Skip to contentNEWRetatrutide beat Ozempic head to head in TRANSCEND-T2D-2. What the sixth Phase 3 trial found
Retatrutide360

Compare Weight-Loss Drugs: Retatrutide vs Tirzepatide vs Semaglutide

Retatrutide vs tirzepatide vs semaglutide side by side, plus 7 newer drugs: weight loss, A1C, side effects, status and US price, each number sourced (Oct 2026).

Pick 2 or 3 drugs

Each number names its dose, trial, length and comparator. The [1], [2] marks link to the source.

Comparing Retatrutide, Tirzepatide and Semaglutide.

Retatrutide, Tirzepatide and Semaglutide compared
DrugRetatrutideTirzepatideZepbound, MounjaroSemaglutideWegovy, Ozempic
MakerEli LillyEli LillyNovo Nordisk
Brand namesNone yetZepbound, MounjaroWegovy, Ozempic
What it acts onGIP, GLP-1 and glucagon receptor agonist (a triple agonist)GIP and GLP-1 receptor agonist (a dual agonist)GLP-1 receptor agonist
How it is takenWeekly injection (in trials)Weekly injection (pen or vial)Weekly injection (Wegovy, Wegovy HD, Ozempic) or a daily pill taken on an empty stomach (Wegovy pill)
Status, Oct 2026In Phase 3Phase 3; six trials have reported. No approved version exists yet. Lilly last said (Sep 29, 2026) it plans to submit to the FDA in Q1 2027; on Oct 2, 2026 the FDA decided an application goes under section 505 (a drug, not a biologic), and Lilly is appealing.[4][5][6]Approved (US)FDA approved: Mounjaro for type 2 diabetes (May 13, 2022), Zepbound for weight management (Nov 8, 2023).[5][6]Approved (US)FDA approved: Ozempic for type 2 diabetes (2017), Wegovy 2.4 mg for weight (Jun 4, 2021), Wegovy pill 25 mg (Dec 22, 2025), Wegovy HD 7.2 mg (Mar 19, 2026).[7][8][2]
Weight change, if everyone stayed on it-28.3%12 mg, TRIUMPH-1, 80 weeks; placebo -2.2%[1]-22.5%15 mg, SURMOUNT-1, 72 weeks; placebo -2.4%[2]-20.7%7.2 mg (Wegovy HD), STEP UP, 72 weeks[2]
Weight change, everyone randomized-25.0%12 mg, TRIUMPH-1, 80 weeks; placebo -3.9%[2]-20.9%15 mg, SURMOUNT-1, 72 weeks; placebo -3.1%[1]-18.7%7.2 mg (Wegovy HD), STEP UP, 72 weeks; placebo -3.9%[1]
A1C change (type 2 diabetes)-2.2points from 8.3%; 12 mg (9 mg also -2.2), TRANSCEND-T2D-2, 80 weeks; Ozempic 2 mg -1.8; efficacy estimand (if everyone stayed on treatment)[3]-2.30points from 8.28%; 15 mg, SURPASS-2, 40 weeks; semaglutide 1 mg -1.86; estimand not named in the source[3]-2.2points from 8.9%; Ozempic 2 mg, SUSTAIN FORTE, 40 weeks; semaglutide 1 mg -1.9; efficacy estimand (if everyone stayed on treatment)[5]
Stomach and gut side effects
Nausea
42.4% vs 14.8%
Vomiting
25.3% vs 4.8%
Diarrhea
32.0% vs 13.5%
Constipation
26.1% vs 10.9%
12 mg, TRIUMPH-1; second figure is placebo[1]
Nausea
28% vs 8%
Vomiting
13% vs 2%
Diarrhea
23% vs 8%
Constipation
11% vs 5%
15 mg, Zepbound label (SURMOUNT-1 and -2 pooled); second figure is placebo[4]
Nausea
44% vs 16%
Vomiting
24% vs 6%
Diarrhea
30% vs 16%
Constipation
24% vs 11%
2.4 mg, Wegovy label; second figure is placebo[6]
Stopped because of side effects11.3%12 mg, TRIUMPH-1; placebo 4.9%[1]6.7%15 mg, Zepbound label (SURMOUNT-1 and -2 pooled); placebo 3.4%[4]6.8%2.4 mg, Wegovy label; placebo 3.2%[6]
US price the maker publishesNone (not approved in the US)Zepbound self-pay on LillyDirect (vials or KwikPen): $299 (2.5 mg), $399 (5 mg), $449 (7.5 to 15 mg) a month. The $449 price needs a refill within 45 days; otherwise 7.5 mg is $499 and 10 to 15 mg are $699.[7]Wegovy self-pay through NovoCare: $349 a month for pens 0.25 to 2.4 mg ($199 for a new patient's first 2 fills of 0.25 and 0.5 mg, through Dec 31, 2026), $399 for Wegovy HD 7.2 mg, $149 to $299 for the pill. List price $1,349.02 per package.[9][10]
Also worth knowingHead-to-head: in TRANSCEND-T2D-2 (type 2 diabetes, open-label), 12 mg lost 20.9% against 9.4% on Ozempic 2 mg at 80 weeks (efficacy estimand). TRIUMPH-5, against tirzepatide, had not reported as of Oct 31, 2026.[3]Head-to-head: in SURMOUNT-5 (open-label, 72 weeks), tirzepatide 10 or 15 mg lost 20.2% against 13.7% on semaglutide 1.7 or 2.4 mg.[8]Other doses: Wegovy 2.4 mg lost 14.9% against 2.4% on placebo at 68 weeks (STEP 1, treatment-regimen). The Wegovy pill lost 13.6% against 2.2% at 64 weeks (OASIS 4, treatment-regimen), or 16.6% if everyone stayed on it. On Wegovy HD 7.2 mg the label lists nausea in 39% and vomiting in 22%.[3][4][8][6]

