Emerging weight-loss medications: a dated pipeline table of retatrutide, CagriSema, zenagamtide, MariTide, survodutide, eloralintide and more, with stages, sponsors, trial links and honest caveats.
Fact-checked against FDA labels and official sources; not yet reviewed by a licensed clinician. This page is education, not medical advice. Talk to your doctor before starting, stopping or changing any treatment.
Key takeaways
- None of the pipeline drugs on this page is FDA approved for weight management as of October 6, 2026; they are available only in clinical trials.[1]
- CagriSema (cagrilintide plus semaglutide) has been submitted to the FDA; Novo Nordisk expects the review to finish around the turn of 2026/2027.[2]
- Retatrutide led to an average 25.0% weight loss at 80 weeks on 12 mg in TRIUMPH-1; Lilly plans to submit it to the FDA in Q1 2027.[4]
- Amylin-based drugs (CagriSema, zenagamtide, eloralintide, petrelintide) are the largest group in late-stage development.[1]
- Results from separate trials are not a head-to-head comparison: lengths, populations and statistical methods differ.[4]
In short: More than a dozen new weight-loss medicines are in late-stage testing, and none of the drugs in the table below is FDA approved for weight management yet. The closest are CagriSema (Novo Nordisk), which has been submitted to the FDA with a decision expected around the turn of 2026/2027, and retatrutide (Eli Lilly), which Lilly plans to submit in early 2027. The others are in Phase 3 or Phase 2. We check each status against ClinicalTrials.gov, company filings and peer-reviewed papers (last checked on 2026-10-06).
This page is a tracker, written for consumers. It explains how drugs move from trials to pharmacies, lists the main candidates with their stage and sponsor, groups them by how they work, and points out what is still unknown. Investigational medicines are available only inside clinical trials. Nothing here is a recommendation; decisions about treatment belong to you and a licensed clinician, and today’s approved options are on our weight-loss medications hub.
The pipeline in numbers
- 12investigational candidates tracked on this pageClinicalTrials.gov and sponsor filings
- 1candidate submitted to the FDA for weight management (CagriSema)Novo Nordisk annual report 2025 (SEC Form 6-K)
- -25.0%largest average weight change in a peer-reviewed Phase 3 obesity trial on this page (retatrutide 12 mg, 80 weeks)NEJM 2026
- 0candidates on this page that are FDA approved todayFDA (Drugs@FDA)
Checked on October 6, 2026
Start here
Use this page in three steps
- Check the stagePhase 2 and 3 mean "still being tested". Only an FDA approval means a medicine can be prescribed for that use.
- Read the results with careDifferent trials used different people, lengths and statistics; numbers from separate trials are not a head-to-head comparison.
- Talk about today's optionsBring questions to a clinician; approved medicines are on our medications hub, and trials are listed on ClinicalTrials.gov.
How a new medicine reaches the pharmacy
New medicines go through phases. Phase 1 studies give the drug to a small number of people to check safety and how the body handles it. Phase 2 studies, usually a few hundred people, test doses and look for early signs that it works. Phase 3 studies enroll hundreds to thousands of people, often for more than a year, to confirm benefits and find less common side effects. The company then submits an application (a New Drug Application or a Biologics License Application) and the FDA reviews the data, the manufacturing and the proposed label. Only after approval can a doctor prescribe it for that use. Many drugs fail along the way, and even approved drugs keep being monitored afterwards.
Two statistics show up in almost every weight-loss trial. The treatment-regimen (or treatment-policy) result counts everyone who was randomized, including people who stopped the drug. The efficacy (or trial-product) result estimates what would happen if everyone had kept taking it, so the number is larger. Company press releases often lead with the larger number; we say which one we show. Our Learn hub explains more about reading research, and the status badges guide explains why these drugs carry the INVESTIGATIONAL badge.
