Certainly one of the downsides of taking recent anti-obesity medications is that patients are inclined to lose lean muscle mass together with body fat. What this implies for patients over the long run is not fully known, but there are several pharmaceutical firms studying the side effect and hoping to develop therapies that may regulate the condition. In a best case scenario, these experimental drugs wouldn’t only protect against muscle loss, they might also speed up fat loss when taken alongside what are called incretin therapies, akin to Ozempic and Mounjaro. “It’s becoming increasingly clear that, at the very least with the present agents, there’s room to enhance,” Piper Sandler analyst Allison Bratzel said in an interview. “That is a significant shortcoming by way of not only quality of life for the patients who must lose lean muscle mass, but there’s actually room to enhance on the burden loss and there [are] other metabolic advantages to improving your lean muscle mass … [including] you may have higher durability of weight reduction.” Biohaven , Regeneron and Scholar Rock are three firms working on this area, Bratzel said. Versanis Bio , a clinical-stage biotech that Eli Lilly acquired this summer can be energetic in the sector. An enormous opportunity The obesity drug market is predicted to be large and lucrative, with several Wall Street firms predicting it could reach $100 billion or more in annual sales by the top of the last decade. That is partly as a result of the variety of people who find themselves obese or obese — some 70% of American adults are one or the opposite — in addition to the chronic nature of the disease. Novo Nordisk’s Ozempic, or semaglutide, mimics stomach hormones like glucagon-like peptide 1, or GLP-1, to manage insulin and quiet food cravings. Eli Lilly’s Mounjaro adds a second incretin, gastric inhibitory polypetide, or GIP. The drugs can assist patients lose 15% to twenty% of their weight, on average. Nevertheless, the burden can come back when patients stop taking the drugs. “Anytime anyone loses weight, they’ll lose adipose tissue, [body fat,] but they’re also going to lose some skeletal muscle mass,” said Dr. Lydia Alexander, president-elect of the Obesity Medicine Association. “The extent to which that happens really is dependent upon the standard of their nutrition,” she continued. “It is dependent upon how much they’re moving their body because that sends signals to the body that those muscles are literally very essential and shouldn’t be dismantled.” Alexander and other obesity specialists recommend patients use a wraparound approach that includes medication, exercise, nutrition and other support. Patients also ought to be monitored to see how much lean mass is being lost, which may hurt the metabolism, movement and balance. This is very vital for people 65 and older as lean muscle is of course lost as a result of aging. Within the drug pipeline Piper Sandler’s Bratzel reiterated an obese rating on Scholar Rock this week, saying it is a “top” small- and midcap pick after the corporate disclosed plans to develop SRK-439, an anti-myostatin antibody, to be used in treating obesity. Scholar Rock already has expertise in targeting different types of myostatin, a protein that limits muscle growth and is considered involved in triggering muscle wasting. The corporate has been developing drugs to treat spinal muscular atrophy, a genetic disease that progressively weakens muscles. Bratzel said she expects Scholar’s approach has a superb shot at achieving a “best-in-class safety profile.” A recent stock offering gives the corporate a money runway through the second half of 2025, the analyst said. By then, Scholar Rock could have proof-of-concept data on SRK-439’s use in treating obesity. Last Tuesday, Bratzel raised her price goal by $2 to $28 per share, about 266% above where Schollar Rock closed Friday. And that valuation doesn’t assume any upside that might come from partnering with a big pharmaceutical company. Scholar’s shares are down 15% yr to this point, putting its market value at $530 million. Bratzel’s price goal is barely above the common goal of $22, with 88% of analysts rating it a buy or obese, based on FactSet. SRRK YTD mountain Scholar Rock shares have fallen greater than 17% for the reason that start of the yr. Bratzel said Lilly’s acquisition of Versanis backs up the concept these drugs might someday be paired with incretins. Versanis’ top drug candidate is bimagrumab, a monoclonal antibody that binds with activin type II A and B receptors to dam activin and myostatin signaling. The drug is being tested in a phase 2b study alongside semaglutide to guard against lack of muscle mass. Meanwhile, Biohaven is working on a myostatin inhibitor that it licensed from Bristol Myers Squibb . Often called taldefgrobep alfa, it was once considered a possible treatment for Duchenne muscular dystrophy. While the compound didn’t work for that disease, it did cause muscle growth, which could possibly be helpful in metabolic diseases. Fueling up on protein Even when these studies are successful, it is going to take years before these drugs could possibly be utilized by patients taking anti-obesity medications. Until then, patients will need to observe what they eat and deal with exercise just as they might on every other weight reduction regimen. Eating extra protein and strength training can be key to stemming the lack of muscle and bone density. On Thursday, Nestle announced plans to market protein-packed products to help those taking GLP-1 medications. “I feel we have vital contributions to make,” Nestle CEO Ulf Mark Schneider said on an earnings call. “For the time that patients spend on these drugs and after, we’re already developing quite a few companion products. The goal can be to deal with the danger of malnutrition and the lack of lean muscle mass while on the GLP-1 therapy, and to avoid or limit weight rebound after the therapy,” he said. “These innovations are right in our wheelhouse, where we will bring our deep understanding of dietary science and appropriate supplementation to the table.” Jeff Jonas, a portfolio manager at Gabelli Funds, which owns Nestle shares, said he has seen the recent losses in food stocks. Nestle’s comments are an try to offset among the “near-term pressure,” but over time, he expects this could possibly be a possibility for the Swiss food company. “The way in which the drug works is that it slows down not only your appetite, but the way in which you process food through your stomach and digestive system, so a protein shake could be a superb solution to get your protein without being as impacted by that a part of the drug,” Jonas said. Stephens’ decision Friday to call Simply Good Foods its “best idea” echoes this trend. The stock is down 14% for the reason that start of the yr, and is trading near its 52-week low, as a part of a broad sell-off in food stocks. Analyst Jim Salera expects the corporate is “attractively positioned” with its Atkins and Quest brands, which sell low carb snacks and meals, and could possibly be an acquisition goal for a bigger food company. SMPL 3M mountain Simply Good Foods shares are trading near 52-week lows. “Because it pertains to the subject du jour, GLP-1 drugs, we imagine that SMPL offers investors some insulation from this headline risk as its products are protein dense and, should widespread GLP-1 adoption occur, can be a conveient way for consumers to make sure they’re still eating the correct quantity of protein.” That is more likely to develop into a much bigger issue over time. Based on a Morgan Stanley survey, patients taking GLP-1 drugs now skew more male than the broader obese population. Also they are younger, have the next income and the next body mass index than the common person with obesity. “We expect it’s because of discrepancies in access, education/awareness, affordability, and health care coverage of early adopters of current weight reduction drugs available on the market, which in lots of cases doesn’t mirror the final obese population,” Morgan Stanley analysts wrote in a research report. “As weight reduction drugs develop into more widely adopted/understood, cheaper, and more widely covered under medical insurance plans, we might expect the profile of those drug users to more closely mirror the final obese population,” they said. When that happens, muscle loss can be an excellent greater issue than it’s now. —CNBC’s Michael Bloom contributed to this report.