Category: What’s New & Innovations

  • What’s Coming in 2027: Weight-Loss Treatments Awaiting FDA Decisions

    What’s Coming in 2027: Weight-Loss Treatments Awaiting FDA Decisions

    In short: The next FDA decisions on weight-loss medicines are close. CagriSema, a weekly combination injection from Novo Nordisk, has been under FDA review since December 2025, with a decision the company expects in the fourth quarter of 2026, so it may land late this year or slip into 2027. Lilly plans to apply for retatrutide in early 2027, and several other drugs finish their main trials during 2027 but will not reach a decision until later. None of these is approved today. Checked on October 7, 2026.

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    Photo: Maximilianovich / Pixabay

    This page is our yearly look ahead. It lists the weight-loss treatments with an FDA decision pending or likely in the next 12 to 18 months, what the trials showed, and the dated changes to price and coverage already set for 2027. For every candidate in development, including early-stage drugs, see our emerging medications tracker. For what you can use today, see our comparison of every FDA-approved weight-loss medication. This is general education, not advice about any treatment.

    The 2027 outlook in four numbers

    Checked on October 7, 2026

    How an FDA decision date is set

    It helps to know the clock before reading any “coming soon” headline. For a brand-new medicine, the FDA first takes up to 60 days to decide whether the application is complete enough to review. Under the user-fee goals the agency has agreed with industry for 2023 to 2027, it then aims to act on a standard application within 10 months and a priority one within 6 months of that 60-day filing date. That is why a drug submitted in a given month usually gets its decision about a year later, or about eight months later with priority review.

    There is now a faster lane. Under the Commissioner’s National Priority Voucher program, launched in 2025, the FDA’s target is a decision within about two months. The first new medicine approved this way was Foundayo (orforglipron), the daily weight-loss pill, on April 1, 2026: 50 days after filing and 294 days ahead of its original goal date of January 20, 2027. A voucher can therefore move a decision forward by most of a year, which makes any forecast less certain.

    From last trial to pharmacy shelf

    1. Phase 3 resultsThe company reports topline results, then full papers in journals.
    2. ApplicationThe company submits a new drug application (NDA) or biologics license application (BLA).
    3. Filing reviewUp to 60 days for the FDA to accept the application for review.
    4. ReviewGoal of 10 months (standard), 6 months (priority) or about 2 months (national priority voucher).
    5. Decision and labelApproval with a label, a request for more data, or a refusal. Launch, price and coverage follow.

    The status board

    The table lists candidates in the order their FDA decision could come, based on public information. It is not a ranking, and later rows are further from a decision.

    Treatment (company)What it isStage on Oct 7, 2026FDA applicationEarliest decision
    CagriSema (Novo Nordisk)Weekly injection: amylin analogue cagrilintide plus semaglutidePhase 3 complete (REDEFINE 1, 2, 4, 5)Filed December 2025 (reported)Q4 2026, company expectation; could move into 2027
    Foundayo for type 2 diabetes (Lilly)Daily pill already approved for weight management; new diabetes usePhase 3 complete (ACHIEVE program)Planned by end of Q2 2026 under a priority voucher (reported); no decision foundNot announced
    Retatrutide (Lilly)Weekly injection acting on GIP, GLP-1 and glucagon receptorsPhase 3: four trials reported; head-to-head vs tirzepatide due Nov 2026 (registry estimate)Planned Q1 2027 (reported)Late 2027 or 2028 on a standard clock; sooner only with a voucher
    Survodutide (Boehringer Ingelheim)Weekly injection acting on glucagon and GLP-1 receptorsPhase 3: SYNCHRONIZE-1 and -2 reported; heart-safety trial completed June 2026None announcedNot before late 2027
    MariTide (Amgen)Monthly or less frequent injection (antibody-peptide)Phase 3: MARITIME-1 (3,853 adults) primary completion Jan 2027 (registry estimate)None announced2028 or later
    VK2735 (Viking)Weekly injection acting on GIP and GLP-1 receptorsPhase 3: VANQUISH 1 primary completion July 2027 (registry estimate)None announced2028 or later
    Eloralintide (Lilly), zenagamtide (Novo Nordisk)Amylin-based injections; zenagamtide was previously called amycretinPhase 3 recruiting; main trials list completion 2028-2029NoneNot before 2028
    INVESTIGATIONAL except Foundayo, which is approved for weight management only. Sources: company releases (reported), ClinicalTrials.gov and openFDA, checked 2026-10-07. “Earliest decision” for rows without a filing is our estimate from the FDA review clock, not a company date.

    CagriSema: the decision closest to happening

    CagriSema pairs semaglutide, the ingredient in Wegovy, with cagrilintide, a long-acting version of amylin, a hormone that helps signal fullness. In REDEFINE 1, published in 2025, 3,417 adults without diabetes lost 20.4% of their body weight on average over 68 weeks, compared with 3.0% on placebo, counting everyone who started. People with type 2 diabetes lost 13.7% vs 3.4% in REDEFINE 2. In an open-label head-to-head trial against tirzepatide, REDEFINE 4, Novo reported that CagriSema did not meet its goal of showing it was at least as effective (20.2% vs 23.6% at 84 weeks, treatment-regimen estimand). Digestive side effects were common, affecting 79.6% vs 39.9% on placebo in REDEFINE 1, mostly mild to moderate and temporary.

    Novo filed with the FDA in December 2025 and, in its September 30, 2026 announcement, still said it expects a decision in the fourth quarter of 2026. We found no FDA decision as of October 7. If approved, the label would set who it is for and its warnings; price and coverage would follow. Our CagriSema explainer has every trial in detail.

    Retatrutide: the application to watch in 2027

    Retatrutide produced the largest average weight losses reported so far in a medicine trial. In TRIUMPH-1, published in the New England Journal of Medicine in September 2026, 2,339 adults with obesity lost 25.0% on the highest dose over 80 weeks vs 3.9% on placebo, counting everyone randomized. Lilly says it plans to submit retatrutide to the FDA in the first quarter of 2027. On a standard clock, that points to a decision in late 2027 or early 2028; Lilly has not said whether it will use a priority voucher. A head-to-head trial against tirzepatide, TRIUMPH-5, lists its primary completion for November 2026, so those results could arrive before the application. Our retatrutide results explainer covers the side effects, including the skin-sensation effect called dysesthesia.

    Weight loss in each candidate's main Phase 3 trial vs placeboValues in %
    Weight loss in each candidate's main Phase 3 trial vs placebo
    ItemInvestigational drug, highest dosePlacebo
    CagriSema, REDEFINE 1, 68 wk20.4%3%
    Retatrutide, TRIUMPH-1, 80 wk25%3.9%
    Survodutide, SYNCHRONIZE-1, 76 wk16.6%3.2%

    INVESTIGATIONAL. Different trials, people and lengths: not a ranking. CagriSema and retatrutide figures count everyone randomized; the survodutide figure is company-reported and assumes everyone stayed on treatment (efficacy estimand), which gives higher numbers.

    Source: Garvey WT et al., NEJM 2025 (REDEFINE 1); Jastreboff AM et al., NEJM 2026 (TRIUMPH-1); Boehringer Ingelheim release, April 28, 2026 (SYNCHRONIZE-1) (checked on October 7, 2026)

    Read those bars with care. They come from separate trials with different lengths, and the survodutide number is measured in the more generous way. Our guide on how to read a weight-loss study headline explains why the same trial can produce two different percentages. For context, people in the trials behind today’s leading approved medicines lost 14.9% with semaglutide 2.4 mg over 68 weeks (STEP 1) and 20.9% with tirzepatide 15 mg over 72 weeks (SURMOUNT-1).

    Further out: survodutide, MariTide, VK2735 and amylin drugs

    Survodutide from Boehringer Ingelheim works on glucagon and GLP-1 receptors. On April 28, 2026, the company reported that in SYNCHRONIZE-1, 725 adults without diabetes lost up to 16.6% vs 3.2% on placebo over 76 weeks (efficacy estimand, company-reported), and 85.1% lost at least 5%. In SYNCHRONIZE-2, published in 2026, 752 adults with type 2 diabetes lost 8.2% and 9.8% on the two doses vs 3.9% on placebo, counting everyone randomized. Its heart-safety trial, with 5,531 participants, lists completion in June 2026. The company has not announced an FDA filing, so a decision before late 2027 is unlikely.

    MariTide (maridebart cafraglutide) from Amgen is designed to be injected once a month or less often. In its Phase 2 trial, published in 2025, adults with obesity lost 12.3% to 16.2% at 52 weeks vs 2.5% on placebo. Its main Phase 3 trial, MARITIME-1, has enrolled 3,853 adults and lists primary completion in January 2027, so results could be one of the big news items of 2027, but a decision would come later. VK2735 from Viking, a weekly GIP and GLP-1 injection with an oral version in earlier testing, has a 4,500-person Phase 3 trial listed to complete in July 2027.

    Several amylin-based medicines are in Phase 3: eloralintide from Lilly (ENLIGHTEN-1, completion listed March 2028), zenagamtide from Novo Nordisk (the AMAZE program, previously called amycretin) and petrelintide (Zealand with Roche). These are at least two years from any decision. Our muscle-preserving weight-loss drugs page follows a different branch of research, drugs meant to protect lean mass during weight loss.

    Already decided: what is changing in 2027 for approved medicines

    Some 2027 changes are already on the calendar. Novo Nordisk announced on February 24, 2026, that the US list price of Wegovy and Ozempic will be $675 a month for all doses from January 1, 2027, roughly half of Wegovy’s earlier list price; it said its direct self-pay prices are not affected. The list price matters most for people whose costs are tied to it, such as those on high-deductible plans. Our Wegovy cost guide has the current self-pay prices.

    For people with Medicare, the Medicare GLP-1 Bridge, which began on July 1, 2026, runs through December 31, 2027, with a $50 copay for Foundayo, Wegovy (injection and tablets) and the Zepbound KwikPen when used for weight management. CMS says it extended the program through 2027 to collect more data; it has not said what replaces it in 2028. Medicare open enrollment runs from October 15 to December 7 each year. Our GLP-1 coverage guide explains the rules.

    Foundayo itself may gain a second use. Lilly said on June 8, 2026, that it planned to submit Foundayo for type 2 diabetes by the end of the second quarter under a priority voucher, after three ACHIEVE trials. As of October 7, the FDA record shows only the April approval for weight management and an August labeling update, so the diabetes use is not approved.

    Devices: two arrivals to know about

    On the device side, the newest approval has already happened: the FDA approved the swallowable Allurion gastric balloon on February 20, 2026, and the company reported treating its first US commercial patients in April. The Epitomee capsule, cleared in September 2024, is in a pre-launch program with selected US clinics. Our list of weight-loss devices the FDA has authorized covers both, with their trial results.

    What a new approval would and would not change

    New medicines bring more choice, but several things stay the same. With every approved GLP-1 medicine so far, weight tends to return after stopping, and our guide on life after a GLP-1 covers what helps. Strength training and enough protein remain important on any strong weight-loss medicine to protect muscle; see muscle loss on GLP-1 medicines. A new label will define who a drug is for, and a launch price and insurance coverage usually lag behind approval.

    If you are weighing whether to wait for a new drug, it may help to bring our printable questions to ask before starting a GLP-1 to your clinician, and to compare today’s options with Find My Options. Any FDA decision on the drugs above will appear first in our monthly news roundup, and this page will be updated.

  • Weight-Loss Devices FDA Has Authorized: Balloons, Capsules and More

    Weight-Loss Devices FDA Has Authorized: Balloons, Capsules and More

    In short: The FDA has authorized about a dozen devices for weight loss or weight management since 2001, from a surgically placed band to balloons you swallow and capsules that swell with water in the stomach. In their pivotal trials, people using them lost on average roughly 2 to 9 percentage points more of their body weight than people in the comparison group, over 6 to 12 months. Several are no longer sold, so an FDA authorization does not mean you can get the device today. Checked on October 7, 2026.

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    Photo: monicore / Pixabay

    This page lists every weight-loss device we could find in the FDA’s databases, with the exact group of people each one is authorized for and whether it is still on the market. For the procedures themselves, see our guides to the gastric balloon, endoscopic sleeve gastroplasty and the Lap-Band, and our side-by-side look at every weight-loss procedure. It is general education, not a recommendation for any device; you and your clinician decide what fits.

    Weight-loss devices at a glance

    • 13weight-loss or weight-management devices we found with an FDA authorization, 2001 to 2026FDA PMA, De Novo and 510(k) databases
    • 8devices on the FDA's own weight-loss device page (current as of March 12, 2026)FDA
    • Feb 20, 2026newest approval: the swallowable Allurion balloon (PMA P250023)FDA PMA database
    • 3authorized devices confirmed off the market (Plenity, Obalon, AspireAssist); 3 more we could not find on sale

    Checked on October 7, 2026

    “Approved”, “cleared” and “granted”: what the FDA words mean

    Devices reach the market by different routes, and the words differ for each. Higher-risk devices, such as balloons that stay in the stomach for months or a band placed in surgery, need premarket approval (PMA), the strictest route, which requires clinical evidence of safety and effectiveness. A new kind of lower-risk device with no earlier example can be granted a De Novo classification, which also sets “special controls” for later devices of the same type. Once a De Novo exists, a similar device can be cleared through a 510(k) by showing it is substantially equivalent to that earlier device. All three are FDA authorizations; none of them is a promise that a device will work for you.

    The FDA’s consumer page splits these products into weight-loss devices (the band, the balloons and the endoscopic suturing device) and weight-management devices (a removable mouthpiece and a swallowed capsule). Its list, last updated on March 12, 2026, names eight products. It does not yet include the Allurion balloon or the Epitomee capsule, both authorized in the database, and it no longer includes several devices that were approved and later left the market.

    Every device we found, with its exact indication

    The table follows the order in which each device works in the body, from the mouth down, not any ranking. “Status” is what we could confirm on October 7, 2026, from company and government sources. All of them are for adults and all are used alongside a diet and activity program; none is a stand-alone fix.

