2027 trends to watch: GLP-1s and metabolic care will reshape more than obesity treatment

The unprecedented demand for glucagon-like peptide-1 (GLP-1) drugs has transformed the healthcare market. In just the last few years, spending on GLP-1s has skyrocketed more than 500%, utilization has nearly quadrupled, and payors are struggling to keep up.

But GLP-1s and other metabolic drugs are poised to effect further industry-spanning change as the list of their approved indications continues to grow beyond type 2 diabetes and obesity.

With major FDA reviews slated for next year, as well as new and ongoing clinical trials, healthcare organizations should understand how the rapid scaling of GLP-1s might present challenges and opportunities in 2027 and beyond.

Cardiovascular care is the new frontier to watch

One of the clearest signs that GLP-1 drugs are moving beyond their original applications is the growing body of evidence around cardiovascular outcomes.

In the 2024 SELECT trial, semaglutide reduced major adverse cardiovascular events by 20% among adults identified as overweight or obese and with established cardiovascular disease. The study also found reductions in kidney-related outcomes and all-cause mortality.

The cardiovascular opportunity has only grown in the past couple of years. In August 2026, the FDA approved Eli Lilly’s Mounjaro (tirzepatide) to reduce the risk of heart attack or stroke in adults with type 2 diabetes and high cardiovascular risk.

Likewise, a study published in August 2026 examined health insurance claims data for nearly 53,000 adults across a three-year period and found a reduction in the risk of heart attack, stroke, and all-cause death by nearly a third.

However, just as previous studies have shown that GLP-1 discontinuation can lead to rapid weight regain, a 2026 study from WashU Medicine found that cessation increases the risk of heart attack, stroke, and death. This emphasizes the importance (and challenges) of adherence and ongoing, personalized care management for cardio patients and their providers.

For providers heading into 2027—especially cardiologists, nephrologists, and other specialists—it’s wise to start planning for a growing number of encounters with patients taking or seeking GLP-1-based therapies, consider ways to improve patient education about side effects as well as risks associated with discontinuation, and address adherence issues early.

These providers will also need to sharpen their abilities to identify potential candidates and understand how GLP-1 use intersects with existing cardiovascular treatment pathways.

For companies selling cardiovascular technologies, pharmaceuticals, or diagnostic capabilities, there will be considerable value in identifying populations with overlapping metabolic and cardiovascular risk, primarily using claims, reference, and health behavior data.

Liver disease will be a bigger part of the GLP-1 conversation

Metabolic dysfunction-associated steatotic liver disease (MASLD) and its more advanced form, metabolic dysfunction-associated steatohepatitis (MASH), represent significant expansion areas for GLP-1 use and potential opportunities for healthcare organizations.

Researchers at the University of California San Diego School of Medicine published research in July 2026 suggesting that semaglutide could reduce liver scarring in patients with MASH and early-stage cirrhosis.

This seems to support earlier research touted by Novo Nordisk, showing that more than 62% of patients receiving semaglutide resolved their steatohepatitis without worsening liver fibrosis, compared to 34% of patients who received a placebo.

The significance of these findings goes beyond liver disease itself. MASLD is closely associated with obesity, insulin resistance, diabetes and cardiovascular disease—all parts of the constellation of conditions in which GLP-1 therapies are already showing promise.

Novo Nordisk’s semaglutide product (Wegovy) was approved for MASH treatment in 2025. Another GLP-1 drug, survodutide, is currently in Phase 3 trials and has demonstrated efficacy in treating obesity as well as reducing scarring and inflammation in patients with fatty liver disease. If developer Boehringer Ingelheim files with the FDA by the end of 2026, this drug could see approval in 2027.

The full potential of GLP-1s in treating liver disease is still emerging. Additional research into novel patient populations could further expand the role of these therapies, making gastroenterologists and hepatologists an increasingly important part of the GLP-1 ecosystem.