Retatrutide sources (checked 2026-10-31)

  1. Lilly's triple agonist, retatrutide, delivered powerful weight loss in pivotal Phase 3 obesity trial (TRIUMPH-1). Eli Lilly and Company (PR Newswire), 2026. prnewswire.com
  2. Retatrutide, a Triple Hormone Receptor Agonist, for Treatment of Obesity (TRIUMPH-1). New England Journal of Medicine, 2026. doi.org
  3. Lilly's retatrutide delivered greater A1C reduction and more than double the weight loss of Ozempic's highest approved dose in head-to-head trial (TRANSCEND-T2D-2). Eli Lilly and Company (PR Newswire), 2026. prnewswire.com
  4. Lilly's triple agonist, retatrutide, delivered substantial weight loss and A1C reduction in people with obesity and type 2 diabetes (TRIUMPH-2, Sep 29, 2026). Eli Lilly and Company (PR Newswire), 2026. prnewswire.com
  5. FDA letter of Oct 2, 2026 on retatrutide (Eli Lilly and Company v. Kennedy, 7th Cir. No. 26-1301, Doc. 46-2). U.S. Food and Drug Administration (via CourtListener), 2026. storage.courtlistener.com
  6. What to know about retatrutide. Eli Lilly and Company, 2026. lilly.com

Tirzepatide sources (checked 2026-10-31)

  1. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1). New England Journal of Medicine, 2022. doi.org
  2. Lilly's SURMOUNT-1 results published in The New England Journal of Medicine show tirzepatide achieved between 16.0% and 22.5% weight loss. Eli Lilly and Company (PR Newswire), 2022. prnewswire.com
  3. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes (SURPASS-2). New England Journal of Medicine, 2021. doi.org
  4. Zepbound (tirzepatide) injection: prescribing information. U.S. National Library of Medicine, DailyMed, 2026. dailymed.nlm.nih.gov
  5. FDA approves Lilly's Mounjaro (tirzepatide) injection, the first and only GIP and GLP-1 receptor agonist for the treatment of adults with type 2 diabetes. Eli Lilly and Company (PR Newswire), 2022. prnewswire.com
  6. FDA approves Lilly's Zepbound (tirzepatide) for chronic weight management. Eli Lilly and Company (PR Newswire), 2023. prnewswire.com
  7. Zepbound on LillyDirect: self-pay prices. Eli Lilly and Company, 2026. lilly.com
  8. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5). New England Journal of Medicine, 2025. doi.org

Semaglutide sources (checked 2026-10-31)

  1. Once-weekly semaglutide 7.2 mg in adults with obesity (STEP UP): a randomised, controlled, phase 3b trial. The Lancet Diabetes & Endocrinology, 2025. doi.org
  2. Wegovy HD (semaglutide 7.2 mg) approved in the US, providing 20.7% mean weight loss. Novo Nordisk (via BioSpace), 2026. biospace.com
  3. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). New England Journal of Medicine, 2021. doi.org
  4. Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity (OASIS 4). New England Journal of Medicine, 2025. doi.org
  5. Efficacy and safety of once-weekly semaglutide 2.0 mg versus 1.0 mg in patients with type 2 diabetes (SUSTAIN FORTE). The Lancet Diabetes & Endocrinology, 2021. doi.org
  6. Wegovy (semaglutide) injection and tablets: prescribing information. U.S. National Library of Medicine, DailyMed, 2026. dailymed.nlm.nih.gov
  7. FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014. U.S. Food and Drug Administration (via BioSpace), 2021. biospace.com
  8. Wegovy pill approved in the US as first oral GLP-1 for weight management (Form 6-K). Novo Nordisk (SEC filing), 2025. sec.gov
  9. NovoCare Pharmacy: self-pay prices. Novo Nordisk, 2026. novocare.com
  10. Wegovy: list price. Novo Nordisk (NovoCare), 2026. novocare.com

Most of these numbers come from different trials

Only a few rows are head-to-head (each drug's notes say which). The rest come from separate trials with different people, lengths, doses and comparators, and they count dropouts in different ways. The efficacy estimand assumes everyone stayed on the drug; the treatment-regimen estimand counts everyone randomized. Compare like with like, and treat a gap of a few points between trials as noise, not a ranking.

All 10 drugs, every number

Checked against the primary sources on October 31, 2026. A blank means we found no published figure, not zero.