    DeviceTypeFDA route and dateAuthorized for (as written by the FDA)Status, October 2026
    SMART device (Scientific Intake)Removable mouthpiece worn at mealsDe Novo DEN150033, Sept 26, 2016; similar SmartByte cleared 2017 (K171165)Overweight to obese adults, BMI 27-35, with behavioral modification instruction; prescriptionWe could not confirm that it is sold
    Plenity (Gelesis)Swallowed capsule; gel takes up spaceDe Novo DEN180060, Apr 12, 2019; over-the-counter version cleared Jan 19, 2024 (K230133)Adults with BMI 25-40, with diet and exerciseMaker filed for Chapter 7 liquidation on Oct 30, 2023; we found no current US seller
    Epitomee (Epitomee Medical)Swallowed capsule; gel takes up space510(k) K240544, Sept 13, 2024Adults with BMI 25-40, with diet and exercise; prescriptionPre-launch program with selected US clinics
    ORBERA (Boston Scientific)Saline balloon placed by endoscopePMA P140008, Aug 5, 2015Adults with BMI 30-40 who have not succeeded with diet, exercise and behavior programs; up to 6 monthsSold in the US
    Spatz3 (Spatz)Adjustable saline balloon placed by endoscopePMA P190012, Oct 15, 2021Adults with BMI 35-40, or 30-34.9 with a major obesity-related condition, after a supervised weight program; up to 8 monthsMaker lists clinics; US availability not confirmed by us
    Allurion Gastric Balloon SystemSwallowed balloon, no endoscopy; empties and passes on its ownPMA P250023, Feb 20, 2026Adults 22-65 with BMI 30-40 and at least one unsuccessful weight-loss program; up to two balloons over 10 months; “short-term limited weight loss”First US commercial patients treated in April 2026
    Obalon Balloon SystemSwallowed gas-filled balloons, removed by endoscopePMA P160001, Sept 8, 2016Adults with BMI 30-40 who have not lost weight with diet and exercise; removed at 6 monthsNot on sale; ReShape reported no Obalon revenue in 2025 and licensed it out
    TransPyloric Shuttle (BAROnova)Device that sits at the stomach outlet and slows emptyingPMA P180024, Apr 16, 2019Adults with BMI 35-40, or 30-34.9 with an obesity-related conditionWe found no evidence it is sold
    Apollo ESG and Revise systemsEndoscopic suturing to make the stomach smallerDe Novo DEN210045, July 12, 2022Adults with BMI 30-50 who have not lost weight, or kept it off, with more conservative measures (see our ESG guide)In use in the US
    Lap-BandAdjustable band placed in surgeryPMA P000008, June 5, 2001; widened in 2011 to BMI 30-34 with a related conditionOriginally BMI 40+, or 35+ with a severe related conditionSold in the US; approval now held by Medtimo
    Maestro (vBloc) systemImplanted nerve-blocking stimulatorPMA P130019, Jan 14, 2015Adults with BMI 40-45, or 35-39.9 with a related condition, after a supervised programWe found no evidence it is sold
    AspireAssistStomach tube to drain part of a mealPMA P150024, June 14, 2016Adults 22+ with BMI 35-55 who failed non-surgical therapyWithdrawn from the market April 8, 2022
    Not a ranking. FDA PMA, De Novo and 510(k) records read on 2026-10-07. A 13th device, the ReShape Integrated Dual Balloon (PMA P140012, 2015), is no longer on the FDA’s device page and is not covered here.
    Who each device is authorized for: BMI range on the FDA indicationValues in BMI
    Who each device is authorized for: BMI range on the FDA indication
    ItemLowHigh
    SMART mouthpiece27 BMI35 BMI
    Plenity and Epitomee capsules25 BMI40 BMI
    ORBERA, Obalon, Allurion balloons30 BMI40 BMI
    Spatz3 balloon, TransPyloric Shuttle30 BMI40 BMI
    Apollo ESG30 BMI50 BMI
    Maestro (vBloc)35 BMI45 BMI
    AspireAssist35 BMI55 BMI

    Some devices require an obesity-related condition at the lower end of the range (Spatz3, TransPyloric Shuttle, Maestro). The Lap-Band has no upper limit and is left out. Use the BMI calculator to see your own number.

    Source: FDA PMA, De Novo and 510(k) records (checked on October 7, 2026)

    If you are not sure where you fall, our BMI calculator gives your number in a few seconds. A BMI inside a range does not make a device right for you: each label also lists conditions that rule it out, such as past stomach surgery, a large hiatal hernia, pregnancy or certain bowel problems.

    Swallowed capsules: Plenity and Epitomee

    These are the least invasive devices. You swallow a capsule with water before lunch and dinner; inside the stomach, it releases particles or a gel that soak up water and take up space, then pass through and leave the body. Plenity’s hydrogel, made from cellulose and citric acid, can absorb up to 100 times its own weight in water, according to its FDA summary.

    The FDA’s own review is candid about how much they do. In Plenity’s 24-week GLOW trial of 436 adults, people lost 6.4% of their body weight on average, compared with 4.4% on a look-alike capsule filled with cane sugar. The trial missed its own goal of a 3-point difference, and the FDA wrote that the effectiveness was “not appropriate for an indication of weight loss”, which is why both capsules are authorized for weight management. People in the US sites saw a smaller difference than people in Europe. In Epitomee’s 24-week RESET trial of 279 adults at nine US sites, average loss was 6.6% vs 4.6% on placebo, and 55.5% lost at least 5%. Neither trial reported serious device-related side effects. With Plenity, the complaints that did occur were mostly digestive, such as bloating, constipation or infrequent bowel movements; in RESET, digestive side effects were no more common than with placebo.

    Plenity’s story shows why “authorized” and “available” are different things. It was sold by prescription from 2020, and the FDA cleared an over-the-counter version in January 2024, but its maker, Gelesis, had filed for liquidation in October 2023 and its consumer website no longer loads. Epitomee says it is a prescription device and is running a pre-launch program with selected US clinics.

    Gastric balloons: four approved, two still clearly sold

    Balloons take up room in the stomach so you feel full sooner. ORBERA and Spatz3 are filled with saline after a doctor places them through the mouth with an endoscope under sedation, and are removed the same way. Obalon used swallowed capsules filled with gas, removed by endoscope at six months. The newest, the Allurion balloon, is swallowed as a capsule attached to a thin tube, filled with fluid in a roughly 15-minute office visit, and opens a valve on its own so it empties and passes naturally; in its trial it stayed in the stomach for 15.3 weeks on average.

    In the Allurion approval trial, AUDACITY, 550 adults were randomized; those in the balloon group received up to two balloons over 10 months, and everyone had a moderate-intensity lifestyle program. At 48 weeks, weight loss averaged 6.87% vs 3.09% in the lifestyle-only group, and 58.0% of balloon users lost at least 5%. That difference missed the trial’s own 3-point “super-superiority” target under the main analysis, and the FDA approved it for “short-term limited weight loss”. Device-related serious adverse events affected 8 people (3.0%), all after the second balloon; one person had a stomach perforation that the investigators linked to an underlying clotting problem. There were no deaths and no small-bowel obstructions. Our gastric balloon guide has the full ORBERA and Spatz3 trial results and the FDA’s warnings about over-inflation, pancreatitis and deaths with liquid-filled balloons.

    Average weight loss in each device's main FDA trial vs the comparison groupValues in %
    Average weight loss in each device's main FDA trial vs the comparison group
    ItemDeviceComparison group
    Plenity capsule, 24 wk6.4%4.4%
    Epitomee capsule, 24 wk6.6%4.6%
    Obalon balloon, 24 wk6.6%3.4%
    Allurion balloon, 48 wk6.9%3.1%
    ORBERA balloon, 6 mo10.2%3.3%
    TransPyloric Shuttle, 12 mo9.5%2.8%
    AspireAssist, 52 wk12.1%3.6%
    Spatz3 balloon, 32 wk15%3.3%

    Percent of starting body weight. Different trials, people, comparison groups and lengths: not a ranking and not head-to-head. Capsule trials used a placebo or sham capsule; most balloon trials compared with a lifestyle program alone.

    Source: FDA De Novo decision summaries and Summaries of Safety and Effectiveness Data (DEN180060, K240544, P160001, P250023, P140008, P180024, P150024, P190012) (checked on October 7, 2026)

    Two things stand out. First, the comparison group lost weight too, because everyone had diet and activity support, so the useful number is the gap between the bars, not the device bar alone. Second, the devices that stay longer or change the stomach more tend to show bigger gaps, and they also carry more procedure risk. For scale, people in the main trials of today’s leading weight-loss medicines lost about 15% to 21% on average over 68 to 72 weeks, as our comparison of FDA-approved medications shows; that is also a different set of trials.

    The TransPyloric Shuttle and endoscopic sleeve gastroplasty

    The TransPyloric Shuttle was a two-bulb silicone device placed by endoscope that sat at the outlet of the stomach and slowed how fast food left it. In its 12-month trial of 270 randomized adults, weight loss averaged 9.5% vs 2.8% in a supervised diet-and-exercise group, and 66.8% lost at least 5%. It is still on the FDA’s device page, but we found no evidence that it is sold today.

    Endoscopic sleeve gastroplasty (ESG) uses the Apollo suturing system, passed through the mouth, to stitch the stomach into a narrower tube without incisions. The FDA granted it De Novo authorization in July 2022 for adults with a BMI of 30 to 50, and the same decision covers the Revise system used to tighten the connection after an earlier bypass. In the randomized MERIT trial, total weight loss at one year was 13.6% with ESG vs 0.8% with lifestyle changes alone. It is the most common endoscopic weight procedure in the US, with 4,587 cases in 2023 by the ASMBS estimate, compared with 1,461 balloon placements. Our ESG guide covers who it suits and what recovery is like.

    Surgical and implanted devices: the band, vBloc and AspireAssist

    The Lap-Band was the first FDA-approved weight-loss device, in June 2001, and in 2011 the FDA widened it to adults with a BMI of 30 to 34 and an obesity-related condition. It is still sold; the FDA database now lists Medtimo, Inc. as the holder of the approval. Its use has fallen sharply as the sleeve and bypass took over: the ASMBS counted 773 band operations in the US in 2023, down from 55,932 in 2011. Our Lap-Band guide and history of bariatric surgery explain why.

    The Maestro system, also sold as vBloc, is an implanted device that sends electrical pulses to block signals in the vagus nerve between the brain and stomach. In its pivotal trial it was measured by excess weight loss, a different scale from the other devices: 24.4% of excess weight at 12 months vs 15.9% with a sham device. We found no current maker filing that mentions it, and no evidence that it is sold.

    AspireAssist used a tube placed through the abdominal wall into the stomach, so that about 20 to 30 minutes after a meal a person could drain about 30% of the food eaten. In its one-year trial, people lost 12.1% of their body weight vs 3.6% with lifestyle therapy alone. Its maker withdrew it from the market on April 8, 2022, for financial reasons, and said the decision was not related to safety or effectiveness.

    Our history of weight-loss hoaxes shows how old some of those products really are, and our guide to body contouring explains what fat-reduction devices can and cannot do.

    What every device has in common

    Every indication on this page includes a diet, behavior or lifestyle program, and the FDA repeats in its consumer advice that devices alone are not the solution. Results are averages: some people lose much more and some lose little. Most of these devices are temporary, and the balloon summaries show that people tend to regain part of the weight after removal unless the new habits hold; our guide to keeping weight off covers what helps. Medicare does not cover gastric balloons under its national policy, and private coverage for devices varies, so ask about cost before you start; our insurance guide explains how to check.

    If you are thinking about a device

    1. Check the authorizationSearch the exact device name in the FDA database and read who it is indicated for.
    2. Check it is still soldAsk the clinic which device they use and since when; several approved devices are no longer made.
    3. Compare the optionsMedicines, surgery and devices differ a lot in results, risks and cost. Our procedures comparison helps.
    4. Ask about side effectsNausea, vomiting and pain are common early on with balloons; ask what support the clinic gives.
    5. Plan for afterwardAsk what the program includes once the device is removed or passes.

    If you would like to see all your options side by side, including medicines and surgery, start with Find My Options or our hub on weight-loss procedures. To find a specialist, see our guide to finding a bariatric surgeon, many of whom also offer endoscopic treatments.

  • AI Calorie Counting From Photos: How Accurate Is It?

    AI Calorie Counting From Photos: How Accurate Is It?

    In short: AI photo logging is fast, but it is not yet precise. In a 2026 study from the National Institutes of Health, four popular photo-based apps underestimated the calories in carefully prepared meals by about a third, or roughly 250 to 345 calories per meal, and missed about 30 grams of fat. General-purpose AI chatbots were off by about 36% on average for calories in a 2025 study. Photo logging works best for simple, visible foods and worst for mixed dishes, sauces and oils. If you use it, treat the number as a rough estimate, check it against labels or a kitchen scale for foods you eat often, and remember that your daily calorie target (from a tool like our calorie calculator) is an estimate too. Checked on October 7, 2026.

    InstaTuck did not test these apps. This page summarizes published and presented research on how well AI estimates calories from food photos, why it misses, and how to get the most from it. For app features, prices and privacy labels, see our researched list of weight-loss and calorie-tracking apps.

    AI photo calorie estimates in numbers

    Checked on October 7, 2026

    How photo calorie counting works

    Most photo-logging features do three things in a row. First, they recognize what is on the plate (a computer-vision step that has become quite good). Second, they estimate how much of each food is there, usually from the image alone, sometimes with a plate or utensil as a size reference. Third, they look up nutrition values in a food database and multiply by the estimated amount. Newer tools also use large language models, the same kind of AI behind chatbots, to describe the meal and estimate nutrients in one step.

    Each step can add error, but research keeps pointing at the second one. A photo is flat, so it cannot show how deep a bowl is, how much oil soaked into vegetables, or what is hidden under a sauce. Two meals that look similar can differ by hundreds of calories because of butter, dressing or cooking oil. That is why fat is the nutrient these tools miss most.

    What the studies found

    Commercial apps vs meals made in a metabolic kitchen (2026). At the American Society for Nutrition’s NUTRITION 2026 meeting in July, researchers from the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases presented a test of four apps with AI photo features: Appediet, Cal AI, Lose It! and MyFitnessPal. They photographed 102 meals prepared in a metabolic kitchen, where every ingredient is weighed and the nutrition is known precisely. All four apps underestimated calories, on average by 252 calories (Appediet), 327 (MyFitnessPal), 333 (Lose It!) and 345 (Cal AI), and underestimated fat by about 30 grams. Carbohydrates were estimated most consistently. Lose It! and MyFitnessPal were more accurate for higher-calorie meals than for lower-calorie ones, and the apps struggled most with low-carbohydrate, high-fat (ketogenic) meals. These are preliminary conference results that had not been published in a peer-reviewed journal when we checked.

