In this column, Claire Gillis, CEO of VML Health, explores how GLP-1s could transform the medical landscape, expanding treatment options in ways that echo the cancer care revolution
Words by Claire Gillis
In the last week of June, thousands of business leaders convened at Cannes Lions to discuss the innovations and cultural trends shaping the future of creativity. Few innovations have entered mainstream conversation as rapidly as GLP-1s. Their rise is as much a cultural story as a medical one.
The rise of GLP-1s
What began as a scientific discussion about diabetes is now everywhere from boardrooms to breakfast TV and from congresses to the Croisette. The science has broadened too. At last month’s ASCO, researchers presented early evidence linking GLP-1 use and cancer outcomes. The boundaries of the category are becoming harder to define.
Against that backdrop, it’s notable that the only pharma company on stage at Cannes this year was a GLP-1 player. Coincidence or not, GLP-1s are now part of everyday conversation.
But while the cultural impact is hard to ignore, the deeper story may be unfolding in the science itself. History suggests that once a disease map becomes clear, entire therapeutic markets can change overnight. We’ve seen this before in oncology.
Lessons from cancer
We’re not at the end of the obesity story. We’re at the moment the map starts to show other ways.
Early in my career I was lucky enough to work with two clients whose discoveries changed oncology permanently: trastuzumab and imatinib. What made those years significant wasn’t just the science, it was the recognition that something structural had shifted in how medicine understood cancer.
The rise of GLP-1s is as much a cultural story as a medical one
For decades, oncology relied on chemotherapy: blunt, systemic, effective enough. Then the Human Genome Project began to resolve the map and the logic changed entirely.
HER2 amplification. BCR-ABL translocation. BRCA1 and BRCA2. Cancer stopped being a disease of organs and became a disease of specific molecular errors: nameable, targetable and correctable.
Trastuzumab wasn’t a better chemotherapy. Imatinib wasn’t a better chemotherapy. They were something categorically different: the first proof that targeted molecular medicine worked.
Beyond weight loss
Fast forward 25 years and a similar shift is emerging around GLP-1s.
The instinct is to frame semaglutide and tirzepatide as weight-loss drugs with ancillary benefits. The data increasingly challenges that view. The Lancet has reported cardiovascular benefit, kidney disease protection, liver fibrosis reversal and improvements in heart failure and sleep apnoea.
But the more telling signal is this: a Swedish study of over 227,000 people found semaglutide was associated with fewer hospitalisations for alcohol use disorder, with effect sizes exceeding medications approved for the condition. Another study found exenatide increased smoking abstinence by 70%. Research is underway in inflammatory bowel disease, psoriasis, rheumatoid arthritis and neurodegeneration.
We’re not at the end of the obesity story
Taken together, these findings suggest something important. Many GLP-1 benefits appear to be independent of weight loss, reflecting reduced systemic inflammation and direct organ effects. Rather than acting only on body weight, the drugs appear to influence biological pathways shared across metabolism, addiction and inflammation.
This is what genomic mapping revealed in oncology. Diseases that once appeared unrelated turned out to share common biological mechanisms. A similar picture may now be emerging in obesity science.
Research published in 2024 concluded that the causes of obesity remain largely unknown. Competing theories differ on where the primary disruption occurs but converge on the same conclusion: obesity is not a caloric accounting failure. It’s a biological programme that the body actively defends.
Every new indication, unexpected finding and biological insight adds another clue. Large-scale genomic and multiomic studies are beginning to resolve obesity’s underlying biology, much as the Cancer Genome Atlas transformed our understanding of tumour biology.
What’s next for GLP-1s?
With more than 40 incretin-based therapies currently in development, this market has a substantial decade ahead. Patients who need treatment need access now, even as the science continues to evolve.
The cancer story is instructive. Imatinib didn’t gradually displace chemotherapy in chronic myeloid leukaemia. Once the molecular target was clear, it replaced it.
If oncology offers a lesson, GLP-1s may prove to be following a similar path. Today’s therapies are treating patients while also revealing new insights into disease. Tomorrow’s treatments may look very different.
The ultimate beneficiaries won’t be markets or companies, but patients whose diseases become better understood and therefore better treated.
Now that’s a conversation worth joining.
