Vivani’s GLP-1 implant tests a new path for weight-loss maintenance

Vivani Medical is trying to solve a problem that matters for patients and investors watching the GLP-1 market: many people stop using weight-loss drugs before they can sustain the benefits. The biotech company is developing a small semaglutide implant that could one day reduce the hassle of regular shots or pills, though it remains years from possible approval.

Semaglutide is the active ingredient in Novo Nordisk’s Wegovy for obesity and Ozempic for diabetes. GLP-1 drugs mimic a gut hormone involved in appetite and blood sugar, and they have become one of the biggest growth stories in health care. CNBC reported that some studies estimate roughly half or more of patients stop GLP-1 medicines within a year, driven by factors such as side effects, costs, injection fatigue and stigma around obesity treatment.

Novo Nordisk announced an agreement with Vivani to evaluate NPM-139, Vivani’s lead semaglutide implant. Novo Nordisk told CNBC the company is working to pair its internal research with outside innovation. Vivani CEO Adam Mendelsohn told CNBC the agreement is not a licensing deal, but called it validation for the product’s potential direction.

How the implant would work

Vivani’s device is a tiny titanium reservoir designed to sit under the skin and release semaglutide over months. Mendelsohn told CNBC the implant uses a membrane with microscopic channels that let drug molecules move into the body at a slow, steady pace.

The company is initially positioning the implant as a maintenance option. Patients would first reach an appropriate semaglutide dose through existing injections or pills, then could switch to an implant meant to deliver a similar weekly amount over time. Vivani is working on a version that would be removed and replaced every six months, with a longer-term goal of a once-a-year implant.

Mendelsohn said the procedure could take a few minutes in a doctor’s office with local anesthesia, with the implant placed under the skin of the upper arm or possibly the abdomen. He compared the experience to Nexplanon, a contraceptive implant. He also said the device has no pump or mechanical parts, and that patients could have it removed or replaced with a different dose if needed.

Vivani says steadier drug levels could reduce some side effects tied to existing GLP-1 medicines, including nausea and vomiting. That claim has not yet been proven in human trials.

Doctors want human data

Several doctors told CNBC the idea could help some patients stay on treatment, but they want evidence on safety, weight loss, tolerability and real-world use. Dr. Miranda Stiewig-Rapp, director of UC Davis Health’s Obesity Clinic, told CNBC she is skeptical overall but open to being proven wrong.

Dr. Harold Bays, chief science officer of the Obesity Medicine Association, told CNBC researchers are studying how to maintain weight loss after patients respond to GLP-1 medicines. Other approaches include lower doses, less frequent dosing and pills.

Dr. Amy Sheer, an assistant professor of medicine at the University of Florida, told CNBC an implant could fit patients who are tired of injections or have trouble remembering pills. Dr. Amy Rothberg, a clinical professor of medicine at the University of Michigan, told CNBC the procedure could add costs and require training for doctors who do not usually place implants.

Coverage is another open question. Vivani has not set a potential price. Mendelsohn told CNBC he expects the implant would cost less than shots because patients may need only one or two implants a year instead of weekly auto-injector pens.

Next step: first human trial

Vivani said in June that an Australian human research ethics committee approved SLIM-1, its first human clinical trial for the implant. The phase one study is expected to start in mid-2026 and enroll about 20 overweight or obese adults who have not taken GLP-1 medicines before.

Participants will receive either the implant or a low-dose weekly Wegovy injection over four weeks. Researchers will mainly study safety, tolerability and pharmacokinetics, meaning how the drug is absorbed and released over time. Weight loss will also be measured.

If the trial is positive, Vivani plans a phase two study testing different implant doses. Larger late-stage trials would still be needed before regulators could consider approval.

This story draws on original reporting from CNBC.