    Average calories missed per meal by AI photo features (102 lab-prepared meals)Values in kcal
    Average calories missed per meal by AI photo features (102 lab-prepared meals)
    ItemValue
    Appediet252 kcal
    Cal AI345 kcal
    Lose It!333 kcal
    MyFitnessPal327 kcal

    Alphabetical; not a ranking. Preliminary conference abstract, not yet peer reviewed. All four underestimated; app versions change often.

    Source: NIDDK researchers at NUTRITION 2026, American Society for Nutrition release (July 25, 2026); Healio report (Aug 4, 2026) (checked on October 7, 2026)

    General AI chatbots (2025). A study in Current Developments in Nutrition gave ChatGPT-4o, Claude 3.5 Sonnet and Gemini 1.5 Pro the same 52 standardized food photos, single foods and full meals in small, medium and large portions, with cutlery and plates in view for scale. Compared with weighed reference values, ChatGPT and Claude had an average error of 35.8% for calories and around 36% to 37% for food weight; Gemini’s errors were much larger. All three underestimated more as portions got bigger. The authors concluded these models are not yet suitable for precise dietary assessment, although their accuracy was similar to people’s own self-reports.

    Australian app review (2024). Researchers who screened the top nutrition apps in Australia’s app stores compared AI food-image recognition in seven apps against food records for Western, Asian and recommended diets. They found automatic energy estimates were inaccurate, even though some apps recognized foods well, and that mixed dishes and culturally diverse foods were a particular weakness. Manual logging apps also drifted: they overestimated energy for a Western diet and underestimated it for an Asian one.

    The research as a whole (2023). A systematic review in the Annals of Medicine found 52 studies from 2010 to 2023 that compared fully automated AI estimates from food images with known values. Average calorie errors ranged from 0.10% to 38.3%, depending on the system and the foods, and errors were lower when images showed single or simple foods. The studies differed too much to be pooled. Many of the best results came from research systems tested on curated photo sets, not the apps people download.

    Is AI worse than doing it yourself?

    Not necessarily. People are not very good at estimating food either. In a 1992 study in the New England Journal of Medicine, people who said they could not lose weight despite eating little were found, with precise measurements, to underreport what they ate by 47% on average. In a 2017 study of portion estimation, people’s median error was 23.5% when they guessed food weights with no aid, and 87.7% when they used household measuring cups; a simple size reference cut the error to 18.9%.

    How far off people are when estimating portions (median error)Values in %
    How far off people are when estimating portions (median error)
    ItemValue
    Household measuring cup87.7%
    Modelling-clay cube as a guide44.8%
    Guessing weight, no aid23.5%
    Cube-shaped size reference (IFU)18.9%

    Human estimates, for comparison with AI. A kitchen scale removes most portion error for foods you weigh.

    Source: Bucher T et al., International Journal of Behavioral Nutrition and Physical Activity 2017 (128 adults, 17 foods) (checked on October 7, 2026)

    So the honest comparison is not AI vs perfect, but AI vs the way most of us log food: quickly and imperfectly. The two kinds of error also lean the same way. Both people and photo apps tend to undercount, especially for large, rich meals, which means a food log often shows fewer calories than were eaten. That can make a plateau confusing. Our guide to calorie deficits explains how to adjust when results do not match the numbers.

    Does a 300-calorie miss matter?

    It depends on what you use the number for. U.S. obesity guidelines from the American Heart Association, American College of Cardiology and The Obesity Society describe a typical weight-loss plan as a daily deficit of about 500 to 750 calories. If an app undercounts one meal a day by around 300 calories, as in the NIH test, a plan that looks like a 500-calorie deficit on screen could in reality be closer to 200. Undercount two or three meals and the “deficit” may disappear. That is one reason people sometimes see their weight stall while their log says they are on track.

    For other uses, a rough number is fine. If you mainly want to notice patterns, such as late-night snacking, sugary drinks or how often you eat out, a photo log that is consistently a little low still shows those patterns clearly. And because the error tends to run in the same direction, comparing this week’s log with last week’s is more meaningful than any single day’s total. The simplest check is your own trend: if your weight is not moving after a few weeks, assume the log is low and adjust portions, rather than eating less than a safe minimum.

    Why logging still helps

    Accuracy is only half the story. Self-monitoring, writing down what you eat in any form, is one of the most consistent habits linked to weight loss in behavioral research, according to a 2011 systematic review. In a 2019 study of 142 adults using online food logging, the most successful participants logged in more often, while the time spent per day fell from about 23 minutes in the first month to about 15 minutes by month six. Speed matters because people stop logging when it feels like a chore, and that is the real promise of photo logging: lowering the effort enough that people keep going.

    The trade-off is that a fast, rough log can lull you into trusting a number that is a third too low. The fix is to use photos for convenience and double-check where it counts. If tracking every bite is not for you, structured approaches like intermittent fasting work without counting; our comparison of intermittent fasting vs calorie counting looks at what trials found.

    When photo estimates are most and least reliable

    Usually easier for AIUsually harder for AI
    Single, whole foods (an apple, a boiled egg, a slice of bread)Mixed dishes (stews, casseroles, curries, stir-fries)
    Packaged foods with a visible label or barcodeHidden fats: cooking oil, butter, dressings, sauces
    Foods spread out on a plate, photographed from aboveDeep bowls, stacked or overlapping foods
    Standard portions of common foodsLarge portions and high-fat, low-carb meals
    Foods common in the app’s training dataHome-cooked and culturally diverse dishes
    Patterns reported in the studies above (Annals of Medicine 2023; Nutrients 2024; Current Developments in Nutrition 2025; NIDDK at NUTRITION 2026). Checked 2026-10-07.

    How to get better numbers from a photo app

    Five habits for more accurate photo logging

    1. Edit the guessCheck the foods and portions the app suggests and fix anything wrong, especially oil, butter and sauces.
    2. Weigh your regularsUse a kitchen scale a few times for foods you eat often, then save them as custom entries.
    3. Use labels when you have themScan the barcode for packaged foods instead of photographing them.
    4. Shoot from above, spread outGood light and a top-down view of a plate, not a bowl, help with portion size.
    5. Watch the trend, not the mealCompare your log with your weight trend over two to four weeks and adjust.

    A kitchen scale is the cheapest accuracy upgrade there is; our researched list of kitchen scales explains what features matter. Our macro calculator and TDEE calculator help set targets, and the nutrition hub covers which foods help with fullness. If you follow a low-carb or keto pattern, be extra careful with photo logs, since the NIH study found these high-fat meals were the hardest; see our keto diet guide.

    Privacy: what a food photo can reveal

    Food photos are personal data. Depending on the app, they may be stored on the company’s servers, used to improve its AI, or linked to your account along with weight and health details. Apple’s App Store privacy labels show what each app says it collects and whether it is linked to you; we summarize those labels in our app list. Before uploading photos, check the app’s privacy settings and whether you can delete your images.

    The bottom line

    AI photo logging is a real step forward in convenience, and it will likely keep improving. Today, it is best used as a quick first draft of your food log, not a precise measurement. Combine it with labels, a scale for foods you eat often and an eye on your weight trend, and it can support the habit that matters most: keeping track. For the longer story of how people have tried to manage weight, see our history of weight loss; for other new tracking tools, our explainer on continuous glucose monitors for weight loss; and for keeping results over time, our guide to maintaining weight loss.

  • 10 Innovations That Changed Weight Loss (2016 to 2026)

    10 Innovations That Changed Weight Loss (2016 to 2026)

    In short: In ten years, weight loss changed more than in the half century before. The biggest shift was a new generation of medicines: semaglutide (Wegovy, 2021) and tirzepatide (Zepbound, 2023) brought average losses of about 15% to 21% in their main trials, then proved benefits for the heart, sleep apnea and liver disease, and in 2025 and 2026 arrived as daily pills. Around them came a clearer food label, a medicine for rare genetic obesity, a stomach-stitching procedure done without incisions, and glucose monitors sold over the counter. Here are ten milestones, listed by date, not ranked, with what each changed and what it did not. Checked on October 7, 2026.

    Doctor, tablet, stethoscope, hospital, nurse, healthcare, clinic, scrubs, woman, glasses, professional, technology, smiling, confident, healthcare worker, modern, light, interior
    Photo: erwinbosman / Pixabay

    For where these options fit today, see every FDA-approved weight-loss medication compared or answer a few questions in Find My Options. For the longer story, from 1860s diets to fen-phen, read our history of weight loss.

    A decade in numbers

    • 2.4 to 14.9%average weight loss on placebo vs semaglutide 2.4 mg in STEP 1 (68 weeks)NEJM 2021
    • 20.9%average loss on tirzepatide 15 mg in SURMOUNT-1 (72 weeks)NEJM 2022
    • 20%lower risk of heart attack, stroke or cardiovascular death with semaglutide in SELECT (hazard ratio 0.80)NEJM 2023
    • 2GLP-1 weight-loss pills approved, December 2025 and April 2026Drugs@FDA

    Checked on October 7, 2026

    1. 2016: A Nutrition Facts label built around calories

    In 2016 the FDA finalized the first major redesign of the Nutrition Facts label in more than two decades. Calories, servings per container and serving size got larger, bold type; “added sugars” appeared in grams and as a percent Daily Value; and serving sizes were updated to reflect what people actually eat (a serving of ice cream went from half a cup to two-thirds, a soda from 8 to 12 ounces). Large manufacturers had to switch by January 1, 2020, and smaller ones by January 1, 2021. Why it mattered: it made the single number most people track easier to find and harder to shrink with tiny serving sizes. What it didn’t do: labels inform; they don’t change appetite. Our calorie deficit guide explains how to use them.

    2. 2019: A swallowable hydrogel for fullness

    On April 12, 2019, the FDA authorized Plenity through its De Novo pathway, as a prescription aid for weight management in adults with a BMI of 25 to 40 alongside diet and exercise. The capsules release particles of a cellulose-and-citric-acid hydrogel that swell in the stomach to add a feeling of fullness. Why it mattered: it was a new kind of option, a device taken by mouth rather than a drug or a procedure. What it didn’t do: commercial staying power; its maker, Gelesis, filed for Chapter 7 liquidation in October 2023. Our procedures hub covers the devices and procedures that remain.

    3. 2020: The first medicine for rare genetic obesity

    On November 25, 2020, the FDA approved Imcivree (setmelanotide) for obesity caused by three rare genetic conditions (POMC, PCSK1 or LEPR deficiency) confirmed by genetic testing. It was later approved for Bardet-Biedl syndrome (2022) and, on March 19, 2026, for acquired hypothalamic obesity. Why it mattered: it was the first weight medicine aimed at a specific biological cause, and it underlined that some obesity is driven by identifiable defects in the brain’s appetite pathway. What it didn’t do: it is not a general weight-loss medicine; it works only in the conditions on its label.

    4. 2021: Wegovy and the new era of GLP-1 medicines

    On June 4, 2021, the FDA approved Wegovy (semaglutide 2.4 mg) for chronic weight management. In the STEP 1 trial, 1,961 adults lost an average of 14.9% of their body weight over 68 weeks, compared with 2.4% on placebo, and 86.4% lost at least 5%. Why it mattered: for comparison, daily liraglutide (Saxenda) averaged 7.4% vs 3.0% in its 56-week label trial, a separate study; Wegovy’s results put GLP-1 medicines at the center of obesity care. Our GLP-1 medications guide explains how they work. What it didn’t do: it isn’t a short course. In the STEP 1 extension, about two-thirds of the lost weight came back within a year of stopping.

    5. 2022: Endoscopic sleeve gastroplasty gets its own authorization

    On July 12, 2022, the FDA granted De Novo authorization to the Apollo ESG system, an endoscopic suturing device that folds and stitches the stomach into a narrower sleeve from the inside, with no incisions, for adults with a BMI of 30 to 50. In the MERIT randomized trial of 209 adults, published in The Lancet in 2022, total weight loss at 52 weeks was 13.6% with endoscopic sleeve gastroplasty plus lifestyle changes vs 0.8% with lifestyle changes alone, with serious adverse events in 2%. Why it mattered: it opened a middle path between medicines and surgery. What it didn’t do: match surgery; in comparisons, typical losses are smaller than with a sleeve gastrectomy. Our bariatric surgery guide covers the surgical options.

    6. 2023: Zepbound and the dual agonist

    On November 8, 2023, the FDA approved Zepbound (tirzepatide), which acts on both GIP and GLP-1 receptors. In SURMOUNT-1, published in 2022, 2,539 adults lost an average of 15.0%, 19.5% and 20.9% on the 5, 10 and 15 mg doses over 72 weeks, vs 3.1% on placebo. Why it mattered: it was the first approved weight medicine to act on two hormone pathways at once, and several drugs now in trials combine even more (see “On the horizon” below). What it didn’t do: end the cost problem; access still depends heavily on insurance and price. See our semaglutide vs tirzepatide comparison.

    Average weight loss in landmark trials (not head-to-head)Values in %
    Average weight loss in landmark trials (not head-to-head)
    ItemTreatmentPlacebo or control
    Wegovy, STEP 1 (68 wk)14.9%2.4%
    Zepbound 15 mg, SURMOUNT-1 (72 wk)20.9%3.1%
    ESG, MERIT (52 wk)13.6%0.8%
    Wegovy tablets, label trial (64 wk)13.6%2.4%
    Foundayo, label trial (72 wk)11.1%2.1%

    Chronological. Separate trials with different people, lengths and comparison groups; not a ranking. Bars show percent of body weight lost.

    Source: NEJM 2021 and 2022; The Lancet 2022 (MERIT); FDA labels on DailyMed (checked on October 7, 2026)

    A joyful family with an adopted child cooking together in a bright kitchen, wearing aprons and smiling.
    Photo: RDNE Stock project / Pexels

    7. 2023-2024: Proof that weight medicines protect the heart

    The SELECT trial, published in November 2023, followed 17,604 adults with overweight or obesity and established cardiovascular disease, but without diabetes, for an average of 39.8 months. Heart attack, stroke or cardiovascular death occurred in 6.5% of those on semaglutide vs 8.0% on placebo, a 20% lower risk. On March 8, 2024, the FDA approved Wegovy to reduce the risk of these events in adults with cardiovascular disease and obesity or overweight, the first weight medicine with that indication. Why it mattered: it was the first time a weight-loss medicine was shown in a large outcomes trial to reduce heart attacks, strokes and cardiovascular deaths. What it didn’t do: apply to everyone; the indication is for people with established heart disease.

