I think the biggest market pharma will ever tackle will actually be weight gain PREVENTION. And the dynamics of this market are going to be very different from the medicalized weight loss market and require better, more convenient products. The race for that market has only just begun. We helped to pivot one of our companies, Terrestrial, to work in prevention (as well as weight loss), and their clinical progress now makes me comfortable sharing our thesis for the weight gain prevention space. They have a needle-free, room-temp stable microneedle patch where the microneedles are made of semaglutide. Apply it for a few min, the base of the needles dissolves leaving drug under the skin, and you can then throw away the patch. That’s the weekly dose. No sharps containers. Once drug is under skin, it behaves very similarly to regularly injected semaglutide. 505b2 path to market is derisked by all existing data on sema. But Terrestrial isn’t stopping at just getting approved for all same indications as sema. It’s also gunning to get it OTC and get weight gain prevention on the label, legitimizing what today is a common off-label use (so common that South Park parodied it). From a societal value, there may not be any single medical breakthrough that rivals what a needle-free, OTC QW GLP-1 can offer to humanity. Excess weight leads to so much disability, disease, cost, lost productivity, and early mortality. Doesn’t make sense for people to have to gain weight to then get help losing it. Makes more sense for them to get help quieting the hunger noise (drive to eat) so they can avoid gaining weight in the first place. Have doubts? No problem. Read the article and then decide. The key insight here is that an OTC needle-free GLP-1 is not simply some late comer to a mature category but actually the beginning of an entirely new market that is so large that it would be worth any consumer-focused company to pay attention and for any standard pharma to consider what it would take to pivot into this space. And if you have never experienced how a GLP-1 can quiet hunger noise, you’ll have a harder time relating. Young people with fast metabolisms will likely miss this. But someday they will say “holy crap, I get it!”. 60% of Americans are overweight or obese… the battle against weight gain is one most people are destined to lose without help. 3B people around the world are overweight/obese. This is a giant global market at even very low unit prices (eg $25/month). Enjoy the read. Godspeed Terrestial! The RA Capital team is really proud to support you.

Here's the link... to the article. The writing was the easy part. Huge thank you to everyone on our team who worked to get this put together. rapport.racap.com/all-storie…

Raj and I just dropped the 2026 Semper Maior report. 20 years of M&A lessons + a massive deep dive into deal data since 2019. Lot's of hard-earned lessons in here. Read it on your way to JPM before your strategic meetings. Good luck out there! #JPM2026