All 10 weight-loss drugs compared
DrugRetatrutideTirzepatideZepbound, MounjaroSemaglutideWegovy, OzempicOrforglipronFoundayoCagriSemaSurvodutideMazdutideEloralintideMariTide (maridebart cafraglutide)Amycretin
MakerEli LillyEli LillyNovo NordiskEli LillyNovo NordiskBoehringer Ingelheim (licensed from Zealand Pharma)Innovent Biologics (licensed from Eli Lilly for China)Eli LillyAmgenNovo Nordisk
Brand namesNone yetZepbound, MounjaroWegovy, OzempicFoundayoNone yetNone yetNone yetNone yetNone yetNone yet
What it acts onGIP, GLP-1 and glucagon receptor agonist (a triple agonist)GIP and GLP-1 receptor agonist (a dual agonist)GLP-1 receptor agonistGLP-1 receptor agonist; a small molecule, not a peptideTwo drugs in one injection: cagrilintide (an amylin analogue) plus semaglutide (a GLP-1 receptor agonist)Glucagon and GLP-1 receptor agonist (a dual agonist)GLP-1 and glucagon receptor agonist (a dual agonist)Amylin receptor agonist only (selective)Turns on the GLP-1 receptor and blocks the GIP receptor; a peptide joined to an antibodyOne molecule that acts on GLP-1 and amylin receptors
How it is takenWeekly injection (in trials)Weekly injection (pen or vial)Weekly injection (Wegovy, Wegovy HD, Ozempic) or a daily pill taken on an empty stomach (Wegovy pill)Daily pill, any time of day, with or without foodWeekly injection (cagrilintide 2.4 mg with semaglutide 2.4 mg)Weekly injectionWeekly injectionWeekly injectionInjection every 4 weeks (some Phase 2 arms every 8 weeks)Weekly injection (an oral version is also in development)
Status, Oct 2026In Phase 3Phase 3; six trials have reported. No approved version exists yet. Lilly last said (Sep 29, 2026) it plans to submit to the FDA in Q1 2027; on Oct 2, 2026 the FDA decided an application goes under section 505 (a drug, not a biologic), and Lilly is appealing.[4][5][6]Approved (US)FDA approved: Mounjaro for type 2 diabetes (May 13, 2022), Zepbound for weight management (Nov 8, 2023).[5][6]Approved (US)FDA approved: Ozempic for type 2 diabetes (2017), Wegovy 2.4 mg for weight (Jun 4, 2021), Wegovy pill 25 mg (Dec 22, 2025), Wegovy HD 7.2 mg (Mar 19, 2026).[7][8][2]Approved (US)FDA approved as Foundayo for weight management (Apr 1, 2026).[2]FiledFiled: Novo submitted a New Drug Application to the FDA (announced Dec 18, 2025). We found no FDA decision as of Oct 31, 2026.[2]In Phase 3Phase 3; SYNCHRONIZE-1 and -2 are published. Not approved anywhere, and we found no filing announcement as of Oct 31, 2026.[1][3][2]Approved outside the USApproved in China (NMPA) for weight management (announced Jun 27, 2025) and for type 2 diabetes (announced Sep 19, 2025). Not approved in the US.[2][4]In Phase 3Phase 3 (ENLIGHTEN) started Dec 15, 2025; no Phase 3 results yet. The best data are from Phase 2.[2][3]In Phase 3Phase 3 (MARITIME-1 started Mar 12, 2025; primary completion Jan 2027, est.). The best data are from Phase 2.[3]In Phase 3Phase 3 (AMAZE 1 started Feb 24, 2026). The best data are from a small Phase 1b/2a study.[3][2]
Weight change, if everyone stayed on it-28.3%12 mg, TRIUMPH-1, 80 weeks; placebo -2.2%[1]-22.5%15 mg, SURMOUNT-1, 72 weeks; placebo -2.4%[2]-20.7%7.2 mg (Wegovy HD), STEP UP, 72 weeks[2]-12.4%36 mg capsule (Foundayo 17.2 mg tablet), ATTAIN-1, 72 weeks; placebo -0.9%[2][3]-22.7%2.4 mg + 2.4 mg, REDEFINE 1, 68 weeks; placebo -2.3%[2]up to-16.6%dose not stated (3.6 or 6.0 mg), SYNCHRONIZE-1, 76 weeks; placebo -3.2%[2]-14.8%6 mg, GLORY-1, 48 weeks; placebo -0.5%[2]-20%9 mg, Phase 2, 48 weeks; placebo -0.4%[1]Phase 2 onlyup to about-20%best arm, Phase 2, 52 weeks[2]Phase 2 onlyNo published figure
Weight change, everyone randomized-25.0%12 mg, TRIUMPH-1, 80 weeks; placebo -3.9%[2]-20.9%15 mg, SURMOUNT-1, 72 weeks; placebo -3.1%[1]-18.7%7.2 mg (Wegovy HD), STEP UP, 72 weeks; placebo -3.9%[1]-11.2%36 mg capsule (Foundayo 17.2 mg tablet), ATTAIN-1, 72 weeks; placebo -2.1%[1][3]-20.4%2.4 mg + 2.4 mg, REDEFINE 1, 68 weeks; placebo -3.0%[1]-13.0%6.0 mg, SYNCHRONIZE-1, 76 weeks; placebo -5.4%[1]-14.01%6 mg, GLORY-1, 48 weeks; placebo +0.30%[1]No published figureup to-16.2%best arm, Phase 2, 52 weeks; placebo -2.5%[1]Phase 2 onlyNo published figure
Weight change, method not namedNo published figureNo published figureNo published figureNo published figureNo published figureNo published figure-16.65%9 mg, GLORY-2, 60 weeks; placebo -1.50%[3]No published figureNo published figure-22.0%20 mg, Phase 1b/2a, 36 weeks; placebo +1.9%[1]Phase 1b/2a only