    8. 2024: Glucose monitors go over the counter

    On March 5, 2024, the FDA cleared the first over-the-counter continuous glucose monitor, for adults who do not use insulin, including people without diabetes who want to see how food and exercise affect their glucose. Others followed later that year. Why it mattered: it put a once-specialist tool in consumers’ hands and fed a wave of personalized-nutrition apps. What it didn’t do: prove itself for weight loss; pooled studies in people without diabetes show no significant effect on BMI. Our explainer on CGMs for weight loss without diabetes covers the evidence, and a related tracking trend is checked in AI calorie counting from photos.

    9. 2024-2025: Treating the conditions that come with weight

    On December 20, 2024, the FDA approved Zepbound for moderate-to-severe obstructive sleep apnea in adults with obesity, the first medicine for that condition. On August 15, 2025, Wegovy received accelerated approval for metabolic dysfunction-associated steatohepatitis (MASH) with moderate to advanced liver fibrosis. Why it mattered: weight medicines started to be approved for diseases linked to excess weight, which can also open other coverage routes; for example, Medicare drug plans can cover Zepbound for sleep apnea. Our guides to sleep apnea and weight and fatty liver and weight explain both. What it didn’t do: replace other treatments; CPAP and liver care still matter.

    10. 2025-2026: GLP-1 pills, a higher dose and new ways to pay

    On December 22, 2025, the FDA approved Wegovy tablets (oral semaglutide 25 mg) for weight management, with average weight change of -13.6% vs -2.4% at 64 weeks in the label trial. On April 1, 2026, it approved Foundayo (orforglipron), a small-molecule daily pill that can be taken with or without food (-11.1% vs -2.1% at 72 weeks on the highest dose). In between, on March 19, 2026, came a 7.2 mg dose, Wegovy HD. At the same time, makers began selling direct at lower self-pay prices, from about $149 a month for the lowest pill strengths as of October 2026, and the Medicare GLP-1 Bridge began on July 1, 2026, with a $50 copay for people who meet its criteria. Why it mattered: no needles, and for many people, a real price. What it didn’t do: make the medicines right for everyone, or remove the need to keep taking them. Our oral GLP-1 guide, insurance guide and cost hub have the details.

    The decade at a glance

    DateInnovationType
    2016New Nutrition Facts label finalized (on most foods by 2020-2021)Food labeling
    April 12, 2019Plenity hydrogel authorized (De Novo); maker liquidated in 2023Device
    November 25, 2020Imcivree approved for rare genetic obesityMedicine
    June 4, 2021Wegovy approved (STEP 1: -14.9% vs -2.4%)Medicine
    July 12, 2022Endoscopic sleeve gastroplasty device authorized (De Novo)Procedure
    November 8, 2023Zepbound approved (SURMOUNT-1: up to -20.9% vs -3.1%)Medicine
    March 5, 2024First over-the-counter CGM clearedDevice
    March 8, 2024Wegovy approved to reduce cardiovascular risk (SELECT)Medicine
    December 20, 2024Zepbound approved for obstructive sleep apneaMedicine
    August 15, 2025Wegovy accelerated approval for MASHMedicine
    December 22, 2025Wegovy tablets approvedMedicine
    March 19, 2026Wegovy HD (7.2 mg) approvedMedicine
    April 1, 2026Foundayo (orforglipron) approvedMedicine
    July 1, 2026Medicare GLP-1 Bridge begins ($50 copay)Access
    Chronological; not a ranking. Sources: Drugs@FDA, FDA approval letters and press releases, FDA device databases, CMS, SEC filing (Gelesis), checked 2026-10-07.

    What did not change

    Every one of these innovations still sits on the same foundation. All the medicine labels pair treatment with a reduced-calorie diet and more physical activity. Strength training and enough protein remain the main ways to protect muscle while losing weight, as our guide to muscle loss on GLP-1s explains. And keeping weight off still takes ongoing effort, with or without medicine; our maintenance guide covers what helps.

    On the horizon (investigational)

    We follow these in our retatrutide results explainer, CagriSema explainer, the article on muscle-preserving weight-loss drugs and the emerging medications tracker. For this year’s developments in one place, see what’s new in weight loss in 2026.

    Using this history to make your own choices

    1. Start with what is approvedCheck which options have an FDA label for your situation.
    2. Look at the trial, not the headlineWho was studied, for how long, and compared with what.
    3. Count the full costPrice, coverage and how long you would need to stay on it.
    4. Ask about the basics tooDiet, activity and sleep still shape results with any treatment.
    5. Talk it throughBring your questions to a clinician, using our tools to prepare.

    Our tools, including the BMI, calorie and protein calculators, can help you prepare for that conversation, and the printable questions to ask before starting a GLP-1 is a good next step if a medicine is on your list. For the story of the drugs that came before this decade, see our history of weight-loss drugs.

  • Muscle-Preserving Weight-Loss Drugs: The Next Wave (Investigational)

    Muscle-Preserving Weight-Loss Drugs: The Next Wave (Investigational)

    In short: A new group of medicines is being tested to help people keep muscle while they lose weight on GLP-1 drugs. The furthest along are antibodies that block muscle-limiting signals (bimagrumab, trevogrumab, apitegromab) and a pill called enobosarm. In Phase 2 trials, adding them to semaglutide or tirzepatide shifted more of the weight lost toward fat and less toward lean mass. None is FDA approved for weight loss or for preserving muscle, no trial has yet shown better strength or daily function, and some combinations had more side effects. Today, the proven ways to protect muscle are strength training and enough protein. Checked on October 7, 2026.

    Bodybuilding, dumbbells, gym, weights, weight training, fitness, fitness room, equipment, elliptical trainer, physical condition, burn calories, sports, tone up, sporty, man, athletic, sweat, motivati
    Photo: janeb13 / Pixabay

    This article explains why researchers are chasing “higher-quality” weight loss, what each trial found, the safety signals so far and what to watch for next. If you are on a GLP-1 medicine now, our guide to muscle loss on GLP-1 medicines covers what you can do today, and our emerging medications tracker follows the wider pipeline. This is general education, not individual advice.

    Why muscle became the next target

    Any large weight loss, whether from diet, surgery or medicine, removes some lean mass along with fat. Lean mass is everything that is not fat: muscle, but also organs, bone and water, so a drop in lean mass is not the same as an equal drop in muscle. In the STEP 1 trial of semaglutide 2.4 mg (Wegovy), a body-scan substudy found that of 13.6 kg lost, about 62% was fat and 38% lean mass, according to a 2025 joint nutrition advisory from four obesity and nutrition societies. In Regeneron’s COURAGE trial, about 35% of the weight lost with semaglutide alone was lean mass.

    Whether this matters for health is still debated. The approved Wegovy label notes greater fat loss than lean loss in its body-composition data, and some researchers think part of the lean loss is a normal adjustment to carrying less weight. The concern is greatest for older adults and people who already have low muscle, for whom losing strength can affect balance, mobility and independence. That is why drug makers are now testing medicines designed to tilt weight loss toward fat.

    The muscle question in numbers

    • 38%share of weight lost that was lean mass with semaglutide in a STEP 1 body-scan substudyJoint advisory, Obesity Pillars 2025
    • 35%share of semaglutide weight loss that was lean mass in the COURAGE trial (company-reported)Regeneron, June 2, 2025
    • 0medicines FDA approved to preserve muscle during weight loss

    Checked on October 7, 2026

    How these medicines are meant to work

    Most candidates target the same natural brake on muscle growth. Myostatin and activin A are proteins that limit how much muscle the body builds and keeps. Blocking them, or the receptors they act on, lets muscle grow or resist breakdown. Bimagrumab (Eli Lilly) is an antibody that blocks type II activin receptors and is designed both to reduce fat, including deep belly fat, and to promote muscle growth. Trevogrumab (Regeneron) blocks myostatin, and garetosmab blocks activin A. Apitegromab (Scholar Rock) targets the inactive “pro” forms of myostatin before they switch on. Enobosarm (Veru) works differently: it is a daily pill from a group called selective androgen receptor modulators, designed to act on muscle and bone in a more targeted way than testosterone.

    In the weight-loss trials, each of these is added to a GLP-1 medicine, semaglutide or tirzepatide, which does most of the weight-lowering work. Our GLP-1 medications guide explains how those work.

    What the trials found

    Bimagrumab plus semaglutide (BELIEVE, Phase 2). Published in Nature Medicine in March 2026, BELIEVE randomized 507 adults with obesity, without diabetes, to nine groups: placebo, bimagrumab infusions every 12 weeks, weekly semaglutide, or combinations. At 48 weeks, average weight change was -9.3 kg with high-dose bimagrumab, -14.2 kg with semaglutide 2.4 mg and -17.8 kg with the high-dose combination, vs -3.3 kg on placebo. In results presented at the 2025 American Diabetes Association meeting, the 72-week figures were -10.8% with bimagrumab, -15.7% with semaglutide and -22.1% with the combination. Lean mass fell 7.4% with semaglutide alone but only 2.9% with the combination, and rose 2.5% with bimagrumab alone. Common side effects with bimagrumab were muscle spasms, diarrhea and acne.

    BELIEVE: share of weight lost that was fat at 72 weeksValues in %
    BELIEVE: share of weight lost that was fat at 72 weeks
    ItemValue
    Semaglutide 2.4 mg alone71.8%
    Bimagrumab + semaglutide92.8%
    Bimagrumab alone100%

    INVESTIGATIONAL: bimagrumab is not FDA approved. Phase 2, 507 adults; body composition by DXA scan. The rest of each group's loss was lean mass.

    Source: BELIEVE results presented at ADA 2025, reported by Healio (June 23, 2025); trial published in Nature Medicine 2026 (checked on October 7, 2026)

    Trevogrumab, with or without garetosmab, plus semaglutide (COURAGE, Phase 2). Regeneron’s interim results in June 2025 covered 599 adults. At 26 weeks, semaglutide alone led to 10.4% weight loss; adding lower- or higher-dose trevogrumab led to 9.9% and 11.3%, and the “triplet” with garetosmab to 13.2%. The add-ons preserved about half (50.8% and 51.3%) of the lean mass that would otherwise have been lost, and the triplet 80.9%. But the triplet came at a cost: 28.3% of people stopped treatment because of side effects, vs 4.6% on semaglutide alone, and two deaths occurred in that group, for which Regeneron said it had not identified a causal link. Full 52-week results presented in October 2026 (in press at The Lancet when we checked) reported that trevogrumab prevented about 70% of thigh-muscle loss on MRI; Regeneron’s next step is a Phase 2 trial in older adults.

    COURAGE: people who stopped treatment because of side effects (26 weeks)Values in %
    COURAGE: people who stopped treatment because of side effects (26 weeks)
    ItemValue
    Semaglutide alone4.6%
    + trevogrumab, lower dose4.1%
    + trevogrumab, higher dose10.6%
    + trevogrumab + garetosmab28.3%

    INVESTIGATIONAL for weight management. Phase 2, 599 adults with obesity. Two deaths occurred in the triplet group; the company did not identify a causal association.

    Source: Regeneron interim COURAGE results, June 2, 2025 (company-reported) (checked on October 7, 2026)

    Apitegromab plus tirzepatide (EMBRAZE, Phase 2). Published in Nature Medicine in 2026, this smaller trial gave 102 adults tirzepatide plus either apitegromab or placebo for 24 weeks. Total weight loss was similar (-11.2 kg vs -12.5 kg), but lean mass fell by 1.6 kg with apitegromab vs 3.5 kg with placebo, a difference of 1.9 kg. Fat made up 85.3% of the weight lost with apitegromab vs 69.5% without. Side effects were similar between groups. The authors note the trial was small, mostly women, short and excluded people with diabetes.

    EMBRAZE: lean mass lost in 24 weeks on tirzepatideValues in kg
    EMBRAZE: lean mass lost in 24 weeks on tirzepatide
    ItemValue
    Tirzepatide + placebo3.5 kg
    Tirzepatide + apitegromab1.6 kg

    Apitegromab is INVESTIGATIONAL for weight management (FDA approved only for spinal muscular atrophy, as Isembyld). Phase 2, 102 adults.

    Source: Pratley RE et al., Nature Medicine 2026 (EMBRAZE) (checked on October 7, 2026)

    Enobosarm plus semaglutide (QUALITY, Phase 2b, and PLATEAU). Veru tested enobosarm in 168 adults aged 60 or older starting semaglutide. In topline results announced in January 2025, the company reported that enobosarm reduced lean-mass loss by 71% vs placebo at 16 weeks across both doses, with the 3 mg dose performing best. Those results are company-reported. Veru has since fully enrolled about 200 adults aged 65 or older with a BMI of 35 or more in a larger Phase 2b trial, PLATEAU, which measures weight at 68 weeks plus fat, lean mass, a stair-climb test of physical function and bone density. An interim look is expected in the first quarter of 2027 and final results in the fourth quarter of 2027, according to the company.

    Bimagrumab plus tirzepatide. Lilly’s Phase 2 trial of 252 adults (NCT06643728) completed its primary data collection in January 2026, and an academic trial at Massachusetts General Hospital (NCT05933499) is still recruiting. We found no published results for either when we checked.

    Candidate (maker)TypePaired withStage for weight managementOther FDA status
    Apitegromab (Scholar Rock)Antibody to pro-myostatinTirzepatidePhase 2 completed (EMBRAZE)Approved for spinal muscular atrophy only (Isembyld, Sept 11, 2026)
    Bimagrumab (Eli Lilly)Activin type II receptor antibodySemaglutide; tirzepatidePhase 2 (BELIEVE published; tirzepatide trials ongoing)None
    Enobosarm (Veru)Oral selective androgen receptor modulatorSemaglutidePhase 2b (PLATEAU enrolled; results expected 2027)None
    Garetosmab (Regeneron)Activin A antibodySemaglutide + trevogrumabPhase 2 (COURAGE triplet arm)Approved for fibrodysplasia ossificans progressiva only (Pasatru, Aug 19, 2026)
    Trevogrumab (Regeneron)Myostatin antibodySemaglutidePhase 2 (COURAGE); older-adult trial plannedNone
    Alphabetical; not a ranking. INVESTIGATIONAL for weight management. Sources: Drugs@FDA (openFDA), DailyMed, ClinicalTrials.gov and company announcements, checked 2026-10-07.
    Female scientist in lab coat working with samples in a laboratory environment.
    Photo: Pavel Danilyuk / Pexels

    What these results do not show yet

    Stronger, not just heavier, muscles. The trials mostly measured lean mass with body scans. Keeping lean mass is a step, but what matters for daily life is strength, balance and function, such as climbing stairs or getting up from a chair. Veru’s PLATEAU trial includes a stair-climb test; results are not out. Until trials show better function, it is fair to call the benefit promising rather than proven.