The pipeline table
| Candidate (sponsor) | How it works | Form | Stage, checked 2026-10-06 | Key trial |
|---|---|---|---|---|
| Retatrutide (Eli Lilly) | GIP + GLP-1 + glucagon receptor agonist (“triple”) | Weekly injection | Phase 3; five positive Phase 3 readouts; Lilly plans to submit to the FDA in Q1 2027 | TRIUMPH-1, NCT05929066 |
| CagriSema, cagrilintide + semaglutide (Novo Nordisk) | Amylin analog + GLP-1 receptor agonist, fixed combination | Weekly injection | Submitted to the FDA (New Drug Application); Novo expects the review to finish around the turn of 2026/2027 | REDEFINE 1, NCT05567796 |
| Cagrilintide alone (Novo Nordisk) | Long-acting amylin analog | Weekly injection | Phase 3 (RENEW program) | RENEW 1, NCT07220642 |
| Zenagamtide, formerly amycretin, NNC0487-0111 (Novo Nordisk) | Single molecule acting on GLP-1 and amylin receptors | Weekly injection; tablets also in Phase 3 | Phase 3 (AMAZE program, started 2026) | AMAZE 1, NCT07339423 |
| Maridebart cafraglutide, “MariTide” (Amgen) | Peptide-antibody conjugate: GLP-1 receptor agonist + GIP receptor antagonist | Injection every 4 weeks or less often (in trials) | Phase 3 (MARITIME program) | MARITIME-1, NCT06858839 |
| Survodutide (Boehringer Ingelheim) | Glucagon + GLP-1 receptor dual agonist | Weekly injection | Phase 3; SYNCHRONIZE-1 and -2 completed | SYNCHRONIZE-2, NCT06066528 |
| Eloralintide (Eli Lilly) | Selective amylin receptor agonist | Weekly injection | Phase 3 (ENLIGHTEN program, recruiting) | ENLIGHTEN-1, NCT07321886 |
| Petrelintide (Zealand Pharma / Roche) | Long-acting human amylin analog | Weekly injection | Phase 3 registered, not yet recruiting | ZUPREME-3, NCT07843498 |
| VK2735 (Viking Therapeutics) | GIP + GLP-1 receptor dual agonist | Weekly injection; oral version in Phase 2 | Phase 3 (VANQUISH program) | VANQUISH 1, NCT07104500 |
| Mazdutide (Innovent) | GLP-1 + glucagon receptor dual agonist | Weekly injection | Phase 3 trials in China; not FDA approved | NCT05607680 |
| Ecnoglutide (Sciwind Biosciences) | GLP-1 receptor agonist | Weekly injection; weekly oral version in Phase 2 | Phase 3 trials in China; not FDA approved | NCT05813795 |
| Bimagrumab (Eli Lilly) | Antibody studied alone and with tirzepatide for body composition | Injection | Phase 2 | NCT06643728 |
| Item | Value |
|---|---|
| Amylin-based (alone or with GLP-1) | 5 |
| GLP-1 with glucagon | 2 |
| GIP + GLP-1 (+ glucagon or blocker) | 3 |
| GLP-1 alone | 1 |
| Body composition (antibody) | 1 |
Our grouping of the table above: amylin-based = CagriSema, cagrilintide, zenagamtide, eloralintide, petrelintide; GIP group = retatrutide, VK2735, MariTide.
Source: InstaTuck pipeline table, from ClinicalTrials.gov records (checked on October 6, 2026)
Triple agonists: retatrutide
Today’s leading approved medicines act on one receptor (semaglutide: GLP-1) or two (tirzepatide: GIP and GLP-1). Retatrutide adds a third, the glucagon receptor. In the peer-reviewed TRIUMPH-1 trial (New England Journal of Medicine, 2026), 2,339 adults with obesity and without diabetes lost an average of 17.6%, 23.7% and 25.0% of their weight at 80 weeks on 4, 9 and 12 mg, compared with 3.9% on placebo, counting everyone randomized. Digestive side effects were common, unusual skin sensations (dysesthesia) were reported more often than with placebo, and stopping because of side effects rose with dose. A 10,000-person heart and kidney outcomes trial runs until about 2029. Full details are on our retatrutide page.
