Novo Nordisk’s new weight-loss drug helped patients lose even more weight on average than its current Wegovy blockbuster treatment, an early-stage trial showed, as the drugmaker races to develop the next generation of obesity medicines.

Some new medications in development are also trying to solve for a persistent side effect of existing drugs: Patients who lose fat also tend to lose muscle. This can be particularly dangerous for older adults because it makes them more likely to fall and can worsen osteoporosis.

In a Phase II trial, Amgen’s investigational therapy MariTide (maridebart cafraglutide) delivered significant, sustained weight loss of up to 20% in adults with obesity, with or without type 2 diabetes,