Again, this highlights a new challenge for commercial organizations: understanding patient populations by connecting diagnoses across specialties rather than viewing each condition in isolation.

Keep an eye on kidney disease

The benefits of GLP-1 for type 2 diabetes are well-established, but its impacts on broader kidney disease are still being revealed.

The aforementioned SELECT study found a 22% reduction in acute kidney failure among patients receiving semaglutide. Other studies have found considerable reductions in major kidney disease events and demonstrated the ability of GLP-1s to reduce kidney fat, improve blood flow, and decrease inflammation and fibrosis.

In 2026, research from the Johns Hopkins Bloomberg School of Public Health found that similar cardiorenal benefits may extend to patients with type 1 diabetes. And researchers in Taiwan learned that GLP-1s may even protect end-stage kidney disease patients from heart failure and other cardiovascular events.

Metabolic disease and chronic kidney disease are deeply interconnected. Diabetes and obesity are chief contributors to kidney disease, and kidney dysfunction can further complicate the management of cardiovascular and metabolic conditions.

As the body of evidence accumulates, GLP-1 therapies could play a key role in the broader approach to protecting kidney health.

For providers and other companies operating within healthcare, this presents new opportunities to identify, target, and treat patients at the intersection of metabolic disease and renal disease. It also adds a new layer of complexity to the patient identification process: Instead of looking solely at populations diagnosed with diabetes or obesity, providers will need to consider patients with a variety of overlapping risk factors associated with kidney disease.

Demand for GLP-1s applies pressure across the industry

The sharp, sudden rise in demand for GLP-1 drugs follows a protracted struggle with obesity in America.

Obesity rates among American adults have tripled since the 1960s, peaking around 40% between 2021 and 2023. Severe obesity (defined as a body mass index above 40) has increased by roughly a factor of 10 within the same period.

The most popular GLP-1 drug was FDA-approved for type 2 diabetes in 2017 (generic name semaglutide), but the early success of its off-label usage for weight loss in 2021 led to additional clinical research and ultimately approval for that indication—albeit under a different brand name. In 2022, the drug wasn’t even in the top 10 of the year’s best-selling pharmaceuticals. By 2023, it had climbed to No. 3.

Jump forward a few years, and now nearly one in five adults say they’ve taken a GLP-1 drug at some point. Around one in eight were actively taking them in late 2025. And expansion into new treatment categories is likely to drive utilization even further.

Morgan Stanley Research predicts that the global market for GLP-1 drugs could hit $190 billion by 2035—that’s a doubling of market size over the course of a decade. J.P. Morgan Global Research takes an even more bullish view, forecasting the market to reach $200 billion by 2030 with 25 million Americans using GLP-1s.

New and more expansive GLP-1s will undoubtedly contribute to this growth. Following successful Phase 3 studies, Eli Lilly is targeting 2027 FDA approval of retatrutide for obesity, knee osteoarthritis pain, and obstructive sleep apnea. (Additionally, retatrutide’s potential to reduce major adverse cardiovascular events is the subject of a study set to end in 2029).

Realizing the broader clinical potential of GLP-1 therapies could have monumental effects on demand and revenue, but access and affordability will remain considerable hurdles for players across the industry in 2027 and beyond.

Employers

Employers are already wrestling with the economics: Brand-name injectable GLP-1s can cost consumers between $1,000 and $1,500 a month, and employers foot between 70% and 100% of the bill. A recent Business Group on Health survey found that pharmacy costs now represent 25% of total healthcare spend.

While cancer treatment represents the leading pharmaceutical expense, some employers see weight loss treatment as an easy opportunity to cut costs, whether by adding higher BMI thresholds, tightening prior authorization rules, or simply dropping coverage entirely. The share of employers covering GLP-1 drugs for weight loss declined from 72% in 2025 to 60% in 2026. Over the course of 2026 alone, the share of employers planning to drop coverage by 2027 rose from 10% to 14%.

