While obesity is increasing rapidly in low and intermediate income countries, health systems are struggling to contain the impact of this silent epidemic. By 2035, almost 80 % of obese people worldwide will live in these regions, where access to treatments remains limited. This context feeds the spread of preventable chronic diseases such as type 2 diabetes or cardiovascular disease, which already represent the majority of premature deaths.
A new generation of treatments, simpler and more accessible against obesity
Unlike injectable treatments that today dominate the obesity medication market, new oral formulations thus open the way to much wider dissemination. Orforglipron, currently in advanced development phase by Eli Lilly, represents the most concrete example of this transition. One of its main innovations is due to its ease of administration. Unlike the oral forms of semaglutide, which must be taken on an empty stomach with strict food constraints, Orforglipron can be swallowed with or without food. This considerably simplifies the taking of the drug on a daily basis. Especially in contexts where living conditions make respect for a specific protocol difficult.
In addition, its chemical structure allows a simpler manufacturing on a large scale and at a lower cost. For countries with limited resources, this reduction in production costs becomes an essential factor. It could accelerate the integration of this type of treatment into public health policies. But provided that the prices charged are adapted to local capacities.
Finally, Orforglipron could also reduce dependence on medical infrastructure. The absence of injection equipment releases patients from heavy technical follow -up. It makes it possible for supervised self -medication, especially in rural areas far from hospitals.
Already promising efficiency … and economic hope
Orforglipron demonstrated, during a phase 3 clinical trial carried out over 40 weeks, a significant reduction in glycated hemoglobin (HBA1C) in diabetic patients, accompanied by significant weight loss. These results, judged comparable to those of the injectable shooting according to Dr. Louis Aronne, specialist in obesity at the Weill Cornell Medical College, place the most promising treatment of his class. He underlines that the interest of Orforglipron also lies in its simplified administration profile, without requirements linked to refrigeration or the use of needles.
On the pharmacological level, Orforglipron acts by mimicking the Hormone GLP-. 1 It then promotes satiety, slows down gastric emptying and increases insulin secretion in response to glucose. Its small molecule structure allows it to resist degradation in the digestive system. This distinguishes it from peptides such as semaglutide, which require higher doses and restrictive conditions of taking. This treatment, easier to take, could help patients better follow their daily treatment.
Beyond clinical aspects, economic ambitions are explicit. David Ricks, CEO of Eli Lilly, sees in Orforglipron a strategic lever, he confides in the Time. The drug was designed via a 30 % faster and seven times more efficient manufacturing process than previous methods, according to Sarah O'Keeffe, product development manager. This approach aims to guarantee mass production at a lower cost, while reducing the environmental impact. If future studies confirm its effectiveness outside of diabetes, Orforglipron could redefine the global market for obesity treatment and extend access to millions of patients hitherto excluded.
Obesity, a major health challenge in low and intermediate income countries
Indeed, in low and intermediate income countries (PRFI), obesity is now established as a major public health issue. By 2035, almost 80 % of obese adults worldwide will live in these regions, according to projections relayed by the World Economic Forum. This rapid development comes up against unsuitable health systems. Indeed, they are often under-cut, little prepared to integrate expensive, specialized or dependent treatments of technical infrastructure. For Sarah Rickwood and Daniel Mora-Brito, analysts at Iqvia and co-authors of a forum forum, the effectiveness of drug treatments cannot be reached without clear articulation with prevention policies, primary care paths and strict public regulation.
The challenge exceeds access to the drug. In many PRFIs, anti-oblilements are not supported by health insurance. They are not available in public establishments either. This limits their use to the most favored segments of the population, still digging health inequalities. However, clinical benefits are undeniable. Professor Naveed Sattar reminds the Guardian Whether certain populations, notably South Asians or Afro-descendants, develop metabolic complications more quickly at lower BI levels than European populations. Early treatments could prevent many chronic avoidable pathologies.
In the short term, the loss of commercial exclusivity of molecules such as semaglutide, planned in China in 2026, could promote the emergence of generics. But this hope must be supervised. The appearance of counterfeits and unleanished uses, amplified by social networks, constitutes a real health threat. The authorities will have to guarantee safe, regulated access based on clearly defined medical needs.
A relationship to deeply modified food
Finally, it should be noted that the new GLP-1 drugs are not content to lose weight. They deeply transform the physiological and psychological relationship to food. Dr. Jorge Moreno insists on an often ignored aspect. “” It is not only a question of will. These treatments calm what patients call “food noise”, this obsessive thought around food ». This phenomenon, linked to the cerebral reward circuits, contributes to the resumption of weight after an initial loss. By acting on these signals, the second generation GLP-1s allow not only to lose weight. But above all they help maintain this loss in the long term.
On the neuroendocrinian level, these drugs modify the metabolic “point of instruction” that the body usually tries to defend. Concretely, these treatments allow the brain to get used to a lower weight without triggering the biological mechanisms usually pushing to repeat. This advance changes the paradigm of care. We no longer fight only against calories, but against a deeply anchored biological system, which pushes to store.
Preliminary work even suggests that these effects could go beyond the framework of obesity. By targeting inflammation and neural circuits involved in gratuity, some GLP-1 could one day be useful against pathologies such as mood disorders, addictions or neurodegenerative diseases such as Alzheimer.
The magnitude of these effects remains to be confirmed. Nevertheless, it already opens a new path in the understanding and treatment of chronic diseases. A path that poses as many promises as responsibilities for health systems.
With an unwavering passion for local news, Christopher leads our editorial team with integrity and dedication. With over 20 years’ experience, he is the backbone of Wouldsayso, ensuring that we stay true to our mission to inform.
