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The GLP-1 pipeline in 2026: every major weight-loss drug, tracked
Contents
Prepared by: Research Desk. Sources are linked for verification.
The first wave of modern obesity medicines (injectable semaglutide and tirzepatide) changed medicine. The second wave is now arriving. It includes pills, amylin-based combinations, drugs that hit two or three hormone receptors at once, and generics in some countries. This guide is our master tracker. For each program we give its mechanism, its key trial data with sources, and its status as of the date at the bottom.
Status labels used on this page: Approved (FDA-approved for weight management), Under review (marketing application with the FDA), Investigational (still in trials, not approved for any use).
First, how to read weight-loss numbers
Before the table, a warning. Headline percentages from different trials are not directly comparable. Four things change them:
Trial length. A 48-week result is not comparable with an 80-week result. Weight loss with these drugs often keeps going for many months.
Population. People with type 2 diabetes consistently lose less weight on the same drug than people without diabetes. Compare TRIUMPH-1 and TRIUMPH-2 below.
Estimand. A “treatment-regimen” (or treatment-policy) estimand counts everyone randomized, whether or not they kept receiving the drug. An “efficacy” estimand assumes everyone stayed on the study drug. Efficacy figures are usually larger.
Placebo response. What matters is the difference from placebo, not the raw number.
The only fair comparison is a head-to-head trial. Those are rare but increasing.
The tracker
Drug (developer)
Mechanism
Status (Oct 2026)
Orforglipron (Lilly)
Small-molecule GLP-1 receptor agonist
Approved
for weight management [9]
Oral semaglutide, higher dose (Novo Nordisk)
Peptide GLP-1 receptor agonist
Approved
for weight management [9]
Cagrilintide + semaglutide (Novo Nordisk)
Amylin analogue + GLP-1
Under review
; FDA decision expected December 2026 [9]
Retatrutide (Lilly)
GIP + GLP-1 + glucagon triple agonist
Investigational
Survodutide (Boehringer Ingelheim / Zealand)
Glucagon + GLP-1 dual agonist
Investigational
Mazdutide (Innovent, in China)
Glucagon + GLP-1 dual agonist
Phase 3
data published; not FDA-approved
Amycretin / zenagamtide (Novo Nordisk)
Single molecule acting on GLP-1 and amylin receptors
Investigational
Orforglipron: the first small-molecule GLP-1 pill
What’s different: Orforglipron isn’t a peptide at all. It’s a small molecule that activates the GLP-1 receptor. Unlike oral peptide drugs, it doesn’t need special absorption technology. That makes it potentially easier to manufacture at scale.
Key published data: In a 72-week phase 3 trial in 1,613 adults with obesity or overweight and type 2 diabetes, mean weight change (treatment-regimen estimand) ranged from −5.1% to −9.6% across the orforglipron groups, versus −2.5% with placebo [6]. That population loses less weight than people without diabetes. The pivotal obesity trial without diabetes, ATTAIN-1, is registered as NCT05869903 [10].
Status: Approved by the FDA for weight management. It is marketed as Foundayo, a trademark of Eli Lilly, named here only for identification [9].
Oral semaglutide (higher dose)
Key data: In a 71-week trial, 307 adults with obesity or overweight with complications were randomized 2:1 to higher-dose oral semaglutide or placebo, alongside lifestyle intervention. At week 64, mean weight change was −13.6% versus −2.2% [1]. Gastrointestinal adverse events were more common with the drug (74.0% vs 42.2%) [1].
Status: Approved for weight management [9].
Cagrilintide + semaglutide
Mechanism: Combines a long-acting amylin analogue (cagrilintide) with semaglutide. Amylin is a hormone released with insulin that contributes to fullness.
Key data: In a 68-week trial in east Asian adults, the combination produced −18.4% mean weight change versus −11.9% with semaglutide alone. That’s an estimated difference of 6.5 percentage points [2]. Gastrointestinal events were the most common adverse events in both groups (53% vs 51%) [2]. The global pivotal program includes REDEFINE 1, registered as NCT05567796 [11].
Status: FDA decision expected December 2026, according to a May 2026 industry summary [9]. Cagrilintide on its own is not approved, and FDA says it cannot be used in compounding (see our regulatory explainer).
Retatrutide: the triple agonist
Mechanism: Activates the GIP, GLP-1 and glucagon receptors. In theory the glucagon component adds energy expenditure on top of appetite reduction.