    Long-term safety. These trials lasted 16 to 72 weeks in a few hundred people each. Side effects such as muscle spasms and acne with bimagrumab, and the high drop-out rate with the garetosmab triplet, show that adding a second or third drug adds risks. Rare problems may only appear in much larger, longer trials.

    Who would benefit most. Researchers expect older adults and people with low muscle to gain the most, but that has to be shown in those groups. Most trials so far enrolled middle-aged adults without diabetes.

    Cost and access. Several of these are infusions or injections given on top of a GLP-1 medicine, which would add cost and complexity. Nothing is known yet about price or insurance coverage, because nothing is approved for this use.

    What protects muscle today

    The good news is that proven tools exist now, and they work alongside any weight-loss method. The 2025 joint advisory on nutrition during GLP-1 therapy recommends resistance (strength) training at least three times a week plus at least 150 minutes of moderate aerobic activity, tailored to the person, and protein of roughly 1.2 to 1.6 grams per kilogram of body weight a day during active weight loss, with a minimum of 0.4 to 0.5 g/kg. The U.S. Physical Activity Guidelines recommend muscle-strengthening activities on at least two days a week for all adults. In a 2021 trial in the New England Journal of Medicine, adults who had just lost weight on a low-calorie diet and then combined liraglutide with an exercise program kept off 9.5 kg more than with placebo over a year, and their body-fat percentage fell by 3.9 points, about twice as much as with exercise or liraglutide alone.

    Protecting muscle on any weight-loss plan

    1. Lift or push somethingStrength training on two to three days a week; our strength training guide has beginner plans.
    2. Make protein a priorityAsk your clinician or dietitian what range fits you; our protein calculator shows common ranges.
    3. Keep moving most daysWalking counts toward the 150 minutes of aerobic activity in the guidelines.
    4. Track more than the scaleWaist, strength and how daily tasks feel tell you about body composition.
    5. Ask about monitoringSome clinicians use DXA scans or strength tests during treatment.

    Our strength training guide and body recomposition guide show how to start safely, the high-protein diet page and protein calculator help with the protein side, and our comparison of ways to measure body fat explains what scales and scans can and cannot tell you. For keeping results after a GLP-1, see life after GLP-1 medicines.

    What to watch for next

    The next year should bring results from Lilly’s bimagrumab and tirzepatide trial, Veru’s PLATEAU interim analysis (expected in the first quarter of 2027) and the full COURAGE publication. The biggest question is whether any company takes a muscle-preserving combination into Phase 3 with strength and function as goals, which is what a future FDA decision would likely rest on. Newer weight-loss drugs in development are being watched for body composition too; our retatrutide results explainer covers one of them. For the approved options available today, see every FDA-approved weight-loss medication compared, and for this year’s wider developments, what’s new in weight loss in 2026.

  • Retatrutide Phase 3 Results Explained

    Retatrutide Phase 3 Results Explained

    In short: Retatrutide, an investigational weekly injection from Eli Lilly, has now reported results from its main Phase 3 trials, and the numbers are the largest average weight losses seen so far in a medicine trial: in TRIUMPH-1, adults with obesity lost 25.0% of their body weight on the highest dose over 80 weeks, compared with 3.9% on placebo, counting everyone who started. People with type 2 diabetes lost less (18.8% vs 5.1% in TRIUMPH-2). Side effects were mostly digestive, rose with the dose, and included a less familiar skin-sensation effect called dysesthesia. Retatrutide is not FDA approved; Lilly plans to apply in the first quarter of 2027. Checked on October 7, 2026.

    Doctor, patient, consultation, discussion, psychiatrist, psychologist, psychotherapist, clinic, medicine, narcology, psychiatry, psychology, doctor's office, medical professional, profession, job, occ
    Photo: Maximilianovich / Pixabay

    This article explains what each Phase 3 trial found, why the same trial can produce two different headline numbers, what the side effects looked like, and what still has to happen before an FDA decision. For the full drug profile, including how the three-hormone design works and the complete list of ongoing trials, see our retatrutide medication page. It is general education, not individual advice.

    Retatrutide's Phase 3 program at a glance

    • 2,339adults with obesity in TRIUMPH-1, the main weight trialJastreboff AM et al., NEJM 2026
    • 25.0%average weight loss at 80 weeks on 12 mg, counting everyone randomized (placebo 3.9%)NEJM 2026
    • 4core TRIUMPH trials with results reported by September 2026 (two peer reviewed)
    • Q1 2027when Lilly plans to submit retatrutide to the FDAEli Lilly, Sept 29, 2026

    Checked on October 7, 2026

    First, how to read these numbers

    Almost every retatrutide headline comes with two different percentages, and both can be correct. They answer different questions.

    The treatment-regimen estimand counts everyone who was randomized, including people who stopped the drug early because of side effects or for any other reason. It is the closest a trial gets to “what happens if a group of people is prescribed this”. The efficacy estimand estimates what would have happened if everyone had stayed on the drug as planned. It is useful for understanding the drug’s biological effect, but it is always the bigger number. Lilly’s press releases use the efficacy estimand; its September 29, 2026 release says plainly that “all data in this press release represent the efficacy estimand”. The peer-reviewed papers report both. On this page we lead with the treatment-regimen figures from the journals and label every company figure as company-reported.

    Same trials, two ways of counting: average weight loss on the highest dose (12 mg)Values in %
    Same trials, two ways of counting: average weight loss on the highest dose (12 mg)
    ItemTreatment-regimen (everyone randomized)Efficacy estimand (if all stayed on drug)
    TRIUMPH-1, obesity, 80 wk25%28.3%
    TRIUMPH-2, type 2 diabetes, 80 wk18.8%20.8%

    INVESTIGATIONAL. Bars show percent of starting body weight lost. Efficacy-estimand figures are company-reported.

    Source: NEJM 2026 and The Lancet 2026 (treatment-regimen); Eli Lilly releases May 21 and Sept 29, 2026 (efficacy estimand) (checked on October 7, 2026)

    TRIUMPH-1: adults with obesity, without diabetes

    TRIUMPH-1 is the pivotal weight trial, published in the New England Journal of Medicine in September 2026. It enrolled 2,339 adults with obesity, or with overweight and a weight-related health problem, who did not have type 2 diabetes. They were randomly assigned to retatrutide at 4 mg, 9 mg or 12 mg once a week, or to placebo, for 80 weeks, alongside diet and activity counseling. Doses were reached in steps every four weeks, starting at 2 mg.

    Counting everyone randomized, average weight change was -17.6% on 4 mg, -23.7% on 9 mg and -25.0% on 12 mg, compared with -3.9% on placebo. By the efficacy estimand, Lilly reported -28.3% on 12 mg. The trial also included 574 people with knee osteoarthritis and 243 with obstructive sleep apnea, and Lilly reported improvements in knee pain and in breathing interruptions during sleep in those groups. In a planned extension for people who started with a BMI of 35 or higher, Lilly reported -30.3% at 104 weeks (efficacy estimand, company-reported).

    TRIUMPH-1: average weight loss at 80 weeks by doseValues in %
    TRIUMPH-1: average weight loss at 80 weeks by dose
    ItemValue
    Placebo3.9%
    Retatrutide 4 mg17.6%
    Retatrutide 9 mg23.7%
    Retatrutide 12 mg25%

    INVESTIGATIONAL: not FDA approved. Treatment-regimen estimand: everyone randomized, including people who stopped. 2,339 adults with obesity and no diabetes.

    Source: Jastreboff AM et al., New England Journal of Medicine 2026 (TRIUMPH-1) (checked on October 7, 2026)

    One way to put the numbers in context: in the trials that led to approval of today’s leading medicines, average weight loss was 14.9% with semaglutide 2.4 mg (Wegovy) over 68 weeks in STEP 1, and 20.9% with tirzepatide 15 mg (Zepbound) over 72 weeks in SURMOUNT-1. Those were different trials, with different people, lengths and years, so the numbers cannot be compared directly. A direct answer will come from TRIUMPH-5, which tests retatrutide head to head against tirzepatide (see “What comes next” below). Our semaglutide vs tirzepatide comparison explains how the two approved molecules differ.

    TRIUMPH-2: adults with type 2 diabetes

    TRIUMPH-2, published in The Lancet and presented at the European Association for the Study of Diabetes meeting in September 2026, enrolled 1,152 adults with type 2 diabetes and a BMI of 27 or more for 80 weeks. Counting everyone randomized, weight changed by -11.9% (4 mg), -16.8% (9 mg) and -18.8% (12 mg) vs -5.1% on placebo, and 84% of participants completed treatment. Lilly’s efficacy-estimand figures were -12.7%, -19.1% and -20.8% vs -4.0%.

    Blood sugar improved too. From an average HbA1c (a three-month blood sugar measure) of 7.7%, Lilly reported reductions of 1.4 to 1.6 points vs 0.2 on placebo, and 28.4% to 40.0% of people on retatrutide reached an HbA1c below 5.7%, the non-diabetes range, vs 4.4% on placebo (efficacy estimand, company-reported). People with type 2 diabetes usually lose less weight on these medicines than people without it, a pattern also seen with approved GLP-1 medicines. Our guide to type 2 diabetes and weight explains why.

    TRIUMPH-3 and TRIUMPH-4: heart disease and knee osteoarthritis

    TRIUMPH-3 enrolled about 1,950 adults with a BMI of 35 or more and established cardiovascular disease, with or without diabetes. In its July 23, 2026 topline release, Lilly reported weight changes of -21.6% (9 mg) and -22.6% (12 mg) vs -3.2% on placebo (efficacy estimand). It was not designed to show heart protection: heart attacks, strokes and cardiovascular deaths were fewer than expected in every group, and the hazard ratio of 1.12 (95% confidence interval 0.64 to 1.96) means the trial could not show a difference either way. A separate outcomes trial of about 10,000 people, TRIUMPH-Outcomes, is designed to answer that question; its primary completion is listed for 2029. No full TRIUMPH-3 paper had been published when we checked.

    TRIUMPH-4 enrolled 445 adults with obesity or overweight and knee osteoarthritis for 68 weeks. In its December 11, 2025 release, Lilly reported treatment-regimen weight changes of -20.0% (9 mg) and -23.7% (12 mg) vs -4.6%, and knee pain scores that improved by up to 75.8% vs 40.3% on placebo. These results are company-reported and not yet peer reviewed.

    TrialWho took partLengthWeight change on 12 mg vs placeboHow it was reported
    TRIUMPH-1 (NCT05929066)2,339 adults with obesity, no diabetes80 weeks-25.0% vs -3.9%Peer reviewed (NEJM 2026), treatment-regimen
    TRIUMPH-2 (NCT05929079)1,152 adults with type 2 diabetes80 weeks-18.8% vs -5.1%Peer reviewed (Lancet 2026), treatment-regimen
    TRIUMPH-3 (NCT05882045)About 1,950 adults, BMI 35+, heart disease80 weeks-22.6% vs -3.2%Company topline, efficacy estimand
    TRIUMPH-4 (NCT05931367)445 adults with knee osteoarthritis68 weeks-23.7% vs -4.6%Company topline, treatment-regimen
    INVESTIGATIONAL. Different trials and populations; not a ranking. Sources: NEJM, The Lancet, Eli Lilly releases and ClinicalTrials.gov, checked 2026-10-07.
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    Photo: Armin Rimoldi / Pexels

    Side effects: what the trials reported

    Because there is no FDA label, the only safety information is what the trials have reported, much of it through company releases. As with the approved GLP-1 medicines, digestive side effects were the most common and rose with the dose. In TRIUMPH-1, Lilly reported nausea in 42.4% of people on 12 mg vs 14.8% on placebo, diarrhea in 32.0% vs 13.5%, constipation in 26.1% vs 10.9% and vomiting in 25.3% vs 4.8%. In TRIUMPH-2, rates were somewhat lower: nausea 28.0% vs 8.0% and vomiting 15.7% vs 4.2% on 12 mg.

    Reported side effects on the highest dose (12 mg) vs placeboValues in %
    Reported side effects on the highest dose (12 mg) vs placebo
    ItemTRIUMPH-1, retatrutide 12 mgTRIUMPH-1, placeboTRIUMPH-2, retatrutide 12 mgTRIUMPH-2, placebo
    Nausea42.4%14.8%28%8%
    Diarrhea32%13.5%33.6%13.2%
    Vomiting25.3%4.8%15.7%4.2%
    Dysesthesia (skin sensations)12.5%0.9%7.3%0.7%
    Stopped due to side effects11.3%4.9%7.7%4.9%

    Company-reported adverse events, not an FDA label table. INVESTIGATIONAL.

    Source: Eli Lilly press releases, May 21 and June 6, 2026 (TRIUMPH-1) and Sept 29, 2026 (TRIUMPH-2) (checked on October 7, 2026)

    Dysesthesia is the effect that drew the most attention. It means unusual skin sensations, such as tingling, burning or sensitivity to touch. It was reported in 12.5% of TRIUMPH-1 participants on 12 mg vs 0.9% on placebo, 7.3% vs 0.7% in TRIUMPH-2, and 20.9% vs 0.7% in TRIUMPH-4. Lilly says most cases were mild to moderate and resolved during treatment. A similar effect is listed on the label of the approved higher-dose Wegovy HD (22% on 7.2 mg vs 6% on 2.4 mg), but why it happens is not settled, and the FDA review of retatrutide will look at it closely.

    Stopping because of side effects rose with dose in TRIUMPH-1 (4.1%, 6.9% and 11.3% vs 4.9% on placebo) and reached 18.2% on 12 mg in TRIUMPH-4. The Phase 2 trial, published in 2023, also showed a dose-dependent rise in heart rate that peaked around week 24. What is not known yet: safety beyond about two years, effects on heart attacks and strokes, rare side effects that only show up in very large groups, and which warnings an eventual label would carry. For the side effects of approved medicines in the same family, see our GLP-1 side effects guide.

    What the results do not tell us yet

    How it compares with tirzepatide. Only a head-to-head trial can say whether retatrutide leads to more weight loss than tirzepatide, the ingredient in Zepbound, and with what trade-offs. That trial, TRIUMPH-5, has not reported.

    What the weight loss is made of. With any large weight loss, some of what is lost is lean mass, which includes muscle. The published abstracts we read do not give body-composition results for the Phase 3 trials, so we cannot say how much of the loss was fat. Our guide to muscle loss on GLP-1 medicines explains why strength training and protein matter on any of these drugs.

