After joining the study, you start receiving one of the study treatments: placebo or zenagamtide (the study medicine in NNC0487-0111).

The medicine is given as a subcutaneous injection, which means an injection under the skin, using a pre-filled pen.

The treatment is given once weekly.

The study compares several dose levels of NNC0487-0111 against placebo. The source data lists the dose as 0 with the unit other, but does not provide a readable dose amount.

You continue with the assigned once-weekly injection for the study period.

Your body weight is checked to see how much it changes over time.

Your waist size is measured.

Your blood pressure is measured, including systolic blood pressure (SBP) and diastolic blood pressure (DBP). Systolic blood pressure is the upper number in a blood pressure reading, and diastolic blood pressure is the lower number.

Your blood is tested for HbA1c, which shows average blood sugar levels over time, fasting plasma glucose (FPG), which is blood sugar after not eating, and fasting insulin.

Your blood is also tested for lipids, which are blood fats, including total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, very low-density lipoprotein (VLDL) cholesterol, non-HDL cholesterol, and triglycerides.

Your blood is tested for hsCRP, which means high-sensitivity C-reactive protein, a marker of inflammation.

You complete questionnaires about how your weight affects your daily life and physical function, including the IWQOL-Lite-CT and SF-36v2 Acute questionnaires. These tools ask about quality of life and physical functioning.

The study records any treatment-emergent adverse events, which means new health problems that appear after treatment starts, and any serious adverse events, which means serious health problems. It also records any side effects that lead to stopping treatment permanently.

If you enter the extension phase, you continue with study assessments that include body weight, body mass index (BMI), which is a measure based on height and weight, waist size, blood pressure, blood sugar measures, lipids, hsCRP, and the same types of questionnaires about daily life and physical function.

The study also continues to track treatment-emergent adverse events, serious adverse events, and side effects that lead to permanent stopping of treatment.

The extension phase also measures relative change in body weight and change in body weight over time.

Your participation ends after the study treatment and any extension phase assessments are completed.

The full study is planned to run from 2026-04-06 to 2029-07-31.