Key data: In TRIUMPH-1, published in the NEJM in September 2026, 2,339 adults with obesity were followed for 80 weeks. Mean weight change ranged from −17.6% to −25.0% across the retatrutide groups, versus −3.9% with placebo [3]. Gastrointestinal events were the most common adverse events [3]. Our sister site TripleReta covers each TRIUMPH trial in detail.
Status: Investigational. Not approved for any use. A May 2026 industry summary lists an FDA decision as a 2027 event [9].
Survodutide
Mechanism: Dual glucagon and GLP-1 receptor agonist. It is also being studied for liver disease (MASH).
Key data: In SYNCHRONIZE-2, 752 adults with obesity and type 2 diabetes were randomized to survodutide or placebo for 76 weeks. Mean weight change was −8.2% to −9.8% across the survodutide groups, versus −3.9% with placebo [4]. HbA1c fell by 0.8 to 0.9 percentage points versus 0.2 with placebo [4]. Gastrointestinal events were very common, occurring in 72.8% of participants in one survodutide group [4].
Status: Investigational. A May 2026 industry summary lists an FDA decision as a 2027 event [9].
Mazdutide
Mechanism: Dual glucagon and GLP-1 receptor agonist, developed for the Chinese market.
Key data: In a 48-week phase 3 trial of 610 Chinese adults with overweight or obesity, mean weight change at week 48 was −11.0% to −14.0% across the mazdutide groups, versus +0.3% with placebo [5]. In a second phase 3 trial (GLORY-2, JAMA 2026), 461 participants saw −16.65% versus −1.50% at week 60 [12]. Vomiting (53.1% vs 1.3%) and nausea (46.9% vs 3.2%) were the most common adverse events [12].
Status: Not FDA-approved. Check Chinese regulatory status separately.
Amycretin (zenagamtide)
Mechanism: A single molecule that acts on both GLP-1 and amylin receptors. It is being developed in more than one formulation.
Key data: The 2026 Lancet publications are 36-week trials in type 2 diabetes. They focus on blood sugar (HbA1c), not weight as the primary outcome. In one formulation, HbA1c fell by 0.9 to 1.7 percentage points across the study groups, with most adverse events gastrointestinal and mild to moderate [7]. A companion paper reports a second formulation [8]. Obesity phase 3 data aren’t yet published.
Status: Investigational.
Generics: liraglutide now, semaglutide abroad
In the U.S., generic liraglutide is available. Teva launched the first generic version for weight management in August 2025 [9]. Generic semaglutide has begun launching in some countries outside the U.S. as patents expire. U.S. patent protection runs longer. We’ll publish a sourced, dated country tracker rather than repeat unverified dates here.
Patterns across the pipeline
More mechanisms, more weight loss, more GI effects. Nausea, vomiting and diarrhoea are the common thread across almost every program [1][2][3][4][12].
Diabetes trials show smaller numbers. Diabetes and obesity trials aren’t directly comparable.
Oral drugs now exist. Published trials of oral drugs have tended to report somewhat smaller average weight change than the strongest injectable drugs.
Head-to-head trials are next. For example, TRIUMPH-5 compares retatrutide with tirzepatide.
What this page is not
This is a research tracker, not medical advice. It doesn’t discuss doses, and it doesn’t point to sources of any drug.
Questions to ask about any “new weight-loss drug” headline
Is it approved, under review or investigational? Check the status column above.
Phase 2 or phase 3? Phase 2 results come from smaller, shorter trials and often look better than later phase 3 data.
Who was studied? Diabetes trials, country-specific trials (such as the Chinese mazdutide trials [5][12]) and global trials aren’t directly comparable.
How long? Look for the week the number was measured.
Which estimand? Treatment-regimen figures are usually lower than efficacy figures.
What about side effects and dropouts? Look for the share of participants who stopped because of adverse events, not just the headline weight change.
Glossary
Incretin: a gut hormone, such as GLP-1 or GIP, that increases insulin release after eating.
Agonist: a drug that activates a receptor.
Dual or triple agonist: a single molecule that activates two or three hormone receptors.
Amylin analogue: a drug that mimics amylin, a fullness hormone released with insulin.
Small molecule: a non-peptide drug that can usually be formulated as a tablet without special absorption technology. Orforglipron is an example.
HbA1c: a blood test reflecting average blood sugar over about three months. It’s the main outcome in diabetes trials such as the amycretin studies [7][8].
Last updated: 18 October 2026.
Not medical advice. This page reports published research and regulatory records for information only.
Research-only notice: Content on this site is provided for research and educational purposes only and is not intended for human use. It is not medical advice.
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