New Weight Loss Drugs: The 2026 and 2027 Pipeline, Led by Retatrutide

Retatrutide leads the new weight loss drugs due in 2026 and 2027. Counting everyone randomized, people on its 12 mg dose lost 25.0% of their body weight over 80 weeks in TRIUMPH-1 (NEJM), the largest average of any drug on this page with Phase 3 results, though no trial has put it head to head with any of them. One newcomer is already in US pharmacies: Lilly's Foundayo (orforglipron), a daily pill approved on April 1, 2026, alongside two new forms of semaglutide, Wegovy HD and the Wegovy pill. Novo Nordisk expects an FDA decision on CagriSema by late 2026. Retatrutide, survodutide, eloralintide, amycretin and MariTide are still investigational as of October 31, 2026.

Each section below takes one drug, with its best published result and its status on October 31, 2026. The deeper one-on-one comparisons have their own pages, and retatrutide alternatives covers the drugs you can already fill.

New weight loss drugs compared side by side

Read every weight loss number here as cross-trial: the trials enrolled different people, ran for different lengths and handled dropouts differently. Where a paper reports it, we use the treatment-regimen (or treatment-policy) estimand, which counts everyone randomized, including people who stopped.

Sources: the paper or release named in each drug's section; Foundayo prices from LillyDirect as of October 31, 2026. A minus sign is weight lost; a plus sign means the placebo group gained.

The fairer number is drug minus placebo, because placebo groups ranged from a 5.4% loss (SYNCHRONIZE-1) to a 1.9% gain (amycretin). For the Phase 3 drugs, the gaps are 21.0 percentage points for retatrutide (the NEJM paper's figure), 17.3 for CagriSema (NEJM), 15.15 for mazdutide 9 mg (JAMA), 13.3 for ecnoglutide (The Lancet Diabetes & Endocrinology), 9.1 for orforglipron and 7.6 for survodutide (our arithmetic for the last two). Starting weights differed too: 112.7 kg in TRIUMPH-1, 108.8 kg in SYNCHRONIZE-1 and 94.0 kg in GLORY-2.

Our read: trial length, starting weight and country all differ, so the ranking is rough. It's still hard to see those differences alone closing a gap of 21.0 points against 7.6 to 17.3.

Retatrutide, the triple agonist at the front

Retatrutide is Lilly's once-weekly injection that acts on three hormone receptors: GIP, GLP-1 and glucagon. Six Phase 3 trials have reported positive results, the first in December 2025 and the latest, TRANSCEND-T2D-2, on October 28, 2026.

In TRIUMPH-1, 2,339 adults with obesity or overweight and no diabetes took 4, 9 or 12 mg or placebo for 80 weeks. Lilly's headline figure is 28.3% on 12 mg under the efficacy estimand, which assumes everyone stayed on the drug; the NEJM paper's primary number is the 25.0% in the table. Side effects were mostly stomach and gut: about 4 in 10 people on 12 mg (42.4%) had nausea, against 14.8% on placebo, and 11.3% stopped because of side effects, against 4.9%. A burning or oversensitive skin feeling (dysesthesia) hit 12.5% on 12 mg and 0.9% on placebo.

The one direct test so far, TRANSCEND-T2D-2 against Ozempic 2 mg in type 2 diabetes, is in the chart: on both 9 and 12 mg, weight loss was more than double Ozempic's, per Lilly's release. TRIUMPH-5, against tirzepatide, has an estimated primary completion of November 2026 on ClinicalTrials.gov. Every dose and trial is broken down in retatrutide weight loss results.

On filing: Lilly last said, on September 29, 2026, that it plans to submit retatrutide to the FDA in the first quarter of 2027 as a Biologics License Application (BLA). On October 2, 2026, the FDA decided that retatrutide is a drug, not a biological product, so an application would need to be filed under section 505 of the Federal Food, Drug, and Cosmetic Act. Lilly's appeal on that question is pending in the Seventh Circuit, and we found no ruling as of October 31, 2026.

Is Foundayo retatrutide?

No. Foundayo is orforglipron, a pill that acts on the GLP-1 receptor only. It's a small molecule rather than a peptide, and Lilly says it can be taken any time of day without food or water restrictions. The FDA approved it on April 1, 2026, for adults with obesity, or overweight with weight-related medical problems.

ATTAIN-1 randomized 3,127 adults without diabetes for 72 weeks. On the top 36 mg dose, weight fell 11.2% against 2.1% on placebo, counting everyone (NEJM). Between 5.3% and 10.3% of people on orforglipron stopped because of side effects, against 2.7% on placebo.

As of October 31, 2026, LillyDirect lists $149 to $299 a month, with temporary cuts on the 2.5 mg and 5.5 mg doses through December 31, 2026. Orforglipron vs retatrutide compares the two, including how a pill's results stack up against a weekly shot's.

CagriSema is the amylin combination waiting on the FDA

CagriSema pairs cagrilintide, a long-acting copy of the fullness hormone amylin, with semaglutide 2.4 mg in one weekly shot. In REDEFINE 1, 3,417 adults without diabetes were randomized for 68 weeks; the combination averaged 20.4% weight loss against 3.0% on placebo, treatment-policy estimand (NEJM). Stomach and gut side effects hit 79.6% against 39.9%.