Amylin-based medicines: CagriSema, zenagamtide, eloralintide, petrelintide
Amylin is a hormone released with insulin after meals; it slows stomach emptying and signals fullness to the brain. Several companies are building long-acting amylin drugs, alone or combined with GLP-1 activity.
- CagriSema combines cagrilintide 2.4 mg with semaglutide 2.4 mg in one weekly injection. In REDEFINE 1 (NEJM 2025), 3,417 adults without diabetes lost an average of 20.4% of their weight at 68 weeks, vs 3.0% with placebo (treatment-policy estimand). Novo Nordisk reported in its 2025 annual report that it submitted a New Drug Application to the FDA for adults with overweight or obesity, based on the REDEFINE program of more than 4,600 adults, and expects the review to be completed around the turn of 2026/2027. In a head-to-head trial in people with type 2 diabetes (REIMAGINE 4), Novo reported that CagriSema was non-inferior to tirzepatide 15 mg for weight loss (15.2% vs 15.8% at 68 weeks, if everyone had stayed on treatment) but not for HbA1c.
- Zenagamtide (formerly amycretin) is a single molecule that acts on both GLP-1 and amylin receptors. Novo Nordisk started its Phase 3 AMAZE program in 2026, testing a weekly injection and tablets.
- Eloralintide (Lilly) acts selectively on amylin receptors. In a 48-week Phase 2 trial (The Lancet, 2025) with 263 adults, average weight change reached about -20% at the highest doses vs -0.4% on placebo (efficacy estimand). Nausea varied by dose, from 11% to 64%. Phase 3 trials started in late 2025 and early 2026.
- Petrelintide (Zealand Pharma with Roche) is a long-acting human amylin analog. In the Phase 2 ZUPREME 1 trial (The Lancet Diabetes and Endocrinology, 2026), 493 adults were randomized; at 28 weeks average weight change was about -7.9% to -9.8% across doses (efficacy estimand). Phase 3 trials are registered but not yet recruiting.
GLP-1 plus glucagon: survodutide and mazdutide
These “dual agonists” pair GLP-1 activity with glucagon-receptor activity, which researchers are studying for possible effects on energy use and liver fat. In SYNCHRONIZE-2 (NEJM 2026), 752 adults with obesity and type 2 diabetes took survodutide 3.6 mg or 6.0 mg weekly or placebo for 76 weeks; average weight change was -8.2% and -9.8% vs -3.9%. Boehringer Ingelheim has registered additional Phase 3 studies that are not yet recruiting. Mazdutide, from Innovent, has completed Phase 3 trials in China; it is not FDA approved.
Less frequent dosing: MariTide
Amgen’s maridebart cafraglutide links GLP-1-activating peptides to an antibody that blocks the GIP receptor, a design meant to last much longer than a week. In its Phase 2 trial (NEJM 2025), people with obesity received injections every 4 or 8 weeks; average weight change at 52 weeks ranged from -12.3% to -16.2% vs -2.5% with placebo, and from -8.4% to -12.3% vs -1.7% in people with type 2 diabetes (treatment-policy estimand). Digestive side effects were common, and less frequent with dose escalation and a lower starting dose. The Phase 3 MARITIME-1 trial lists primary completion in January 2027.
Pills and other new forms
Two GLP-1 pills already crossed the finish line: the Wegovy pill (oral semaglutide) and Foundayo (orforglipron) are FDA approved for weight management, and our oral GLP-1 guide compares them. In the pipeline, zenagamtide tablets are in Phase 3, and oral versions of VK2735 and of ecnoglutide (a weekly pill) have been tested in Phase 2. A pill is not automatically better: daily pills often have rules about food and water, and side effects are similar to injections.
Protecting muscle during weight loss
Part of the weight lost on any treatment is lean mass. A 2026 review in the Diabetes and Metabolism Journal notes that incretin-based therapies generally reduce fat preferentially, that available evidence does not show obvious functional harm, that long-term data remain limited, and that resistance training, nutrition and emerging drug strategies are being studied to protect muscle. Lilly’s Phase 2 trial of bimagrumab, alone and with tirzepatide, is one example. Until such drugs are proven, the best-supported tools are strength training and enough protein; see muscle loss on GLP-1s, strength training and the protein calculator.
