Oral VikingTide: VK2735 Looked Like a 10. So Why Is Wall Street’s Swiping Left?

Dave Knapp
Sep 18
4 min read

Original posted at obesity.news/ on Aug 19, 2025

At first glance, this pill has looked like the one. We were even there in-person for the poster reveal last year at Obesity Week. We will be there again this year, and as with many things we do here at OTP, I believe we have started a bit of a trend as there promises to be a good bit of content creators attending this year.

We’re talking about Viking Therapeutics’ once-daily oral GLP-1/GIP dual agonist, VK2735, or as we have dubbed it, VikingTide. It just posted some of the strongest weight loss data we’ve ever seen in a pill. A full 12.2% average body weight reduction in just 13 weeks. That’s not just promising, it’s legitimately competitive with injectables. And it’s fast.

But then Viking’s stock fell nearly 50%.

So what happened? Why did Wall Street swipe left?

Let’s break it down, because the story here says a lot about where obesity medicine is heading and who these trials are actually built to serve.

The Tinder Profile vs the First Date

Phase 2 trials are like I hear folks describing a Tinder profile.

The lighting is always perfect. The angle is always flattering. The background is always clean. You think, “Wow, this might be the one.” But when they show up in person, it’s never quite what the profile promised. Perhaps it’s still good. But it’s not that filtered 10 out of 10 from the app.

That’s what happens when drugs transition from Phase 2 to Phase 3. Everything in Phase 2 is designed to make the drug look as good as possible. Small, carefully selected groups. Shorter timelines. Aggressive titration schedules. Doses that most real people probably can’t tolerate outside of a study. It’s optimized to impress.

But when you get to Phase 3, the real world shows up. Trials get longer. Dosing has to be more conservative. Side effects start to matter more. And sometimes, the results just don’t look as pretty.

We saw this happen with Orforglipron, Lilly’s once-daily oral GLP-1. In Phase 2, it delivered up to 14.7% weight loss at 36 weeks. But in the Phase 3 ACHIEVE-1 trial, that number dropped to 8% after 40 weeks. The reason? Gentler titration. Lower top dose. A more realistic patient population. The Tinder effect.

So now we look at VK2735 and we ask the same question. Is this the profile pic? Or the person walking in the door?

What the VK2735 Data Actually Says

Let’s talk about what Viking just reported.

At the highest dose of a staggering 120 mg, people lost an average of 12.2% of their body weight in just 13 weeks
Nearly 80% of people on that dose lost at least 10% of their body weight
Placebo group only lost 1.3%, which is pretty typical

That’s all impressive.

But then we get into what wasn’t in the headlines.

Dropout rates on the highest dose hit 38%
Even the 90 milligram group had a 28%
Side effects were common. Nausea hit 58% in the drug group and still showed up in 48% of people on placebo
Vomiting was reported in 10% of the drug group and 8% of placebo

This is where things start to feel a little strange.

Why were so many people in the placebo group reporting nausea and vomiting? Is that a flaw in the trial design? Are people so informed about the known side effects of GLP-1 agonism that they go in expecting these side effects, and thus report them in larger numbers?

Either way, it tells us one thing clearly. This pill might work, but a lot of people don’t seem to tolerate it, especially at the higher doses.

Investors Read Between the Lines

That’s why Viking’s stock fell hard today. Because even though the weight loss numbers were strong, the signs are all there that the final product will look very different in Phase 3.

If they can’t keep using the 120 mg dose because of dropouts or toxicity, then the 12.2% weight loss number probably isn’t coming with them into the next phase. If they have to adjust titration to make it more tolerable, we might see weight loss come down even further. This is exactly what happened with Orforglipron.

So investors aren’t just reacting to the data. They’re reacting to what happens next. They’re saying, we’ve been on this date before, and until they “walk in the door”, we reserve our right to be skeptical.

What This Means for Patients

If you’re someone who’s been waiting for a once-daily oral medication to compete with injections, VK2735 is still the one to watch, in my opinion. The molecule clearly works. But tolerability matters. If nearly 40% of people on the high dose are tapping out early, that’s not sustainable. Especially not in a real-world setting where people have jobs, kids, responsibilities, and don’t have a study coordinator calling them every week.

There’s also a bigger issue here. The placebo group in this trial got sick too. Nearly half of them reported nausea. Nearly 10% of them vomited. And they got no treatment at all. This should not be happening. We are still designing obesity trials where some people are given nothing and can expect side effects with nearly zero medical improvement.

In an era where excellent treatments exist to compare new drugs vs. old, this is not science anymore, this is cruelty. It’s time to change obesity trials from placebo controlled, to head to head trials. We need to 86 placebos.

We’re long overdue for a better model.

The Bottom Line

VK2735 has real potential. But the dose that delivered these results may not survive Phase 3. And if they walk it back, the stellar numbers also come down with it.

So if you’re watching from the sidelines thinking, "Is this the pill that changes everything?" The answer is still, maybe. But only if it makes it through the first date.