Then came REDEFINE 4, an open-label 84-week trial of 809 people against tirzepatide 15 mg. CagriSema missed its primary goal of showing it was no worse: 20.2% against 23.6%, counting everyone, and 23.0% against 25.5% on the efficacy estimand. Novo says it submitted CagriSema to the FDA in December 2025 and expects a decision by late 2026. We found no decision as of October 31, 2026. The full matchup with retatrutide is on CagriSema vs retatrutide.

Survodutide and mazdutide keep glucagon and drop GIP

These two act on GLP-1 and glucagon, two of retatrutide's three receptors. They're the nearest test of whether GIP adds anything on top.

Survodutide

Boehringer Ingelheim's weekly injection reported two Phase 3 trials in 2026. In SYNCHRONIZE-1, 725 adults without diabetes lost 13.0% on 6.0 mg over 76 weeks against 5.4% on placebo, treatment-regimen estimand (NEJM). Boehringer's "up to 16.6%" headline is the efficacy estimand. Stomach and gut side effects were common: 89.7% on 6.0 mg against 47.9% on placebo. In SYNCHRONIZE-2, 752 adults with type 2 diabetes lost 9.8% on 6.0 mg against 3.9%. We found no filing announced by Boehringer as of October 31, 2026. More on survodutide vs retatrutide.

Is mazdutide better than retatrutide?

Not on weight loss, but it's ahead on access. Innovent's mazdutide, licensed from Lilly for China, was approved there for chronic weight management on June 27, 2025. In GLORY-1, 610 Chinese adults with an average BMI of 31.1 lost 14.01% on 6 mg over 48 weeks against a 0.30% gain on placebo, treatment-policy estimand. GLORY-2 tested 9 mg for 60 weeks: 16.65% against 1.50%, with vomiting in 53.1% against 1.3%. China's drug regulator accepted the 9 mg dose for review on November 25, 2025, and we found no decision as of October 31, 2026. See mazdutide vs retatrutide.

Eloralintide, amycretin and MariTide report from 2027

None of these three has Phase 3 results yet; their big trials are running now.

Eloralintide

Lilly's eloralintide acts on the amylin receptor alone, with no GLP-1 component. In its Phase 2 trial of 263 adults, 9 mg averaged 20% weight loss at 48 weeks against 0.4% on placebo (The Lancet), but only under the efficacy estimand. Fatigue was more common than nausea on that dose: 43% against 12% on placebo, with nausea at 33% against 14%. The Phase 3 program, ENLIGHTEN, began in December 2025 with ENLIGHTEN-2 in type 2 diabetes; ENLIGHTEN-1 measures weight at 64 weeks, with an estimated primary completion of March 2028. Details on eloralintide vs retatrutide.

Amycretin

Novo Nordisk's amycretin, which Novo now calls zenagamtide, is one molecule that acts on both GLP-1 and amylin receptors. In a Phase 1b/2a study of 125 people at a single clinic in San Antonio, the 20 mg arm lost 22.0% over 36 weeks against a 1.9% gain on placebo, and the authors note that a large number of participants withdrew. The 60 mg arm lost 24.3%, against 1.1% on placebo. Novo says its AMAZE Phase 3 program started in the first half of 2026. One of those trials, AMAZE 7, pits zenagamtide against semaglutide over 84 weeks; it started on September 22, 2026, with an estimated primary completion of October 2028.

MariTide

Amgen's maridebart cafraglutide is an antibody joined to a peptide. It switches on the GLP-1 receptor and blocks the GIP receptor, the opposite of what retatrutide does at GIP, and it's dosed every 4 weeks, so about 13 shots a year instead of 52. In the Phase 2 trial's obesity group, weight fell 12.3% to 16.2% at 52 weeks against 2.5% on placebo, treatment-policy estimand (NEJM). Stomach side effects were common and eased with a lower starting dose. MARITIME-1 enrolled 3,853 adults and has an estimated primary completion of January 21, 2027.

What you can get now, and what's still in trials

In the US, the new options you can fill are Foundayo and two new forms of semaglutide: the Wegovy pill, launched on January 5, 2026, and Wegovy HD (7.2 mg), approved in March 2026, per Novo's August report. NovoCare lists them at $149 to $299 and $399 a month, self-pay. Mazdutide and ecnoglutide are approved only in China.

Retatrutide, survodutide, eloralintide, amycretin and MariTide are legally available only inside clinical trials. Lilly says retatrutide "cannot be legally sold or marketed for human use", and the FDA says it has warned companies selling unapproved retatrutide, survodutide or mazdutide online with labels claiming the products aren't meant for people. If you're weighing vials sold online, our page on retatrutide for sale covers what lab reports can and can't tell you, including a TGA test of a vial sold as retatrutide that held only undeclared semaglutide.

Our read: retatrutide's 21.0-point placebo gap is the number to beat, and the next two readouts that could test it are TRIUMPH-5, against tirzepatide (November 2026, estimated), and MARITIME-1 (January 2027). If you need treatment before then, ask your doctor which of the drugs you can fill today fits your goals.