Headline results, side by side (with caveats)
Read this chart as “what each trial reported”, not as a ranking. A 13-week Phase 2 trial and an 80-week Phase 3 trial measure very different things, people with type 2 diabetes lose less weight on every medicine, and placebo groups lost between about 0.4% and 5% depending on the trial. The only fair way to rank two medicines is a head-to-head trial; for approved drugs, see Wegovy vs Zepbound.
Recently approved: no longer in the pipeline
Some drugs we tracked have graduated to approved status. Wegovy HD, a 7.2 mg weekly semaglutide dose, was approved on March 19, 2026. The Wegovy pill was approved on December 22, 2025. Foundayo (orforglipron) was approved on April 1, 2026 (Drugs@FDA, NDA 220934). For setmelanotide, approved for specific rare genetic and hypothalamic causes of obesity, see Imcivree.
Stay safe: no “research peptides”
How to look for a clinical trial
ClinicalTrials.gov, run by the U.S. National Library of Medicine, lists studies with their eligibility rules, locations and contacts. Search by drug name or condition, filter to “recruiting”, and read the inclusion and exclusion criteria. Trials provide the study drug under medical supervision, but you may receive placebo, and there are visits, tests and time commitments. Ask the study team about risks, costs, what happens when the study ends, and whether you can continue other treatments. Your own clinician can help you decide. Meanwhile, the foundations in how to lose weight and the approved GLP-1 medications remain the starting point.
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- Which approved medicines fit me today, and is there a reason to wait for a new one?
- Would a clinical trial be a reasonable option for me, and how do I evaluate one?
- How should I read headline weight-loss numbers from company announcements?
- If a new medicine is approved, how would we decide whether to switch?
- How do I protect my muscle and my long-term results on any treatment?
Frequently asked questions
What is the newest weight-loss drug?
Among approved medicines, Wegovy HD (semaglutide 7.2 mg) was approved on March 19, 2026. Among pipeline drugs, CagriSema has been submitted to the FDA and retatrutide is expected to be submitted in early 2027. None of the pipeline drugs is approved yet.
When will retatrutide be approved?
No one knows yet. Lilly plans to submit an application in the first quarter of 2027; the FDA review usually takes many months and approval is not guaranteed.
What is CagriSema?
A weekly injection that combines cagrilintide (a long-acting amylin analog) with semaglutide. In REDEFINE 1, adults lost 20.4% of their weight on average at 68 weeks vs 3.0% with placebo. Novo Nordisk submitted it to the FDA and expects the review to end around the turn of 2026/2027.
What does amylin do?
Amylin is a hormone released with insulin after meals. It slows stomach emptying and signals fullness. Several new medicines copy or extend its action, alone or combined with GLP-1 activity.
Are there new weight-loss pills coming?
Two GLP-1 pills are already approved (the Wegovy pill and Foundayo). Zenagamtide tablets are in Phase 3, and oral versions of VK2735 and ecnoglutide have been studied in Phase 2.
Can I get pipeline drugs before approval?
Only by joining a clinical trial. Products sold online under pipeline drug names, including "research peptides", are not legitimate medicines; the FDA has warned companies that sold retatrutide.
Will new drugs work better than Zepbound or Wegovy?
Some trials report larger average weight loss, but only head-to-head trials can show that. Retatrutide is being compared directly with tirzepatide in TRIUMPH-5, with primary completion listed for November 2026.
Do any new drugs prevent muscle loss?
Not proven yet. Antibodies such as bimagrumab are in Phase 2 trials. Strength training and adequate protein remain the best-supported ways to protect muscle while losing weight.
How often is this page updated?
We re-check every status against ClinicalTrials.gov, company filings and the FDA at least every 90 days and when major results or decisions are announced. The date at the top shows the last check.