A1C change (type 2 diabetes)-2.2points from 8.3%; 12 mg (9 mg also -2.2), TRANSCEND-T2D-2, 80 weeks; Ozempic 2 mg -1.8; efficacy estimand (if everyone stayed on treatment)[3]-2.30points from 8.28%; 15 mg, SURPASS-2, 40 weeks; semaglutide 1 mg -1.86; estimand not named in the source[3]-2.2points from 8.9%; Ozempic 2 mg, SUSTAIN FORTE, 40 weeks; semaglutide 1 mg -1.9; efficacy estimand (if everyone stayed on treatment)[5]-1.48points from 8.0%; 36 mg capsule, ACHIEVE-1, 40 weeks; placebo -0.41; estimand not named in the source[4]No published figure-0.9points from 7.4%; 3.6 mg (6.0 mg: -0.8), SYNCHRONIZE-2, 76 weeks; placebo -0.2; estimand not named in the source[3]-2.15points; 6 mg, DREAMS-1, 24 weeks; placebo -0.14; efficacy estimand (if everyone stayed on treatment)[4]No published figure-1.2 to -1.6points; 140 to 420 mg, Phase 2 (obesity with type 2 diabetes), 52 weeks; placebo +0.1; treatment-regimen estimand (everyone randomized)[1]No published figure
Stomach and gut side effects
Nausea
42.4% vs 14.8%
Vomiting
25.3% vs 4.8%
Diarrhea
32.0% vs 13.5%
Constipation
26.1% vs 10.9%
12 mg, TRIUMPH-1; second figure is placebo[1]
Nausea
28% vs 8%
Vomiting
13% vs 2%
Diarrhea
23% vs 8%
Constipation
11% vs 5%
15 mg, Zepbound label (SURMOUNT-1 and -2 pooled); second figure is placebo[4]
Nausea
44% vs 16%
Vomiting
24% vs 6%
Diarrhea
30% vs 16%
Constipation
24% vs 11%
2.4 mg, Wegovy label; second figure is placebo[6]
Nausea
35% vs 10%
Vomiting
24% vs 4%
Diarrhea
25% vs 11%
Constipation
24% vs 9%
17.2 mg, Foundayo label (2 weight trials pooled); second figure is placebo[5]
Nausea
55% vs 12.6%
Vomiting
26.1% vs 4.1%
Constipation
30.7% vs 11.6%
Any stomach or gut effect
79.6% vs 39.9%
2.4 mg + 2.4 mg, REDEFINE 1; second figure is placebo[2][1]
Any stomach or gut effect
89.7% vs 47.9%
6.0 mg, SYNCHRONIZE-1; second figure is placebo[1]
Nausea
46.9% vs 3.2%
Vomiting
53.1% vs 1.3%
Diarrhea
39.4% vs 6.5%
9 mg, GLORY-2; second figure is placebo[3]
Nausea
33% vs 14%
9 mg, Phase 2; second figure is placebo[1]		No published figureNo published figure
Stopped because of side effects11.3%12 mg, TRIUMPH-1; placebo 4.9%[1]6.7%15 mg, Zepbound label (SURMOUNT-1 and -2 pooled); placebo 3.4%[4]6.8%2.4 mg, Wegovy label; placebo 3.2%[6]10%17.2 mg, Foundayo label (2 weight trials pooled); placebo 3%[5]5.9%2.4 mg + 2.4 mg, REDEFINE 1; placebo 3.5%[2]No published figure0.5%6 mg, GLORY-1; placebo 1.0%[1]No published figure7.8%Up to this share stopped for stomach or gut side effects; dose-escalation arms, Phase 2[2]No published figure
US price the maker publishesNone (not approved in the US)Zepbound self-pay on LillyDirect (vials or KwikPen): $299 (2.5 mg), $399 (5 mg), $449 (7.5 to 15 mg) a month. The $449 price needs a refill within 45 days; otherwise 7.5 mg is $499 and 10 to 15 mg are $699.[7]Wegovy self-pay through NovoCare: $349 a month for pens 0.25 to 2.4 mg ($199 for a new patient's first 2 fills of 0.25 and 0.5 mg, through Dec 31, 2026), $399 for Wegovy HD 7.2 mg, $149 to $299 for the pill. List price $1,349.02 per package.[9][10]Foundayo self-pay on LillyDirect: $149 (0.8 and 2.5 mg), $199 (5.5 mg), $299 (9, 14.5 and 17.2 mg) a month. The 2.5 and 5.5 mg prices are temporary cuts through Dec 31, 2026; the top doses are $299 if refilled within 45 days.[6]None (not approved in the US)None (not approved in the US)None (not approved in the US)None (not approved in the US)None (not approved in the US)None (not approved in the US)
Also worth knowingHead-to-head: in TRANSCEND-T2D-2 (type 2 diabetes, open-label), 12 mg lost 20.9% against 9.4% on Ozempic 2 mg at 80 weeks (efficacy estimand). TRIUMPH-5, against tirzepatide, had not reported as of Oct 31, 2026.[3]Head-to-head: in SURMOUNT-5 (open-label, 72 weeks), tirzepatide 10 or 15 mg lost 20.2% against 13.7% on semaglutide 1.7 or 2.4 mg.[8]Other doses: Wegovy 2.4 mg lost 14.9% against 2.4% on placebo at 68 weeks (STEP 1, treatment-regimen). The Wegovy pill lost 13.6% against 2.2% at 64 weeks (OASIS 4, treatment-regimen), or 16.6% if everyone stayed on it. On Wegovy HD 7.2 mg the label lists nausea in 39% and vomiting in 22%.[3][4][8][6]The trials used capsules; a 36 mg capsule matches the 17.2 mg Foundayo tablet, and the two are not swapped mg for mg. Lilly's release gives 11.1% for the treatment-regimen result; the NEJM paper gives 11.2%.[3][2][1]Against semaglutide alone: in REDEFINE 5 (Japan and Taiwan, 68 weeks), CagriSema lost 18.4% against 11.9% on semaglutide 2.4 mg (trial product estimand, the efficacy kind).[3]In adults with type 2 diabetes (SYNCHRONIZE-2), 6.0 mg lost 9.8% against 3.9% on placebo at 76 weeks (treatment-regimen).[3]Every trial here enrolled Chinese adults, who started lighter (87.2 kg on average in GLORY-1). In GLORY-2, 2.9% stopped 9 mg for side effects against 0% on placebo.[1][3]A Phase 2 trial of 263 people. Fatigue was common: 43% on 9 mg against 12% on placebo.[1]Nothing to addA single-site study of 125 people, and many withdrew. The 60 mg group lost 24.3% against 1.1% on placebo at 36 weeks.[1]

