For years, Novo Nordisk was the poster child of growth. Its GLP-1 drugs, Ozempic and Wegovy, didn’t just change obesity treatment — they reshaped the company’s balance sheet. Demand outpaced supply, public awareness skyrocketed, and Novo’s market cap surged. But growth always attracts challengers. Enter Eli Lilly with Mounjaro and Zepbound, and a wave of competitors and compounded generics threatening margins. Add in slowing sales growth and operational bloat from years of expansion, and suddenly Novo’s leadership had to answer tough questions about sustainability.