    What happens after stopping, and long-term heart effects. A maintenance trial (TRIUMPH-6) and the outcomes trial are still running. With approved GLP-1 medicines, weight tends to come back when people stop, and there is no reason yet to expect retatrutide to be different.

    Who it would be for, and what it would cost. Neither is known. A label, if the FDA approves one, would define who it is indicated for. There is no price, because it is not on the market.

    What comes next

    Retatrutide's road from here (as of October 7, 2026)

    1. TRIUMPH-5 resultsThe head-to-head trial against tirzepatide lists primary completion for November 2026 on ClinicalTrials.gov.
    2. Application to the FDALilly says it plans to submit in the first quarter of 2027 for obesity and related conditions.
    3. FDA reviewThe agency reviews benefits, risks and manufacturing; it can approve, ask for more data or decline.
    4. Label, if approvedAn official label would set who it is for, doses, warnings and side-effect tables.
    5. Longer-term answersTRIUMPH-6 (maintenance) and TRIUMPH-Outcomes (heart and kidney) run into 2028 and 2029.

    A planned submission is not an approval, and FDA reviews often take many months. When something changes, it will appear in our monthly news roundup and on the emerging medications tracker, which also follows CagriSema, amylin-based drugs and other candidates. For a similar investigational story further along the road, see our CagriSema explainer.

    Why not to buy “retatrutide” online

    Strong headlines have led to products sold online as “retatrutide”, “reta” or “research peptides”, often labeled “not for human consumption”. Lilly states that retatrutide cannot be legally sold or marketed for human use. The FDA says retatrutide is not a component of any FDA-approved drug and cannot be used in compounding, and it has warned telehealth companies, ingredient distributors and outsourcing facilities over it. Products from these channels have no verified identity, purity, sterility or dose, and the trial results above say nothing about them. We do not link to sellers. Our page on compounded GLP-1s explains how the FDA treats copies of approved drugs, which is a different situation.

    If you are interested in treatment now

    Several FDA-approved medicines with strong evidence are available today, including weekly injections and daily pills. Our comparison of every FDA-approved weight-loss medication sets their label trials side by side, and our GLP-1 medications guide explains how the class works. If you would like to take part in research, you can search for recruiting studies on ClinicalTrials.gov; most retatrutide trials are no longer recruiting. Before any decision, our printable questions to ask before starting a GLP-1 can help you and your clinician talk through options, and the cost hub covers what approved medicines cost today.

  • Viral Workout Trends Checked: 12-3-30, Japanese Walking, Cozy Cardio

    Viral Workout Trends Checked: 12-3-30, Japanese Walking, Cozy Cardio

    In short: All three viral workouts are forms of walking, and all three can help, in different ways. 12-3-30 (12% incline, 3 mph, 30 minutes) is the hardest: in a 2025 lab study it burned about 10 calories a minute, a bit slower than running but with no impact. Japanese walking (3 minutes fast, 3 minutes easy, repeated) has the best research behind it: a 2007 trial in older adults found bigger gains in leg strength, fitness and blood pressure than steady walking. Cozy cardio (gentle walking at home, made pleasant) burns the least per minute but may be the easiest to keep doing. None of them burns off body fat on its own; weight loss still depends on your overall calorie balance and on doing it consistently. Our walking guide covers the basics. Checked on October 7, 2026.

    Three trends, three kinds of evidence

    Checked on October 7, 2026

    Below, each trend is checked against the research: what it is, what is known about it, who it suits, and how to try it safely. We researched these workouts; we did not test them. For how to turn any activity into a calorie estimate for your own weight, use our calories burned calculator.

    A quick guide to METs

    Exercise scientists rate effort in METs (metabolic equivalents). One MET is the energy you use sitting quietly; an activity of 5 METs uses about five times as much. The 2024 Adult Compendium of Physical Activities is the standard reference. Because 1 MET is roughly 1 calorie per kilogram of body weight per hour, a common estimate is: calories = METs × weight in kg × hours. These are averages, and individual results vary with fitness, body size and how hard you actually go.

    How hard is it? Energy cost in METsValues in METs
    How hard is it? Energy cost in METs
    ItemValue
    Strolling, under 2 mph2.3 METs
    Treadmill-desk walking, 1-2 mph (cozy cardio pace)2.8 METs
    Moderate walk, 2.8-3.4 mph3.8 METs
    Brisk walk, 3.5-3.9 mph4.8 METs
    Very brisk walk, 4.0-4.4 mph5.5 METs
    Uphill walking, 6-10% grade7 METs
    12-3-30, measured in a lab study8.1 METs
    Running, 6 mph9.3 METs

    The 12-3-30 figure is our calculation from one small lab study of young, active adults; the others are Compendium values.

    Source: 2024 Adult Compendium of Physical Activities; 12-3-30 value calculated from Wong et al., Int J Exerc Sci 2025 (10.23 kcal/min at 75.4 kg) (checked on October 7, 2026)

    12-3-30: the incline treadmill walk

    What it is. Set a treadmill to a 12% incline and 3 miles per hour, and walk for 30 minutes. Influencer Lauren Giraldo first shared the routine on YouTube in 2019 and on Instagram and TikTok in 2020, where her video drew more than 2 million likes, according to ABC News. She said she arrived at it by trial and error because running was not working for her.

    What the research says. Until recently there was no peer-reviewed study of 12-3-30 itself. In 2025, researchers compared it with self-paced treadmill running in 14 young, recreationally active adults, matching the two sessions for total energy. Both burned about 310 calories. The 12-3-30 session took 30 minutes and burned about 10.2 calories a minute; the run took about 24 minutes and burned about 13.1 a minute. During 12-3-30, about 41% of the energy came from fat vs 33% during running. The authors concluded it is less time-efficient than running for burning energy, but may suit people who want a low-impact option.

    What that means. 12-3-30 is a genuinely vigorous workout for most people, close to running in effort, without the pounding. The “fat-burning” claims are overstated, though: using a higher share of fat during a workout is not the same as losing more body fat over weeks, and the study did not measure fat loss. Over time, total calories burned, total calories eaten and consistency matter far more than which fuel your muscles used in a session. Participants in the study were not allowed to hold the handrails; holding on lowers the effort.

    Who it suits, and cautions. People with a treadmill who are already walking comfortably and want more intensity without running. A Cleveland Clinic sports medicine physician quoted by ABC News suggested building up gradually (flat walking first, then a treadmill, then adding incline), said using the handrails at first is fine, and recommended mixing in strength training to avoid overuse problems. If you have joint, calf or back problems, start at a lower incline and check with a clinician. If you are choosing equipment, our comparison of a walking pad vs a treadmill covers the differences in incline and speed.

    Japanese walking: intervals for your legs and heart

    What it is. Interval walking training was developed by Shinshu University researchers Hiroshi Nose and Shizue Masuki in Japan, and went viral as “Japanese walking” in 2025. The format: about 3 minutes of fast walking at a pace that feels “somewhat hard”, then 3 minutes of easy walking, repeated five times for at least 30 minutes, at least four days a week.

    What the research says. The key study, published in Mayo Clinic Proceedings in 2007, randomly assigned 246 middle-aged and older adults (60 men and 186 women, average age 63) to no training, steady moderate walking (8,000 or more steps a day, at least four days a week) or interval walking, for five months. In the interval group, knee extension strength rose 13%, knee flexion strength 17%, and peak aerobic capacity 8% to 9%, all significantly more than with steady walking, and resting systolic blood pressure fell more. Not everyone kept it up: in the interval group, 42 of 87 participants met the training targets, a reminder that intervals are harder to sustain.

    Japanese walking trial: gains after 5 months of interval walkingValues in %
    Japanese walking trial: gains after 5 months of interval walking
    ItemValue
    Knee extension strength13%
    Knee flexion strength17%
    Peak aerobic capacity, cycling8%
    Peak aerobic capacity, walking9%

    All gains were significantly greater than with steady moderate walking. Weight change was not a main outcome in the abstract.

    Source: Nemoto K et al., Mayo Clinic Proceedings 2007 (246 adults, average age 63) (checked on October 7, 2026)

    What that means. This is the trend with the most solid evidence, but the evidence is for fitness, strength and blood pressure in older adults, not specifically for weight loss. Intervals do let you spend part of your walk at a higher effort, which adds some calories compared with a steady easy stroll. As an exercise physiologist writing in The Conversation in 2025 noted, reaching a daily step count has stronger long-term evidence than any one walking style; the best routine is the one you keep.

    Who it suits. Almost anyone who can walk briskly, including older adults, and people who get bored with steady walks. No equipment is needed; a watch or phone timer is enough. If you like to track your walks, see our fitness tracker picks, and our comparison of walking vs running shows how walking stacks up.

    Cozy cardio: making movement feel good

    What it is. TikTok creator Hope Zuckerbrow popularized “cozy cardio”: low-intensity movement, often on a walking pad, in a comfortable setting with soft lighting, a favorite drink and a show or podcast. According to TODAY, her first video drew nearly 2 million views. She has said she created it to rebuild a positive relationship with exercise after intense workouts had left her anxious about it.

    What the research says. There are no studies of cozy cardio as such. Its usual pace, slow treadmill or walking-pad walking, is rated at about 2.8 METs in the Compendium, more than double sitting but well below a brisk walk. So per minute it burns the least of the three. Its argument is not intensity but consistency: an activity you look forward to is one you are more likely to repeat.

    What that means. For someone who is not exercising at all, 30 to 45 minutes of cozy walking most days is a real step up, and every minute of moderate effort counts toward the guidelines. Light walking at a very slow pace may not reach “moderate” intensity for everyone, so it is worth nudging the speed up over time, or pairing cozy sessions with a couple of brisker or strength days. Our researched lists of walking pads and low-impact workouts have options, and the walking pad guide explains what to look for.

    Side by side: calories in 30 minutes

    Estimated calories in 30 minutes, by body weightValues in kcal
    Estimated calories in 30 minutes, by body weight
    Item150 lb (68 kg)200 lb (91 kg)
    Cozy cardio, slow walking pad (2.8 METs)95 kcal127 kcal
    Japanese walking, half very brisk and half easy (about 4.2 METs)141 kcal188 kcal
    Brisk walk, flat (4.8 METs)163 kcal218 kcal
    12-3-30 (about 8.1 METs)276 kcal367 kcal
    Running, 6 mph (9.3 METs)316 kcal422 kcal

    Estimates. The Japanese walking value is our approximation (average of 5.5 and 2.8 METs). Your numbers will differ.

    Source: 2024 Adult Compendium MET values; 12-3-30 from Wong et al. 2025; calories = METs x kg x 0.5 hour (checked on October 7, 2026)

    To put those numbers in context, U.S. weight-management guidelines describe a typical daily deficit of about 500 to 750 calories. One 30-minute workout of any of these kinds covers part of that, not all of it. The American College of Sports Medicine’s position stand on weight loss notes that 150 to 250 minutes of activity a week usually leads to modest weight loss, that more than 250 minutes a week is linked with larger losses, and that activity combined with eating changes works better than either alone. Our guide to calorie deficits and the comparison of cardio vs strength training explain how activity fits in.

    The verdict

    TrendEffortBest evidence forMain caution
    12-3-30Vigorous (about 8 METs measured)Burning energy without impact; one small lab studyDemanding for beginners; needs a treadmill that inclines to 12%
    Japanese walkingModerate to vigorous in burstsLeg strength, aerobic fitness and blood pressure in older adults (randomized trial)Harder to stick with; about half met targets in the trial
    Cozy cardioLight (about 2.8 METs at slow pace)Enjoyment and getting started; no direct studiesMay not reach moderate intensity unless the pace rises
    Sources: Wong et al. 2025; Nemoto et al. 2007; 2024 Adult Compendium; TODAY and ABC News for trend origins. Checked 2026-10-07.

    How to try them safely

    Starting any viral walking workout

    1. Start with flat walkingIf you are new to exercise, build up to 20 to 30 minutes of comfortable walking first.
    2. Add one thing at a timeRaise speed, incline or interval length gradually over weeks, not all at once.
    3. Use the talk testModerate means you can talk but not sing; vigorous means you cannot say more than a few words without pausing for breath (CDC).
    4. Mix in strengthAdd muscle-strengthening work on two days a week, as the guidelines recommend.
    5. Check in if neededAsk a clinician first if you have heart, joint or balance problems, or new symptoms with exercise.

    The best workout is the one you will do again next week. You can rotate all three: cozy sessions on tired days, intervals outdoors when the weather is good, and an incline walk when you want a challenge. For more ideas, see our exercise hub, the list of best exercises for weight loss with calories for each, our strength training guide, and, for perspective on how today’s trends compare with yesterday’s, the history of exercise fads.

  • Fibermaxxing: Is the 2026 Fiber Trend Worth It?

    Fibermaxxing: Is the 2026 Fiber Trend Worth It?

    In short: “Fibermaxxing” means eating as much fiber as you can, and as social-media trends go, this one points in a good direction: most Americans eat about 17 grams of fiber a day, while the recommended amount is about 25 grams for adult women and 38 grams for adult men (14 grams per 1,000 calories), and only about 5% of people get there. Higher-fiber diets are linked with lower risk of heart disease, type 2 diabetes and colorectal cancer, and with lower body weight in trials. The catches are the “maxxing” part and the speed: jumping to 50 or 60 grams overnight tends to bring gas, bloating and cramps, and some people should not push fiber high at all. Meeting the target with whole foods, built up over a few weeks with plenty of fluids, gets most of the benefit. If you are thinking about pills or powders instead, see our fiber supplements guide. Checked on October 7, 2026.

    Fiber in numbers

    Checked on October 7, 2026

    What fibermaxxing is

    The term took off on TikTok in 2025. As registered dietitian Steph Grasso put it to Good Morning America in August 2025, “Fibermaxxing is slang for eating tons of fiber, either meeting or exceeding the daily recommendations.” Posts show bowls loaded with chia seeds, berries, beans, lentils and nuts, and some people chase totals well above the guidelines.

    Unlike many trends, it does not ask you to cut out a food group or buy a product. That is why many dietitians have been more welcoming of this one than usual, with the caveats below.

    The fiber gap: average U.S. intake vs the Adequate IntakeValues in g
    The fiber gap: average U.S. intake vs the Adequate Intake
    ItemValue
    Average U.S. intake17 g
    Adequate Intake, adult women25 g
    Adequate Intake, adult men38 g

    Grams per day. The Adequate Intake is based on 14 g per 1,000 calories; MedlinePlus puts current average intake at about 16 g.