There’s an interesting tension here: While GLP-1s could potentially reduce the cost burdens associated with multiple costly chronic conditions—those related to obesity as well as others—widespread adoption drives upfront pharmacy spending, and employers and payors will likely have to wait to capture any downstream savings.

This could likely lead to further coverage restrictions based around questions like:

• Which patients benefit most?
• Which therapies produce the greatest downstream savings?
• And how should payors/employers measure ROI when the real impact spans multiple coverage years?

Pharmacies

The original GLP-1 boom demonstrated how quickly demand can overwhelm pharmaceutical supply chains. While the FDA determined that the semaglutide injection shortage was resolved in February 2025, some localized disruptions are ongoing.

But heading into 2027, the greater challenge lies in the fact that high demand doesn’t automatically translate into attractive economics, especially for smaller, independent pharmacies. A 2026 study of independent community pharmacies found that reimbursement for GLP-1s frequently fell below the cost of acquisition, with revenue losses of 5% or greater in more than 4 of 5 cases.

As GLP-1 indications expand, pharmacists could also find themselves at the heart of a more team-based metabolic care model. Pharmacists’ position in the care continuum—in some cases, interfacing with chronic disease patients with greater frequency than physicians—gives them unique insights into patient eligibility, medication access, adherence, and adverse effects.

Providers

Providers are actively feeling the operational impact of GLP-1 demand and are likely to feel it more as these drugs are approved for new indications.

One 2026 survey of 374 clinicians found that providers spent an average of 8.7 hours per week on GLP-1-related administrative work alone. That’s about a quarter of the average clinical week for these providers.

Nearly 3 in 4 clinicians said GLP-1-related tasks had caused them to delay, shorten, or reschedule patient care. And more than one-third said GLP-1 demand had moderately or significantly contributed to feelings of burnout.

While the recent introduction of oral GLP-1 therapies is often seen as a boon to adherence, durability, and clinical integration, around 1 in 3 physicians surveyed said they expect it to increase their workload.

But workload is just the tip of the iceberg in terms of GLP-1s likely impact on providers. As indications and treatment options expand and demand increases, GLP-1s could change demand for other services. The reduction of obesity-related complications, for instance, could produce shifts in utilization across cardiology, endocrinology, bariatrics, orthopedics, and other specialty service lines.

Service lines built on repeat admissions, complications, and downstream interventions associated with obesity and other chronic disease could see reductions or shifts in demand that require provider networks to rethink their business models. This doesn’t necessarily mean shrinking service lines, but instead:

• Identifying patients earlier based on novel combinations of diagnoses, risk factors, and utilization patterns
• Reimagining therapy offerings and points of intervention across service lines
• Using data to determine where unmet demand exists and building or expanding metabolic-care programs

Developers

As the opportunities for GLP-1s grow beyond type 2 diabetes and obesity, biopharma developers will face fiercer competition to develop differentiated or multi-indication therapies. Oral formulations, less frequent dosing, improved tolerability, and new mechanisms or combinations will become important points of differentiation.

The expanding GLP-1 market could also create more opportunities for digital health and technology companies that help patients and providers manage treatment, from virtual weight-management programs and digital coaching to wearables, remote monitoring, and adherence tools.

Above all, developers need to identify and understand the patients, providers, and markets where demand is concentrated. That means going into 2027 with the intelligence and analytical capability to determine:

• Where are the patients most likely to benefit from GLP-1s?
• Which providers treat them—and which tend to be early adopters of new therapies?
• Which specialties are prescribing?
• Where is there substantial untreated or undertreated demand?

Grow into 2027 with data-driven confidence

GLP-1 drugs have a role to play in the strategies of organizations across healthcare, from providers and payors to biopharma developers and pharmacies. Those with a deeper understanding of how GLP-1s could shift utilization patterns, patient behaviors, and coverage decisions will be best positioned to grow and succeed along with these exciting developments.

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