Retatrutide sources (checked 2026-10-31)

  1. Lilly's triple agonist, retatrutide, delivered powerful weight loss in pivotal Phase 3 obesity trial (TRIUMPH-1). Eli Lilly and Company (PR Newswire), 2026. prnewswire.com
  2. Retatrutide, a Triple Hormone Receptor Agonist, for Treatment of Obesity (TRIUMPH-1). New England Journal of Medicine, 2026. doi.org
  3. Lilly's retatrutide delivered greater A1C reduction and more than double the weight loss of Ozempic's highest approved dose in head-to-head trial (TRANSCEND-T2D-2). Eli Lilly and Company (PR Newswire), 2026. prnewswire.com
  4. Lilly's triple agonist, retatrutide, delivered substantial weight loss and A1C reduction in people with obesity and type 2 diabetes (TRIUMPH-2, Sep 29, 2026). Eli Lilly and Company (PR Newswire), 2026. prnewswire.com
  5. FDA letter of Oct 2, 2026 on retatrutide (Eli Lilly and Company v. Kennedy, 7th Cir. No. 26-1301, Doc. 46-2). U.S. Food and Drug Administration (via CourtListener), 2026. storage.courtlistener.com
  6. What to know about retatrutide. Eli Lilly and Company, 2026. lilly.com

Tirzepatide sources (checked 2026-10-31)

  1. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1). New England Journal of Medicine, 2022. doi.org
  2. Lilly's SURMOUNT-1 results published in The New England Journal of Medicine show tirzepatide achieved between 16.0% and 22.5% weight loss. Eli Lilly and Company (PR Newswire), 2022. prnewswire.com
  3. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes (SURPASS-2). New England Journal of Medicine, 2021. doi.org
  4. Zepbound (tirzepatide) injection: prescribing information. U.S. National Library of Medicine, DailyMed, 2026. dailymed.nlm.nih.gov
  5. FDA approves Lilly's Mounjaro (tirzepatide) injection, the first and only GIP and GLP-1 receptor agonist for the treatment of adults with type 2 diabetes. Eli Lilly and Company (PR Newswire), 2022. prnewswire.com
  6. FDA approves Lilly's Zepbound (tirzepatide) for chronic weight management. Eli Lilly and Company (PR Newswire), 2023. prnewswire.com
  7. Zepbound on LillyDirect: self-pay prices. Eli Lilly and Company, 2026. lilly.com
  8. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5). New England Journal of Medicine, 2025. doi.org

Semaglutide sources (checked 2026-10-31)

