Novo Nordisk pushed out a press release this week in the spirit of “My Dog’s Better Than Your Dog.” The gist of it was to claim that Novo’s Wegovy (semaglutide) tablets are best in comparison to the newly approved Foundayo (orforglipron) tablets for obesity treatment. The basis for the claim? A “simulated treatment comparison” soon to be presented at the Obesity Medicine Association meeting coming up in San Diego.

To be honest, we’re not taking this claim of superiority too seriously. But it is a useful reminder to be wary of distortions that increased competition will bring in the market for obesity care. One of those distortions is the fiction of a “best” obesity treatment.

There’s no such thing.

A Simulated Treatment Comparison

The reason for our caution about this PR spin from Novo Nordisk is the utilization of a simulated treatment comparison. It’s a modeling technique to compensate for the lack of any real, robust head-to-head comparative study data. Remember: “All models are wrong, but some are useful.”

In this case, the simulated treatment comparison is useful to Novo for promoting their product. But it is a poor substitute for a valid head-to-head study.

Such a study was recently published in the Lancet to compare the old version of semaglutide tablets (Rybelsus) to orforglipron. In this instance, orforglipron appeared to be superior to Rybelsus for glycemic control and weight reduction, but inferior on tolerability.

The Lancet study was certainly more robust than a simulated comparison study that has neither been peer-reviewed nor even presented at a meeting yet. However, even the head-to-head study in Lancet has limitations, as we explained when it came out.

A False Premise

The real problem, though, is the false premise of looking for a “best” obesity treatment. It’s just as absurd as the quest for a best diet to follow. There is no one best obesity treatment, just as there is no one best diet.

That’s because obesity is heterogeneous. It is different in every individual who lives with it. And thus, people respond differently to different treatments at different times in the course of this chronic disease. What is best for one person at one point in time will not necessarily be best for the next person. Nor will it definitely be best for that same person at another point in time.

So the good news in the launch of Foundayo tablets to compete with Wegovy tablets is that we now have more options – and better odds for finding the best therapies for treating obesity in each and every person seeking care.

Click here for the press release from Novo Nordisk, but take it with a grain of salt. For further perspective, click here.

Foundayo and Wegovy Tablets, illustration created with Gemini image generation for ConscienHealth