Beyond Ozempic and Wegovy: Novo’s next obesity pipeline moves into Phase 3

What the source reports

Novo Nordisk has entered a new phase under Maziar Mike Doustdar, who became president and chief executive in August 2025. The company says its priorities include strengthening its obesity and diabetes pipeline, improving execution and focusing investment on related cardiovascular, kidney and liver conditions.

Two developments support the idea that Novo is planning beyond its best-known injectable products. Once-daily Wegovy tablets launched in the United States in January 2026, while the company says its AMAZE Phase 3 programme for zenagamtide has begun and is designed to investigate both oral and injectable versions.

The wider story needs boundaries. Zenagamtide remains investigational, the registered late-stage trials will take years, Novo’s Alzheimer’s programme failed, and research into alcohol use disorder does not make semaglutide an approved addiction treatment.

Oral Wegovy is an approved product—not a future candidate

The US Food and Drug Administration approved Wegovy tablets in December 2025. The tablets contain semaglutide and are taken once daily, while injectable Wegovy is taken once weekly. The current US label includes different strengths and escalation schedules for the two formulations.

Novo launched the tablets in the United States on 5 January 2026. In June, the company reported more than three million prescriptions during the first five months and said more than 80% were for people new to GLP-1 therapy. Those prescription figures come from Novo and should be read as company-reported commercial data, not an independent measure of adherence or clinical outcomes.

Approval and availability vary by country. The existence of a US tablet does not mean it is approved, supplied or reimbursed everywhere, and oral and injectable semaglutide should not be treated as automatically interchangeable.

Zenagamtide combines GLP-1 and amylin activity

Zenagamtide, previously called amycretin, is a single investigational molecule designed to activate both GLP-1 and amylin receptors. It is not simply a new brand or tablet version of Ozempic or Wegovy, and it has not been approved for obesity or diabetes.

Novo says the AMAZE Phase 3 obesity programme will assess oral and subcutaneous formulations, several maintenance doses and obesity-related conditions. Its published programme outline includes a future oral study called AMAZE 9 as well as studies in obesity, type 2 diabetes, obstructive sleep apnoea and knee osteoarthritis.

One registered Phase 3 study, AMAZE 7, plans to compare once-weekly injectable zenagamtide with injectable semaglutide in 650 adults with obesity. ClinicalTrials.gov listed it as not yet recruiting with an estimated September 2026 start and October 2028 completion when accessed on 4 August 2026.

Phase 3 status means the medicine is undergoing large confirmatory testing; it does not mean approval is likely or imminent. Regulators will need to evaluate efficacy, adverse effects, discontinuations, dosing and manufacturing data after the trials report.

The strategy reaches into cardiovascular, kidney and liver disease

Novo’s stated strategy remains centred on obesity, diabetes and related comorbidities. Its 2026 investor material highlights cardiovascular disease, chronic kidney disease and metabolic dysfunction-associated steatohepatitis, known as MASH, as areas of unmet need that overlap with its core metabolic business.

This is partly pipeline development and partly expansion of evidence for existing semaglutide products. Selected semaglutide products already have defined US indications involving cardiovascular risk, diabetic chronic kidney disease and MASH. Those indications apply to particular products and patient groups; they do not transfer automatically to zenagamtide or every medicine described as GLP-1 based.

Novo is also developing CagriSema, cagrilintide and acquired or licensed medicines that use amylin, FGF21 and multi-receptor approaches. The direction is therefore broader than placing semaglutide into a pill: it is a portfolio of different molecules, combinations and delivery formats.

Alzheimer’s and addiction need very different wording

Alzheimer’s disease is not an expanding success story for Novo. In November 2025, the company reported that two Phase 3 trials involving 3,808 adults did not show a statistically significant slowing of early symptomatic Alzheimer’s disease with oral semaglutide. The programme was terminated.

Alcohol-use research remains active outside an approved indication. A Danish investigator-led trial involving 108 people with alcohol use disorder and obesity reported results in 2026, and other trials are testing semaglutide in different alcohol-use populations. The SEMALCO protocol states that Novo Nordisk had no financial interest or involvement in that study.

These trials may help answer an important research question, but semaglutide is not approved as a treatment for alcohol or other substance-use disorders. People should not use an obesity or diabetes medicine as addiction treatment outside qualified clinical care.

Why medication history becomes more valuable

A growing mix of tablets, weekly injections, higher-dose formulations and multi-receptor medicines could make treatment histories harder to reconstruct. Two entries that both say ‘semaglutide’ may refer to different products, routes, schedules and labelled uses.

A useful personal record can distinguish the exact product and active ingredient, tablet or injection, prescribed dose and schedule, start and stop dates, treatment gaps, reason for a change, and any symptoms or observations discussed with the prescriber. That context may become especially helpful when changing clinic, pharmacy, insurer, country or treatment format.

An app record can support a conversation but is not a prescribing instruction or complete medical record. Switching formulation, dose or medicine remains a decision for the prescriber and patient, informed by availability, contraindications, tolerability, goals and local approval.

What remains uncertain

Zenagamtide’s Phase 3 efficacy, safety, tolerability and discontinuation rates are unknown. Trial designs and timelines can change, and a programme covering oral and injectable development does not guarantee that both formulations will eventually be submitted or approved.

It is also too early to know whether most people will move between oral and injectable treatment. Novo’s company-reported early US figures suggest the Wegovy pill initially expanded treatment to many new users rather than simply replacing injections, but longer independent evidence is needed.

The most accurate conclusion is that treatment choice is becoming more varied—not that a particular successor to Ozempic or Wegovy has already won.

Bottom line

Novo Nordisk is investing beyond its original injectable semaglutide products. Oral Wegovy is already approved in the United States, while zenagamtide is a distinct GLP-1/amylin medicine in a Phase 3 programme spanning oral and injectable development.

The company is concentrating on obesity, diabetes and connected cardiovascular, kidney and liver conditions. Alzheimer’s was a prominent failure, and addiction remains investigational research rather than an approved use.

For OurGLP1 users, the practical signal is clear: as products, formulations and schedules multiply, a precise medication timeline becomes more useful than a simple record saying only ‘GLP-1’.