    Source: Academy of Nutrition and Dietetics position paper, 2015 (Institute of Medicine values) (checked on October 7, 2026)

    So the trend starts from a real gap. For most adults, closing it means adding roughly 8 to 21 grams a day, the amount in a cup of raspberries plus a half cup of beans, or a bowl of oatmeal with chia. The fight on social media is mostly about what happens beyond the recommendation.

    What fiber does in the body

    Dietary fiber is the part of plant foods the body cannot digest. The Institute of Medicine defines it as “nondigestible carbohydrates and lignin that are intrinsic and intact in plants.” MedlinePlus, the National Library of Medicine’s health site, describes two broad types. Soluble fiber dissolves in water and forms a gel that slows digestion; it is found in oat bran, barley, nuts, seeds, beans, lentils, peas and some fruits and vegetables, and research links it with lower cholesterol. Insoluble fiber does not dissolve; it adds bulk to stool and helps food move through the gut, and it is found in wheat bran, vegetables and whole grains. Most high-fiber foods contain both.

    What the evidence says about fiber and health

    The strongest summary comes from a series of systematic reviews and meta-analyses published in The Lancet in 2019. Pooling 185 prospective studies (about 135 million person-years) and 58 clinical trials, the authors found that people who ate the most fiber had 15% to 30% lower rates of death from all causes and from cardiovascular disease, and lower rates of coronary heart disease, stroke, type 2 diabetes and colorectal cancer, than those who ate the least. Clinical trials showed lower body weight, systolic blood pressure and total cholesterol with higher fiber intakes. The biggest risk reductions were seen at 25 to 29 grams a day, and the dose-response curves suggested even higher intakes could add benefit for some conditions. The certainty of the evidence for fiber was graded moderate.

    Most of that evidence is observational, meaning it shows a link, not proof that fiber alone caused the benefit; people who eat a lot of fiber also tend to eat more whole plant foods in general. That is not a reason to ignore it, just a reason to think “eat more whole plant foods” rather than “chase a fiber number”.

    Does fibermaxxing help with weight loss?

    Fiber can help, mostly by making meals more filling for fewer calories. In the POUNDS Lost trial, where 345 adults followed calorie-reduced diets for six months, a 2019 analysis found that fiber intake was the strongest single dietary predictor of weight loss, independent of calories and the diet’s mix of fat, protein and carbohydrate, and it was linked to better adherence to the diet. Supplements show a smaller effect: our fiber supplement page covers a meta-analysis of 62 trials in which viscous fiber supplements lowered body weight by an average of only 0.33 kg (under a pound) when people did not change anything else.

    Put simply, fiber helps when it comes packaged in foods that replace something more calorie-dense: beans instead of some of the meat, fruit instead of a pastry, a big salad before the main course. Adding a high-fiber topping to an otherwise unchanged diet adds calories too. Fiber still works inside the basic math of a calorie deficit, not around it. Our list of filling foods for weight loss ranks foods by fullness research, and many of the top ones are high in fiber.

    Where the fiber is: everyday foods

    Fiber in common servings (grams)Values in g
    Fiber in common servings (grams)
    ItemValue
    Chia seeds, 1 oz (about 2 tbsp)9.8 g
    Raspberries, 1 cup8 g
    Lentils, cooked, 1/2 cup7.8 g
    Black beans, cooked, 1/2 cup7.5 g
    Avocado, half6.7 g
    Chickpeas, cooked, 1/2 cup6.2 g
    Pear, 1 medium5.5 g
    Broccoli, cooked, 1 cup5.1 g
    Apple with skin, 1 medium4.4 g
    Oatmeal, cooked, 1 cup4 g
    Popcorn, air-popped, 3 cups3.5 g
    Almonds, 1 oz3.5 g
    Whole-wheat bread, 1 slice1.9 g
    White bread, 1 slice0.8 g

    Rounded to one decimal. Beans, lentils, berries and seeds give the most fiber per serving.

    Source: USDA FoodData Central (SR Legacy), per-100 g values times USDA portion weights (checked on October 7, 2026)

    Those numbers make the target look reachable. Oatmeal with a cup of raspberries and an ounce of chia at breakfast (about 22 grams), an apple and a handful of almonds as snacks (about 8), and a lentil or bean dish with broccoli at dinner (about 13) already add up to more than 40 grams. Most people do not need that much, which is the point: a few swaps get you to the recommendation without “maxxing”. Our healthy snacks guide and high-protein smoothie recipes show more ways to work fiber in, and eating patterns built around plants, such as the Mediterranean diet and DASH, naturally land near the target.

    The downsides: why “maxxing” fast backfires

    Gut bacteria ferment some fibers, which is good for them and produces gas. MedlinePlus notes that adding a lot of fiber quickly can cause gas, bloating and cramping, which usually ease as the gut adjusts, and it advises introducing fiber slowly over several weeks. It also notes that too much fiber may interfere with the absorption of minerals such as iron, zinc, magnesium and calcium. Fiber needs fluid to move through the gut; MedlinePlus suggests about 8 glasses of water or other non-caloric fluid a day.

    The GLP-1 point deserves a word. Constipation is common on these medicines (24% vs 11% with placebo in the Wegovy label, for example), and fiber with enough fluid can help regularity. But very large fiber loads on a slowed stomach can worsen fullness and nausea. It is a balance to work out with your prescriber or a dietitian; our GLP-1 side effects guide and the article on GLP-1 companion foods cover eating on these medicines.

    Is more than the recommendation better?

    Maybe a little, for some outcomes, but the evidence is thinner up there. In the Lancet review, the biggest risk reductions came at 25 to 29 grams a day, and the dose-response curves suggested higher intakes might add some protection against cardiovascular disease, type 2 diabetes and colorectal and breast cancer. Those curves come mainly from observational studies, where few people eat very large amounts, so they are less certain at the top. The review did not test 50 or 60 grams a day as a target, and MedlinePlus gives a range of 21 to 38 grams for older children, teens and adults.

    A sensible reading: reaching the recommendation is clearly worthwhile; going somewhat above it with whole foods is fine for most people who tolerate it; and treating fiber as a score to maximize adds discomfort without clear extra benefit. If a high total crowds out protein or makes you too full to eat a balanced meal, that is a sign to ease off, especially if you are eating less overall.

    How to raise fiber without the bloat

    Ramp up slowly

    1. Start where you areFor a few days, note roughly how much fiber you eat now using labels or an app.
    2. Add one swap at a timeFor example, oats instead of a low-fiber cereal, or beans in one meal a day.
    3. Go up over several weeksAdd a few grams at a time and give your gut time to adjust, as MedlinePlus advises.
    4. Drink with itAim for plenty of water or other non-caloric fluids through the day.
    5. Spread it outFiber at each meal is easier on the gut than one huge bowl.
    6. Stop at the target, not the maximumAbout 14 g per 1,000 calories is the goal; more is optional, not required.

    Food or supplements?

    Food is the better first choice. Whole foods bring fiber along with vitamins, minerals and other plant compounds, and they replace less filling foods on the plate. The Academy of Nutrition and Dietetics’ position is that people should get adequate fiber “from a variety of plant foods” while cutting back on foods high in added sugar and fat and low in fiber. Supplements such as psyllium have a role, for example for regularity or cholesterol under a clinician’s guidance, and they carry warnings to take them with plenty of fluid. Our fiber supplements page rates the evidence for each type.

    The verdict

    Claim you will seeWhat the evidence says
    Most people don’t eat enough fiberTrue: average intake is about 17 g a day and only about 5% meet the Adequate Intake.
    More fiber is linked to better healthTrue, with moderate certainty: lower rates of heart disease, type 2 diabetes and colorectal cancer in large reviews.
    Fiber helps with weight lossPartly true: it helps meals fill you up for fewer calories, but it does not cancel out extra calories.
    The more the better, as fast as possibleNot supported: fast increases cause gas and bloating, and very high amounts may affect mineral absorption.
    Fiber is natural OzempicNo: fiber does not work like a prescription GLP-1 medicine. See our “Nature’s Ozempic” myth-buster.
    Sources: Academy of Nutrition and Dietetics 2015; Reynolds et al., Lancet 2019; MedlinePlus; Miketinas et al., J Nutr 2019. Checked 2026-10-07.

    Fibermaxxing gets the direction right and the dose wrong. Aim to meet the recommendation, mostly from beans, lentils, whole grains, fruit, vegetables, nuts and seeds, and build up gradually. For a quick sense of your calorie needs (which sets your fiber target at 14 grams per 1,000 calories), try our calorie calculator, and for the bigger picture of eating well, visit the InstaTuck nutrition hub. More myths are checked in our weight-loss myths roundup.

  • GLP-1 Companion Foods: What They Are and Whether You Need Them

    GLP-1 Companion Foods: What They Are and Whether You Need Them

    In short: “GLP-1 friendly” and “GLP-1 companion” foods are ordinary foods, usually higher in protein and fiber and portioned smaller, that companies now market to people taking medicines like Wegovy, Zepbound and Ozempic. The term has no official definition: the FDA does not regulate it, and the USDA, which approved it on some meat-containing products, says there is no regulatory standard for it. You do not need special products to eat well on a GLP-1. What the evidence supports is enough protein, fiber and nutrients in smaller meals, which everyday foods can provide; branded options can be a convenience if you check the label. Our GLP-1 diet guide covers the full eating plan. Checked on October 7, 2026.

    Man in black hoodie washing fresh vegetables at a market stall, maintaining cleanliness and appeal.
    Photo: Josh Hild / Pexels

    This page explains why these foods appeared, how to judge one in 30 seconds, and how to cover the same needs with groceries you already know. It is general nutrition education, not individual advice; if you take a GLP-1 medicine, a registered dietitian or your prescriber can help you set your own targets.

    Why “GLP-1 friendly” foods appeared

    The short answer is scale. In a KFF poll taken from late October to early November 2025, 12% of U.S. adults said they were currently taking a GLP-1 drug, for weight loss, diabetes or another condition, up 6 percentage points from May 2024, and 18% said they had ever taken one. These medicines reduce appetite: according to a 2025 joint nutrition advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association and The Obesity Society, people on them eat about 16% to 39% fewer calories. Eating less changes what people buy, and food companies noticed.

    The GLP-1 food trend in numbers

    Checked on October 7, 2026

    An Associated Press report in January 2026 listed some of the launches: Nestlé’s Vital Pursuit frozen meals (fall 2024), “GLP-1 Friendly” badges on 26 Healthy Choice frozen meals from Conagra Brands (early 2025), a “GLP-1 Support Menu” at Smoothie King, “GLP-1 Balance” meal kits from Factor, a high-protein, high-fiber yogurt from Lactalis, and protein-heavy menu items at restaurant chains such as Chipotle and Shake Shack. The AP reported that the labels “are not regulated by the U.S. Food and Drug Administration”, and that the USDA’s Food Safety and Inspection Service approved the term on some products because it appeared with protein and fiber statements and was not misleading, while noting there is no regulatory standard for it.

    What people on GLP-1 medicines actually need from food

    The 2025 joint advisory is the most detailed guidance so far. It names the main nutrition challenges as digestive side effects, falling short on nutrients when eating much less, loss of muscle and bone, and weight regain if the medicine stops. Its practical points:

    • Protein first. The advisory discusses about 1.2 to 1.6 grams of protein per kilogram of body weight a day during active weight loss (or roughly 80 to 120 grams a day as an alternative way to express it), and not less than 0.4 to 0.5 g/kg. Our protein calculator shows these ranges for your weight; your clinician or dietitian can say which fits you.
    • Nutrient density. Below about 1,200 calories a day for women or 1,800 for men, it becomes hard to meet nutrient needs. Vitamin D, calcium and vitamin B12 are among the nutrients it flags.
    • Gentler meals for side effects. Smaller, more frequent meals, and going easy on fatty foods, can help with nausea. The advisory also suggests keeping alcohol minimal, since it may worsen nausea and reflux, and staying hydrated.
    • Movement to protect muscle. Strength training at least three times a week plus at least 150 minutes of moderate aerobic activity, adapted to the person. See our strength training guide and muscle loss on GLP-1s.
    • Professional support. It recommends counseling from a registered dietitian where possible.

    Notice what is not on that list: no special product, ingredient or “GLP-1 activating” food. The advisory’s food advice is about familiar things, such as lean proteins, vegetables, fruit, legumes and whole grains, in amounts that fit a smaller appetite. Our high-protein eating guide shows how to build meals around protein.

    How to judge a “GLP-1 friendly” product in 30 seconds

    Ignore the badge and use the rules that do have legal definitions. Under FDA regulations, a food can say it is a “good source” of a nutrient when one serving provides 10% to 19% of the Daily Value, and “high” or “excellent source” when it provides 20% or more. The Daily Value for protein is 50 grams and for fiber 28 grams. In practice that means a serving with about 10 grams of protein meets “high protein”, and a serving with about 2.8 grams of fiber is a “good source” of fiber, with 5.6 grams or more counting as “high”. (Those gram figures are our arithmetic from the FDA percentages.) The FDA’s own rule of thumb is that 5% DV or less of a nutrient per serving is low and 20% or more is high.

    Nutrient-density label check

    1. ProteinLook for roughly 10 g or more per serving (20% DV). With a smaller appetite, each bite should count.
    2. Fiber3 to 6 g or more per serving helps fullness and regularity; build up slowly if you are not used to it.
    3. Calories and portionCheck the serving size and whether the package is one serving or two.
    4. Added sugars and sodium5% DV or less is low; 20% DV or more is high. Frozen meals often run high in sodium.
    5. Ingredients and priceCompare with a homemade or simpler option that gives the same protein and fiber for less.

    Two more claims are worth knowing. The FDA updated the meaning of “healthy” on food labels in a rule announced on December 19, 2024: a “healthy” food must now contain a meaningful amount from a food group, such as fruit, vegetables, grains, low-fat dairy or protein foods, and stay under limits for added sugars, sodium and saturated fat. That is a stricter test than “GLP-1 friendly”. And claims that a food helps you lose weight, controls appetite or “supports GLP-1” are marketing unless backed by evidence you can see; a food is not a medicine.

    A loving couple enjoys cooking fresh vegetables together in a cozy, modern kitchen setting.
    Photo: Gustavo Fring / Pexels

    Everyday foods that already do the job

    Many unbranded foods meet the “high protein” or “good source of fiber” bar on their own. The values below come from the USDA’s FoodData Central database for common portions.

