Novo Nordisk Touts Muscle-Sparing Weight Loss Data as CagriSema Decision Looms

Novo Nordisk's high-dose Wegovy preserves muscle (84% fat loss), CagriSema files for FDA approval; stock down 60% but narrows 2026 outlook.

Novo Nordisk is sharpening its narrative on two fronts: a higher-dose Wegovy formulation that preserves muscle mass and a pipeline candidate, CagriSema, that could redefine its competitive standing. The Danish drugmaker, which has shed more than 60% of its market value over two difficult years, is now betting that clinical differentiation—not just weight loss—will restore investor confidence.

Data presented at the European Congress on Obesity in Istanbul from a subanalysis of the STEP-UP study showed that early responders on a 7.2?mg semaglutide dose lost an average of 27.7% of their body weight over 72 weeks. Early responders were defined as participants who shed at least 15% in the first 24 weeks. Across the full trial of more than 1,400 adults with obesity but without type 2 diabetes, the higher dose produced a mean weight loss of 21%, versus 17.5% for the current Wegovy dose and 2.4% for placebo. The safety profile was broadly in line with lower doses.

Crucially, around 84% of the weight lost came from fat mass, with muscle mass declining by only about 10% from baseline. The company said muscle function was preserved and muscle health improved. In an obesity market increasingly focused on body composition rather than just the number on the scale, that distinction gives Novo Nordisk ammunition against rivals such as Eli Lilly, whose Zepbound has set a high bar for pure weight reduction.

But the immediate catalyst for the stock lies elsewhere. The market is watching CagriSema, a combination of a GLP-1 receptor agonist and an amylin analogue. In the REDEFINE 1 trial, CagriSema delivered a mean weight loss of 22.7% after 68 weeks, compared with 16.1% for semaglutide alone. Novo Nordisk has already filed for US approval, with a decision expected in the fourth quarter of 2026. A large cardiovascular outcomes study, REDEFINE 3, is under way with 7,000 participants. Earlier CagriSema data had disappointed investors by falling short of Zepbound’s efficacy, making the upcoming FDA verdict a pivotal moment for the stock’s recovery.

Meanwhile, the oral version of Wegovy, launched at the start of the year, is gaining traction. Management said it is already being used by more than one million patients, and the drug accounts for 65% of all new prescriptions for GLP-1 treatments in the US. Novo Nordisk still holds roughly 55% of the weekly injectable GLP-1 market, despite losing ground to Eli Lilly in recent quarters.

The quarterly update in May offered a modest relief. Adjusted revenue fell 10% to 70.1 billion Danish kroner and adjusted earnings per share dropped 3%, but both figures were less dire than feared. The company revised its 2026 outlook upward, now expecting a currency-adjusted decline in revenue and operating profit of 4–12%, a narrower range than previously anticipated. Research, development and marketing spending in the first quarter reached 22.4 billion Danish kroner, and a share buyback programme of up to 15 billion Danish kroner is under way for 2026.

Shares closed at €39.59 on Thursday, down 1.47%, before edging up to €40.02. Over the past month the stock has rallied 19.57% but remains down 10.42% year to date and 31.63% lower over twelve months. The 200-day moving average of €42.41 represents the next technical hurdle; a sustained break above that level would lend credibility to the recent rebound.

At 13.6 times expected earnings, Novo Nordisk trades at a discount to the healthcare sector average of 16.8 times, reflecting deep scepticism. Yet the addressable market for obesity drugs remains enormous—more than 900 million people globally are obese, and only about 1% currently use branded medication. With CagriSema’s US decision still 18 months away and ongoing studies for next-generation candidates such as Amycretin and UBT251, the company’s pipeline could yet provide the catalysts needed to change the narrative.