  1. Once-weekly semaglutide 7.2 mg in adults with obesity (STEP UP): a randomised, controlled, phase 3b trial. The Lancet Diabetes & Endocrinology, 2025. doi.org
  2. Wegovy HD (semaglutide 7.2 mg) approved in the US, providing 20.7% mean weight loss. Novo Nordisk (via BioSpace), 2026. biospace.com
  3. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). New England Journal of Medicine, 2021. doi.org
  4. Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity (OASIS 4). New England Journal of Medicine, 2025. doi.org
  5. Efficacy and safety of once-weekly semaglutide 2.0 mg versus 1.0 mg in patients with type 2 diabetes (SUSTAIN FORTE). The Lancet Diabetes & Endocrinology, 2021. doi.org
  6. Wegovy (semaglutide) injection and tablets: prescribing information. U.S. National Library of Medicine, DailyMed, 2026. dailymed.nlm.nih.gov
  7. FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014. U.S. Food and Drug Administration (via BioSpace), 2021. biospace.com
  8. Wegovy pill approved in the US as first oral GLP-1 for weight management (Form 6-K). Novo Nordisk (SEC filing), 2025. sec.gov
  9. NovoCare Pharmacy: self-pay prices. Novo Nordisk, 2026. novocare.com
  10. Wegovy: list price. Novo Nordisk (NovoCare), 2026. novocare.com

Orforglipron sources (checked 2026-10-31)

  1. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment (ATTAIN-1). New England Journal of Medicine, 2025. doi.org
  2. FDA approves Lilly's Foundayo (orforglipron), the only GLP-1 pill for weight loss that can be taken any time of day without food or water restrictions. Eli Lilly and Company (PR Newswire), 2026. prnewswire.com
  3. What dosages of Foundayo (orforglipron) capsules are equivalent to the tablet dosages?. Lilly Medical Information, 2026. medical.lilly.com
  4. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist, in Early Type 2 Diabetes (ACHIEVE-1). New England Journal of Medicine, 2025. doi.org
  5. Foundayo (orforglipron) tablets: prescribing information. U.S. National Library of Medicine, DailyMed, 2026. dailymed.nlm.nih.gov
  6. Foundayo on LillyDirect: self-pay prices. Eli Lilly and Company, 2026. lilly.com

CagriSema sources (checked 2026-10-31)

  1. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity (REDEFINE 1). New England Journal of Medicine, 2025. doi.org
  2. Novo Nordisk files for FDA approval of CagriSema, the first once-weekly combination of GLP-1 and amylin analogues for weight management. Novo Nordisk, 2025. novonordisk.com
  3. Co-administered cagrilintide and semaglutide versus semaglutide alone in adults with overweight or obesity in Japan and Taiwan (REDEFINE 5). The Lancet Diabetes & Endocrinology, 2026. doi.org

Survodutide sources (checked 2026-10-31)

  1. Survodutide Once Weekly for the Treatment of Adults with Obesity (SYNCHRONIZE-1). New England Journal of Medicine, 2026. doi.org
  2. Boehringer Ingelheim's novel glucagon/GLP-1 dual agonist survodutide achieved significant weight loss of 16.6% in Phase III trial. Boehringer Ingelheim (Cision), 2026. newswire.ca
  3. Survodutide Once Weekly in Adults with Obesity and Type 2 Diabetes (SYNCHRONIZE-2). New England Journal of Medicine, 2026. doi.org

Mazdutide sources (checked 2026-10-31)

  1. Once-Weekly Mazdutide in Chinese Adults with Obesity or Overweight (GLORY-1). New England Journal of Medicine, 2025. doi.org
  2. Innovent announces mazdutide, first dual GCG/GLP-1 receptor agonist, received approval from China's NMPA for chronic weight management. Innovent Biologics (PR Newswire), 2025. prnewswire.com
  3. Treatment With 9-mg Mazdutide for Weight Reduction in Chinese Adults With Obesity: The GLORY-2 Randomized Clinical Trial. JAMA, 2026. doi.org
  4. Innovent announces mazdutide received approval from China's NMPA for glycemic control in adults with type 2 diabetes. Innovent Biologics (via BioSpace), 2025. biospace.com

Eloralintide sources (checked 2026-10-31)

  1. Eloralintide, a selective amylin receptor agonist for the treatment of obesity: a 48-week phase 2, multicentre, double-blind, randomised, placebo-controlled trial. The Lancet, 2025. doi.org
  2. A Study of Eloralintide (LY3841136) in Participants With Obesity or Overweight, and Type 2 Diabetes (ENLIGHTEN-2, NCT07282600). ClinicalTrials.gov, 2026. clinicaltrials.gov
  3. A Study of Eloralintide (LY3841136) in Participants With Obesity, or Overweight Without Type 2 Diabetes (ENLIGHTEN-1, NCT07321886). ClinicalTrials.gov, 2026. clinicaltrials.gov

MariTide (maridebart cafraglutide) sources (checked 2026-10-31)

  1. Once-Monthly Maridebart Cafraglutide for the Treatment of Obesity: A Phase 2 Trial. New England Journal of Medicine, 2025. doi.org
  2. Results from Amgen's Phase 2 obesity study of monthly MariTide presented at the American Diabetes Association 85th Scientific Sessions. Amgen, 2025. amgen.com
  3. Evaluation of Maridebart Cafraglutide in Adult Participants Without Type 2 Diabetes Mellitus Who Have Obesity or Are Overweight (MARITIME-1, NCT06858839). ClinicalTrials.gov, 2026. clinicaltrials.gov

Amycretin sources (checked 2026-10-31)