References
- ClinicalTrials.gov records for the candidates listed (API v2 queries). U.S. National Library of Medicine. (accessed October 7, 2026) Government page
- Novo Nordisk annual report 2025 company announcement (Form 6-K): CagriSema submitted to the US FDA; zenagamtide (previously amycretin). Novo Nordisk A/S, via U.S. Securities and Exchange Commission, 2026. (accessed October 6, 2026) Other
- Novo Nordisk financial report January-June 2026 (Form 6-K): REIMAGINE 4, AMAZE program, Wegovy HD. Novo Nordisk A/S, via U.S. Securities and Exchange Commission, 2026. (accessed October 6, 2026) Other
- Jastreboff AM, Kaplan LM, Davies MJ, et al.. Retatrutide, a Triple Hormone Receptor Agonist, for Treatment of Obesity (TRIUMPH-1). New England Journal of Medicine, 2026. doi:10.1056/NEJMoa2604169 · PMID 42814954 · NCT05929066 (accessed October 7, 2026) Randomized trial
- Lilly’s triple agonist, retatrutide, delivered substantial weight loss and A1C reduction (BLA planned Q1 2027). Eli Lilly and Company (press release), 2026. (accessed October 7, 2026) News (reported facts only)
- Garvey WT, Bluher M, Osorto Contreras CK, et al.. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity (REDEFINE 1). New England Journal of Medicine, 2025. doi:10.1056/NEJMoa2502081 · PMID 40544433 · NCT05567796 (accessed October 7, 2026) Randomized trial
- Billings LK, Hsia S, Bays H, et al.. Eloralintide, a selective amylin receptor agonist for the treatment of obesity: a 48-week phase 2 trial. The Lancet, 2025. doi:10.1016/S0140-6736(25)02155-5 · PMID 41207310 (accessed October 6, 2026) Randomized trial
- Jastreboff AM, Ryan DH, Bays HE, et al.. Once-Monthly Maridebart Cafraglutide for the Treatment of Obesity: A Phase 2 Trial. New England Journal of Medicine, 2025. doi:10.1056/NEJMoa2504214 · PMID 40549887 · NCT05669599 (accessed October 7, 2026) Randomized trial
- Wharton S, le Roux CW, Startseva E, et al.. Survodutide Once Weekly in Adults with Obesity and Type 2 Diabetes (SYNCHRONIZE-2). New England Journal of Medicine, 2026. doi:10.1056/NEJMoa2607219 · PMID 42820639 · NCT06066528 (accessed October 7, 2026) Randomized trial
- Garvey WT, Ard J, Connery L, et al.. Petrelintide, a human amylin analogue for the treatment of obesity (ZUPREME 1): a phase 2 trial. The Lancet Diabetes and Endocrinology, 2026. doi:10.1016/S2213-8587(26)00213-5 · PMID 42810355 (accessed October 6, 2026) Randomized trial
- Bays HE, Toth P, Alkhouri N, et al.. Weekly Subcutaneous VK2735, a GIP/GLP-1 Receptor Dual Agonist, for Weight Management: Phase 2, 13-Week VENTURE Study. Obesity, 2026. doi:10.1002/oby.70106 · PMID 41508550 · NCT06068946 (accessed October 6, 2026) Randomized trial
- Beyond Fat Loss: Addressing the Sarcopenia Challenge of Incretin-Based Therapies. Diabetes and Metabolism Journal, 2026. doi:10.4093/dmj.2026.0702 · PMID 42722378 (accessed October 6, 2026) Review
- FDA’s concerns with unapproved GLP-1 drugs used for weight loss. U.S. Food and Drug Administration, 2026. (accessed October 7, 2026) Government page
- Drugs@FDA: Wegovy tablets, NDA 218316. U.S. Food and Drug Administration. (accessed October 7, 2026) Government page
- Drugs@FDA: Foundayo, NDA 220934. U.S. Food and Drug Administration. (accessed October 7, 2026) Government page
- Drugs@FDA: Wegovy, NDA 215256, approval history. U.S. Food and Drug Administration. (accessed October 7, 2026) Government page
Facts checked on October 6, 2026
Educational information, not medical advice. Talk with a qualified healthcare professional about your own situation. In an emergency call 911.