and nearly 69% lost at least 20%, that is a startling statistic that is difficult to write off as statistical noise.
It’s important to consider what a 25% reduction in weight truly means for people. That’s 55 pounds lost in a little over a year for a woman who weighs 220 pounds. The CagriSema group’s average waist circumference decreased by 20.5 centimeters during the trial, while the placebo group’s decreased by 4.7 centimeters.
This difference has significant metabolic ramifications, such as a lower risk of cardiovascular disease, hypertension, and blood sugar dysregulation. These percentages aren’t theoretical. These are the kinds of adjustments that completely remove a person from a high-risk category.
Although it has been understudied, the sex-based variation in GLP-1 response is not new. Even though numerous studies have shown that women lose more weight than men when using these medications, clinical trials have traditionally treated the two groups equally.
A level of clinical nuance that has been absent from the discussion is added by Novo’s choice to divide this data into three categories: premenopausal, perimenopausal, and postmenopausal. It turns out that the average loss for the postmenopausal group was still 23.1%. That is significantly less than the premenopausal number, which raises important concerns about how hormonal aging affects drug response and whether treatment plans or dosage should eventually consider it.
The analysis’s lead, Dr. Maria Hurtado Andrade of the Mayo Clinic, was cautious not to make too many claims. She referred to the figures as “encouraging” and noted that the variations between the groups suggest further study rather than firm conclusions.
We appreciate that level of caution. The degree to which anyone should rely on these analyzes is limited by their post hoc nature, which means they weren’t predetermined in the trial design. The formal statistical tests were not designed to validate treatment-by-sex interaction in this case, and subgroup data have a tendency to appear more meaningful than they actually are.
However, compared to a month ago, Novo’s overall position is arguably stronger. Before the end of 2026, an FDA decision regarding CagriSema, which combines semaglutide, the active component of Wegovy, with cagrilintide, an amylin analog, is anticipated. The gastrointestinal side effect profile of the medication is still a serious concern: over 25% of participants experienced vomiting, and 55% experienced nausea. Pharmacists and prescribers will need to exercise caution when managing these rates, especially in older women whose bone density and protein intake are already issues.
Perhaps the most direct rival is Lilly’s retatrutide, which is still undergoing testing. Similar to what Novo recently reported, Tirzepatide’s own data for women revealed weight loss in SURMOUNT of up to 24.6%. Neither of the two businesses has emerged victorious in their parallel race. Whether the final FDA labeling, actual adherence rates, or insurance coverage will ultimately determine which medication takes the lead is still up in the air.
Observing this development gives the impression that the obesity medication market is about to embark on a more complex phase than the initial Ozempic frenzy indicated. The drugs in the headlines are effective. As of right now, the data is fairly consistent in that regard.
The more difficult questions are whether the clinical picture being assembled in trials will hold up once millions of patients with complicated medical histories are actually receiving these injections, as well as who benefits most and under what circumstances. The outcomes of CagriSema for women are truly encouraging. The more difficult test will be the real-world version that follows.
FAQs
Q1. How much weight did women lose on CagriSema in the REDEFINE 1 trial?
Women lost an average of 25% of their body weight over 68 weeks.
Q2. Which group of women responded best to CagriSema?
Premenopausal women saw the highest weight loss, averaging 26.7%.
Q3. What are the most common side effects of CagriSema?
Nausea, constipation, and vomiting affected the majority of participants taking the drug.
Q4. When is the FDA expected to make a decision on CagriSema?
An FDA decision is anticipated before the end of 2026.
Q5. Who is Novo Nordisk’s biggest competitor in the obesity drug market?
Eli Lilly, with tirzepatide and the pipeline drug retatrutide, is CagriSema’s closest rival.