  1. Amycretin, a novel, unimolecular GLP-1 and amylin receptor agonist administered subcutaneously: results from a phase 1b/2a randomised controlled study. The Lancet, 2025. doi.org
  2. Novo Nordisk to advance subcutaneous and oral amycretin for weight management into phase 3 clinical development. Novo Nordisk, 2025. novonordisk.com
  3. Efficacy and Safety of NNC0487-0111 (amycretin) s.c. Once-weekly in Participants With Obesity (AMAZE 1, NCT07339423). ClinicalTrials.gov, 2026. clinicaltrials.gov

Retatrutide vs tirzepatide vs semaglutide, on the best numbers each has published: retatrutide 12 mg lost 28.3% of body weight on average at 80 weeks (TRIUMPH-1), tirzepatide 15 mg lost 22.5% at 72 weeks (SURMOUNT-1) and semaglutide 7.2 mg lost 20.7% at 72 weeks (STEP UP). All three figures assume everyone stayed on treatment. They come from three different trials, so the gaps between them are a rough guide, not a ranking. The tool above lines up those three by default, and the full table puts all 10 drugs side by side with the source for every number, checked on October 31, 2026.

How to read the table

Each cell names its dose, trial, length in weeks and comparator, and the small [1], [2] marks link to the source under the table. A blank cell means we found no published figure. It doesn't mean zero.

Two things deserve a second look. The "Status" row tells you whether you could get the drug at all: tirzepatide, semaglutide and orforglipron are FDA approved, mazdutide is approved only in China, CagriSema has been filed, and the rest are still in trials. Rows flagged "Phase 2 only" or "Phase 1b/2a only" (eloralintide, MariTide, amycretin) come from small, short studies, and early numbers often shrink in Phase 3. The amycretin result comes from 125 people at a single site, and many of them withdrew.

Side-effect rates are the share of people who reported each problem at least once, against placebo in the same trial. For approved drugs we use the FDA label, which pools the main weight trials.

Two numbers from one trial

Most trials report weight loss two ways, and the table gives both rows. The efficacy estimand (Novo calls it the trial product estimand) asks what would have happened if everyone had stayed on the drug. The treatment-regimen estimand (or treatment policy) keeps everyone who was randomized, including people who stopped.

For retatrutide in TRIUMPH-1 that's 28.3% against 25.0%, and the New England Journal of Medicine paper leads with the 25.0%. For tirzepatide in SURMOUNT-1 it's 22.5% against 20.9%. Read across one row at a time. Putting retatrutide's 28.3% next to tirzepatide's 20.9% mixes two methods and inflates the gap.

Why cross-trial gaps mislead

The trials enrolled different people. TRIUMPH-1 participants started at 112.7 kg, while the Chinese adults in GLORY-1 (mazdutide) started at 87.2 kg. The weight results run from 36 to 80 weeks. People with type 2 diabetes tend to lose less: retatrutide 12 mg lost 20.8% in TRIUMPH-2 against 28.3% in TRIUMPH-1 (both efficacy estimand), and survodutide 6.0 mg lost 9.8% in SYNCHRONIZE-2 against 13.0% in SYNCHRONIZE-1 (both treatment-regimen).

A few trials did test one drug against another, and they're the fairest comparisons on the page:

TrialWhoResult
SURMOUNT-5 (72 weeks, open-label)Obesity, no diabetesTirzepatide 20.2% vs semaglutide 13.7%
TRANSCEND-T2D-2 (80 weeks, open-label)Type 2 diabetesRetatrutide 12 mg 20.9% vs Ozempic 2 mg 9.4% (efficacy estimand)
REDEFINE 5 (68 weeks)Japan and TaiwanCagriSema 18.4% vs semaglutide 2.4 mg 11.9% (trial product estimand)
SURPASS-2 (40 weeks, open-label)Type 2 diabetesA1C: tirzepatide 15 mg -2.30 points vs semaglutide 1 mg -1.86

The one most people are waiting for, TRIUMPH-5 (retatrutide against tirzepatide), hadn't reported as of October 31, 2026.

Our read: in both direct weight tests so far, the drug that acts on more receptors lost more, tirzepatide over semaglutide and retatrutide over Ozempic. Two trials can't say the extra receptors are the reason, and the second one was in people with type 2 diabetes. Whether retatrutide beats tirzepatide in the same people, and by how much, waits on TRIUMPH-5.

What you can actually get

Retatrutide has no approved version yet. Lilly last said, on September 29, 2026, that it plans to submit retatrutide to the FDA in the first quarter of 2027, and on October 2, 2026 the FDA decided an application would go under section 505 of the Federal Food, Drug, and Cosmetic Act; Lilly's appeal is pending. Anything sold online as retatrutide isn't Lilly's product; the retatrutide for sale page explains what those vials are and what can go wrong, and the price page covers what the approved options cost.

The price row lists only what the makers publish for US self-pay: Zepbound and Foundayo on LillyDirect, Wegovy on NovoCare. Several of those offers end on December 31, 2026.

The one-on-one comparisons

Each pairing has its own page with the full trial evidence: retatrutide vs tirzepatide, vs semaglutide, vs Zepbound, vs Mounjaro, vs Ozempic and vs orforglipron. For the drugs still in trials there are CagriSema, survodutide, mazdutide and eloralintide, and the new weight loss drugs page covers the whole pipeline. If you're asking whether retatrutide counts as a GLP-1 at all, that page answers it, and retatrutide results has every trial's numbers in one place.

