The Patent for GLP-1 in Obesity That No One Cared About
Twenty-nine years ago, scientists discovered that GLP-1 agonists, acting in the brain, could regulate feeding behaviors. In a keynote address to the Columbia Cornell Obesity Medicine course yesterday, Richard DiMarchi presented a compelling, detailed description of how this all unfolded. Way back in 1996, DiMarchi and colleagues at Lilly sought a patent for using a GLP-1 agonist to treat obesity. It was granted in 2003.
But at the time, Lilly had no interest in bringing such a drug to market for this purpose. DiMarchi explained:
“They chose to do nothing with this patent. The reason being: ‘Obesity is not a disease. There’s no registrable path for moving this forward. Furthermore, we don’t believe you’ll ever decrease body weight more than you can with conventionals agents – basically 5%.’
“And even if that was not enough, they went on to say, ‘No one would ever take an injection to treat a disease as benign as obesity.’”
Persistence to Meet a Staggering Need
From there he detailed the dogged work of Lotte Knudsen at Novo Nordisk that demonstrated the medical value of liraglutide – first for type 2 diabetes and then for obesity. Where Lilly had said, “no thanks,” Novo worked away at the unmet need for obesity therapy.
That took them from liraglutide to semaglutide and a genuine breakthrough in effectiveness. On top of that came the proof that obesity was not so “benign” when the SELECT study showed that obesity treatment with semaglutide reduces strokes, heart attacks, and deaths by 20%.
From there came a race for Lilly to let go of its reluctance to embrace obesity therapy and bring its dual agonist, tirzepatide, to market with even greater efficacy. Practical learning from mistakes takes time.
From No Interest to Frenzied Competition
DiMarchi went on to describe the work on multi-agonist drugs and give us a taste of the further innovation that lies ahead. But what is striking is how the bias that obesity is “benign” led such a smart organization as Lilly to initially walk away from a patent for GLP-1 in treating obesity.
Now, the essence of that patent has defined a market for therapies that will be worth hundreds of billions of dollars. The competition to innovate in this space is intense. But more important, it is transforming the lives and health of millions of people.
In short, this is a case study of the value that can come from challenging our biases about obesity. It requires choosing the discomfort of thought over keeping the comfort of our opinions.
Click here for a thoughtful review by DiMarchi and colleagues, detailing the development of these remarkable drugs.
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March 14, 2025
