Novo Nordisk (NYSE:NVO) just got a reality check. The company's latest trial for a higher-dose Wegovy showed it helps patients shed more weightbut not enough to dethrone Eli Lilly's (NYSE:LLY) Zepbound. Patients on the 7.2mg dose of Wegovy lost 20.7% of their body weight over 72 weeks, an improvement over the 17.5% seen with the standard 2.4mg dose. But here's the kickerZepbound has already clocked over 20% weight loss in trials, and a recent head-to-head showdown showed Lilly's drug delivering 47% more weight loss than Wegovy. Investors weren't thrilledNovo's U.S.-listed shares dropped more than 2% this morning, as worries about growing competition and looming Medicare price negotiations piled on.

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Analysts aren't exactly throwing confetti. Sydbank's Soren Lontoft Hansen called the results fine but not super data. Meanwhile, Leerink Partners analysts doubled down on their confidence in Zepbound's long-term market share. Novo is already licking its wounds from another setbackits experimental two-drug combo, CagriSema, underwhelmed in trials, landing at 22.7% weight loss, barely moving the needle against Zepbound. With Wegovy now playing catch-up and CagriSema failing to shake up the game, Novo is staring down a serious challenge from Lilly, which is running away with the weight-loss drug crown.

So, what's next? Novo is hoping its upcoming trial for the higher-dose Wegovy in Type 2 diabetics can shake things up. But at this point, Eli Lilly is stacking wins, and Novo is running out of room to surprise. Investors will be watching the next data drop closelybecause in the high-stakes obesity drug market, second place doesn't cut it.