Frequently asked questions

Which works better, retatrutide, tirzepatide or semaglutide?

On the best published averages, retatrutide 12 mg lost 28.3% at 80 weeks (TRIUMPH-1), tirzepatide 15 mg 22.5% at 72 weeks (SURMOUNT-1) and semaglutide 7.2 mg 20.7% at 72 weeks (STEP UP), all as if everyone stayed on treatment. Those are three separate trials. The direct tests so far: tirzepatide beat semaglutide in SURMOUNT-5 (20.2% vs 13.7%), and retatrutide beat Ozempic 2 mg in TRANSCEND-T2D-2 (20.9% vs 9.4%). Retatrutide against tirzepatide (TRIUMPH-5) hadn't reported as of October 31, 2026.

Why does the same drug show two weight-loss numbers?

Trials count people who stop in two ways. The efficacy estimand asks what would have happened if everyone had stayed on the drug; the treatment-regimen estimand keeps everyone randomized, including people who quit. For retatrutide in TRIUMPH-1 that's 28.3% against 25.0%. Compare efficacy with efficacy and treatment-regimen with treatment-regimen.

Is retatrutide approved?

No. No approved version exists yet anywhere. Six Phase 3 trials have reported, Lilly last said it plans to submit to the FDA in the first quarter of 2027, and on October 2, 2026 the FDA decided an application would go under section 505 (as a drug, not a biologic). Lilly is appealing that decision.

Which of these drugs come as a pill?

Two are approved as daily pills in the US: Foundayo (orforglipron), which can be taken any time with or without food, and the Wegovy pill (semaglutide 25 mg), taken on an empty stomach. Novo Nordisk is also developing an oral version of amycretin. Every other drug in the table is an injection, weekly for most and every 4 weeks for MariTide.

Where do the prices come from?

Only from the makers' own US pages: LillyDirect for Zepbound and Foundayo, NovoCare for Wegovy. We list a price only where the maker publishes one, so drugs that aren't approved in the US show none. Some of those offers end on December 31, 2026.

Sources

  1. Retatrutide, a Triple Hormone Receptor Agonist, for Treatment of Obesity (TRIUMPH-1). New England Journal of Medicine, 2026. doi.org
  2. Lilly's triple agonist, retatrutide, delivered powerful weight loss in pivotal Phase 3 obesity trial (TRIUMPH-1). Eli Lilly and Company (PR Newswire), 2026. prnewswire.com
  3. Lilly's retatrutide delivered greater A1C reduction and more than double the weight loss of Ozempic's highest approved dose in head-to-head trial (TRANSCEND-T2D-2). Eli Lilly and Company (PR Newswire), 2026. prnewswire.com
  4. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1). New England Journal of Medicine, 2022. doi.org
  5. Lilly's SURMOUNT-1 results published in The New England Journal of Medicine show tirzepatide achieved between 16.0% and 22.5% weight loss. Eli Lilly and Company (PR Newswire), 2022. prnewswire.com
  6. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5). New England Journal of Medicine, 2025. doi.org
  7. Once-weekly semaglutide 7.2 mg in adults with obesity (STEP UP): a randomised, controlled, phase 3b trial. The Lancet Diabetes & Endocrinology, 2025. doi.org
  8. Wegovy HD (semaglutide 7.2 mg) approved in the US, providing 20.7% mean weight loss. Novo Nordisk (via BioSpace), 2026. biospace.com
  9. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes (SURPASS-2). New England Journal of Medicine, 2021. doi.org
  10. Co-administered cagrilintide and semaglutide versus semaglutide alone in adults with overweight or obesity in Japan and Taiwan (REDEFINE 5). The Lancet Diabetes & Endocrinology, 2026. doi.org
  11. Once-Weekly Mazdutide in Chinese Adults with Obesity or Overweight (GLORY-1). New England Journal of Medicine, 2025. doi.org
  12. Amycretin, a novel, unimolecular GLP-1 and amylin receptor agonist administered subcutaneously: results from a phase 1b/2a randomised controlled study. The Lancet, 2025. doi.org
  13. Novo Nordisk files for FDA approval of CagriSema, the first once-weekly combination of GLP-1 and amylin analogues for weight management. Novo Nordisk, 2025. novonordisk.com
  14. FDA approves Lilly's Foundayo (orforglipron), the only GLP-1 pill for weight loss that can be taken any time of day without food or water restrictions. Eli Lilly and Company (PR Newswire), 2026. prnewswire.com
  15. Lilly's triple agonist, retatrutide, delivered substantial weight loss and A1C reduction in people with obesity and type 2 diabetes (Sep 29, 2026). Eli Lilly and Company (PR Newswire), 2026. prnewswire.com
  16. FDA letter of Oct 2, 2026 on retatrutide (Eli Lilly and Company v. Kennedy, 7th Cir. No. 26-1301, Doc. 46-2). U.S. Food and Drug Administration (via CourtListener), 2026. storage.courtlistener.com
Medical disclaimer. Retatrutide is an investigational medicine and no approved version exists yet. This page is educational, not medical advice. Talk to a doctor before starting, changing or stopping any medication, and get urgent care for severe symptoms.