    Protein per common serving (grams)Values in g
    Protein per common serving (grams)
    ItemValue
    Chicken breast, roasted, 3 oz26 g
    Cod, cooked, 3 oz19 g
    Greek yogurt, plain nonfat, 6 oz container17 g
    Cottage cheese, 1% milkfat, 4 oz14 g
    Eggs, hard-boiled, 2 large13 g
    Lentils, cooked, 1/2 cup9 g

    Rounded to the nearest gram. 10 g or more per serving meets the FDA's 'high protein' level (20% of the 50 g Daily Value).

    Source: USDA FoodData Central (SR Legacy), per-100 g values times USDA portion weights (checked on October 7, 2026)

    Fiber per common serving (grams)Values in g
    Fiber per common serving (grams)
    ItemValue
    Raspberries, raw, 1 cup8 g
    Lentils, cooked, 1/2 cup7.8 g
    Black beans, cooked, 1/2 cup7.5 g
    Pear, raw, 1 medium5.5 g
    Broccoli, cooked, 1 cup5.1 g
    Oatmeal, cooked with water, 1 cup4 g

    2.8 g or more is a 'good source' and 5.6 g or more is 'high' fiber under FDA rules (10% and 20% of the 28 g Daily Value).

    Source: USDA FoodData Central (SR Legacy), per-100 g values times USDA portion weights (checked on October 7, 2026)

    Put together, a small plate can cover a lot. Using the same USDA values, a 6-ounce container of plain nonfat Greek yogurt with a cup of raspberries comes to about 165 calories, 18 grams of protein and 8 grams of fiber; 3 ounces of cooked cod with a cup of cooked broccoli is about 145 calories, 23 grams of protein and 5 grams of fiber; and half a cup of cooked lentils alone gives about 115 calories, 9 grams of protein and 8 grams of fiber. Each of those reaches or comes close to the “high protein” level and is at least a “good source” of fiber, without any special packaging. A few caveats from the advisory apply here too. High-fiber foods can worsen bloating or nausea for some people early in treatment, so it is fine to go slowly, and fatty or fried versions of these foods are harder on a GLP-1 stomach. Our lists of filling foods and healthy snacks have more ideas, and our new look at the fibermaxxing trend covers how to raise fiber comfortably.

    Product types you will see, and what to check

    Product typeWhat it usually offersWhat to check on the label
    Frozen meals with a GLP-1 badgeSmaller portions with added protein and fiberProtein per serving, sodium (% DV), whether vegetables are a real part of the meal
    High-protein, high-fiber yogurts and dairy drinksProtein in a small, easy-to-eat volumeAdded sugars, serving size, protein source
    Protein shakes and barsConvenient protein when meals are smallProtein per 100 calories, added sugars and sugar alcohols, third-party testing
    Meal kits and prepared-meal plansPortion-controlled dinnersCalories and protein per meal, price per meal, delivery area
    Restaurant “GLP-1” or protein menusSmaller or protein-forward portionsPosted calories, fried or creamy items, sauces on the side
    Product types from the Associated Press report (January 2026). What to check is based on FDA labeling rules and the 2025 joint advisory. No product is recommended here.

    When a branded product can help

    There are fair reasons to use them. A portioned, high-protein frozen meal can be easier than cooking when you have little appetite, and some people find it simpler to know exactly what is in a serving. Prepared-meal services can save time; our researched list of meal delivery services for weight loss compares calorie and protein transparency, and our protein powder picks focus on third-party testing. The trade-offs are usually cost and sodium, and a badge does not make one product better than a similar one without it.

    One thing to keep separate: drinks, capsules and powders sold as “GLP-1 boosters” or “natural GLP-1” are a different category from foods, and the evidence for them is weak. Our myth-buster on “Nature’s Ozempic” products covers what the research says.

    After the medicine: why food habits matter even more

    The advisory lists weight regain after stopping as one of the main challenges of GLP-1 treatment, and calls nutrition after stopping an area that needs more research. Habits built while on the medicine, such as protein at each meal, plenty of vegetables and legumes, regular strength training and paying attention to fullness, are the ones that carry over. Branded “GLP-1” products are, by design, aimed at the time on the medicine; ordinary foods work before, during and after. Our guide to life after GLP-1 medicines covers that transition, and our GLP-1 medications guide and side effects guide explain the medicines themselves.

    Bottom line: “GLP-1 friendly” is a useful reminder of what matters (protein, fiber, nutrients, smaller portions), not a requirement. Read the panel, not the badge, and choose whatever helps you eat that way consistently. For the wider food picture, visit the InstaTuck nutrition hub.

  • Continuous Glucose Monitors for Weight Loss Without Diabetes: What the Evidence Says

    Continuous Glucose Monitors for Weight Loss Without Diabetes: What the Evidence Says

    In short: Since 2024, you can buy a continuous glucose monitor (CGM) without a prescription, and many people without diabetes now wear one hoping it will help them lose weight. The evidence so far is thin. Pooled trials in people without diabetes found no significant effect on BMI, and a six-month trial of a diet built around each person’s blood-sugar responses did not beat a standard low-fat diet. A CGM can show how meals, walks and sleep affect your glucose, which some people find motivating, but it does not measure calories or fat. If you have signs of prediabetes or insulin resistance, a lab test and a talk with your clinician come first. Checked on October 7, 2026.

    A doctor discusses coronavirus test results with a patient in a medical office.
    Photo: cottonbro studio / Pexels

    This page explains what over-the-counter CGMs are cleared to do, what normal glucose looks like on one, what the weight-loss research shows and how to get useful information from a sensor if you try one. It is general education, not medical advice, and it does not recommend any device.

    Over-the-counter CGMs at a glance

    • Mar 5, 2024FDA clears the first over-the-counter CGM (Dexcom Stelo)FDA
    • 18+age on the labels, for people not using insulinStelo; Lingo
    • 14-15 dayshow long one sensor lasts (maker-stated)
    • 0large, long-term trials showing CGMs cause weight loss in people without diabetes

    Checked on October 7, 2026

    What a CGM is, and what the FDA cleared

    A CGM is a small sensor worn on the upper arm or belly with a tiny filament under the skin. It measures glucose in the fluid between cells (not in blood directly) every few minutes and sends readings to a phone app. For years, CGMs were prescription devices for people with diabetes, especially those using insulin.

    On March 5, 2024, the FDA cleared the first over-the-counter CGM, Dexcom’s Stelo, for adults 18 and older who do not use insulin, including people with diabetes managed with oral medicines and people without diabetes who want to learn how diet and exercise affect their blood sugar. The FDA said it is not for people with problematic low blood sugar, because it does not alert users to dangerous lows, and that users should not make medical decisions based on it without talking to a health care provider. In June 2024, Abbott announced FDA clearance of two more: Lingo, for consumers 18 and older “looking to improve their overall health and wellness”, and Libre Rio, for adults with type 2 diabetes who do not use insulin. Abbott states that Lingo is “not intended for diagnosis of diseases, including diabetes.”

    As of October 7, 2026, the makers list Stelo at $89 a month by subscription for two 15-day sensors, and Lingo at $54 for a two-week plan with one 14-day sensor (maker-stated prices, checked today; they change). That is roughly $1,000 to $1,400 a year for continuous use.

    What normal glucose looks like on a CGM

    One of the most useful things to know before wearing a CGM is that glucose rises after meals in everyone, and that a rise is not a problem in itself. A 2019 study of 153 healthy, non-pregnant people without diabetes (ages 7 to 80) who wore a blinded CGM for up to 10 days found an average glucose of 98 to 99 mg/dL in most age groups (104 mg/dL over age 60). They spent a median of 96% of the day between 70 and 140 mg/dL, about 30 minutes a day above 140 mg/dL and about 15 minutes a day below 70 mg/dL.

    A typical day for adults and children without diabetes wearing a CGM
    A typical day for adults and children without diabetes wearing a CGM
    ItemValue
    70-140 mg/dL96%
    Above 140 mg/dL2.1%
    Below 70 mg/dL1.1%

    Median share of time in each range. Short spikes above 140 mg/dL are normal after meals.

    Source: Shah VN et al., Journal of Clinical Endocrinology and Metabolism 2019 (153 healthy participants) (checked on October 7, 2026)

    Diagnosis does not use CGM readings. The CDC lists the standard lab cut-offs: an A1C below 5.7% is normal, 5.7% to 6.4% is prediabetes and 6.5% or above is diabetes; a fasting plasma glucose of 99 mg/dL or below is normal, 100 to 125 mg/dL is prediabetes and 126 mg/dL or above is diabetes. If your CGM shows numbers that worry you, those tests, ordered by a clinician, are the way to find out what is going on.

    Lab testNormalPrediabetesDiabetes
    A1CBelow 5.7%5.7% to 6.4%6.5% or above
    Fasting plasma glucose99 mg/dL or below100 to 125 mg/dL126 mg/dL or above
    2-hour oral glucose tolerance test140 mg/dL or below140 to 199 mg/dL200 mg/dL or above
    Source: CDC, Diabetes Testing, checked 2026-10-07. These are lab tests, not CGM readings.

    Where the idea came from

    Interest in CGMs for people without diabetes grew out of research on “personalized nutrition”. In a widely cited 2015 study in the journal Cell, Israeli researchers had 800 people wear glucose monitors for a week and measured their responses to 46,898 meals. Responses to identical meals varied a lot from person to person. The team built a computer model that predicted each person’s response from their blood tests, habits, body measurements, activity and gut bacteria, and in a small trial, diets tailored by that model lowered after-meal glucose.

    Notice what that study measured: blood sugar after meals, not weight. Lower glucose rises are a reasonable goal for people with prediabetes or diabetes, but the step from “steadier glucose” to “more weight loss” is an assumption that has to be tested on its own. Many consumer programs now combine a sensor with an app and coaching and market the package for weight. That is where the research below comes in.

    What the research says about CGMs and weight

    Pooled studies in people without diabetes. A 2026 systematic review and meta-analysis in the European Journal of Medical Research gathered 23 studies with 1,074 participants without diabetes from 11 countries (7 of them randomized trials). CGM use modestly improved average blood glucose compared with controls, but there was no significant difference in BMI. The review found CGM use was linked with better adherence to programs and some specific diet changes, and that glucose benefits showed up in people with prediabetes rather than in healthy people with normal glucose.

    Pooled trials across people with and without diabetes. A 2024 meta-analysis of 25 randomized trials (2,996 participants, mostly with type 2 diabetes) found that CGM-based feedback lowered HbA1c by 0.28 percentage points and increased time in range, with non-significant effects on BMI and weight. Eleven of the 25 studies reported conflicts of interest linked to CGM makers, and only 4 measured diet changes.

    Personalized glucose diets. The idea behind many CGM programs is that people respond differently to the same foods, so a diet that keeps your own glucose steady should work better. The Personal Diet Study tested this in 204 adults with obesity and prediabetes or early type 2 diabetes. For six months, one group got a personalized diet based on a machine-learning prediction of their glucose responses, with color-coded meal scores in an app; the other got a standard low-fat diet. Both had 14 counseling sessions. Weight loss was -3.26% with the personalized diet and -4.31% with the low-fat diet, which was not a significant difference.

    A small positive trial. In a 2026 randomized trial of 35 women with overweight or obesity, all of whom had supervised exercise and the same diet counseling, those who wore a CGM at three points during 12 weeks lost 5.5 kg on average vs 0.2 kg in the comparison group, which wore it only at the start and end. The authors say larger, longer trials are needed. Small, short studies like this can show what is possible, but they often shrink or disappear in bigger trials.

    Personal Diet Study: weight change at 6 monthsValues in %
    Personal Diet Study: weight change at 6 months
    ItemPersonalized glucose-based dietStandard low-fat diet
    Average weight loss3.26%4.31%

    The difference (1.05 percentage points) was not statistically significant. Bars show percent of starting weight lost.

    Source: Popp CJ et al., JAMA Network Open 2022 (Personal Diet Study, 204 adults) (checked on October 7, 2026)

    What a CGM can and can’t tell you

    That last point matters for weight loss. Weight change still comes down to energy balance over time, as our calorie deficit guide explains. A glucose rise tells you how a meal affected your blood sugar, not how many calories it had or how full it kept you. Treating every rise as a problem could steer someone away from fruit, beans or whole grains, foods whose fiber is linked with better long-term health in large reviews. Our list of filling foods and our nutrition hub focus on what helps with hunger and calories.

    There is also the question of accuracy. CGMs read fluid under the skin rather than blood, so readings will not always match a fingerstick test. Abbott’s own instructions for Libre Rio tell users to check with a fingerstick meter when readings do not match how they feel. Some people find the constant numbers stressful. Abbott advises people with a history of eating disorders to talk to a professional before making diet or exercise changes with Lingo, and anyone whose CGM is making them anxious about eating should take that seriously.

    Who might get more out of one

    The research so far suggests the clearest glucose benefits are in people who already have raised blood sugar, such as prediabetes, rather than in people whose glucose is normal. That group should start with a clinician, because a lab diagnosis opens the door to structured prevention programs and to treatment if needed. Our guides to type 2 diabetes and weight and PCOS and weight explain where glucose fits in. People who use insulin need a prescription CGM with low-glucose alerts, not an over-the-counter wellness sensor.

    For people without diabetes, a CGM is best thought of as an optional, short experiment that some find motivating, not a weight-loss treatment. If the cost is a stretch, the habits it tends to encourage, like walking after meals, pairing carbohydrates with protein and fiber, and sleeping enough, are free and backed by broader research. Our guide to metabolism and weight covers what really changes how much energy you burn.

    If you decide to try one

    Getting useful information from a two-week CGM trial

    1. Check you are in the labelOver-the-counter sensors are for adults 18+ not using insulin. If you use insulin or have frequent lows, ask for a prescription device.
    2. Pick one or two questionsFor example, "does a 10-minute walk after dinner change my readings?" rather than tracking everything.
    3. Log meals and activityReadings mean more next to notes on what you ate, how much you moved and how you slept.
    4. Look for patterns, not spikesA single rise after a meal is normal; look at repeated patterns over days.
    5. Share results with a clinicianEspecially readings that seem high when fasting, which may call for a lab test.

    Pair any sensor with the basics that have the strongest evidence: a steady calorie deficit you can live with (our calorie calculator gives a starting point), regular walking and strength work, and an eating pattern you enjoy, such as the Mediterranean diet. If you like data, our fitness tracker picks and smart scale picks cover other self-tracking tools, and our explainer on AI calorie counting from photos looks at another new tracking technology. For the bigger picture of what has changed in weight loss, see 10 innovations that changed weight loss.