The next GLP-1 drugs, and when they might arrive

Which new weight-loss drugs were approved in the past year?

Three in the US: two daily pills, the Wegovy pill and Foundayo, and Wegovy HD, a higher weekly dose of semaglutide. Two more drugs, mazdutide and ecnoglutide, are approved only in China.

• Wegovy pill, December 22, 2025. Semaglutide as a daily tablet.¹ More on the pills
• Wegovy HD, March 19, 2026. A 7.2 mg weekly dose of semaglutide, approved 54 days after Novo Nordisk applied, under FDA’s national priority voucher program. People lost 18.7% of their weight over 72 weeks, compared with 15.6% on the usual 2.4 mg dose and 3.9% on placebo.^9,10
• Foundayo, April 1, 2026. Lilly’s orforglipron pill, approved 50 days after filing, the first new drug approved under that voucher program.²
• Approved in China only. Mazdutide in June 2025 and ecnoglutide in March 2026, both for weight management.^11,12
• Semaglutide for liver disease. Wegovy shots were approved in August 2025 for MASH, a fatty liver disease, with moderate to advanced scarring. Novo Nordisk expects the FDA’s decision on adding it to the pill in early 2027.^13,14

Which drugs are closest to approval?

CagriSema: the FDA is reviewing it, and Novo Nordisk expects a decision by the end of 2026. Retatrutide comes next; Lilly plans to apply in the first quarter of 2027.

• Survodutide may be next after that. Zealand Pharma, which licensed it to Boehringer Ingelheim, said in May 2026 that its results may lead to applications in 2026.³¹
• Finish dates are estimates. The dates in the chart are what each company has entered on ClinicalTrials.gov, and results can take months more. Survodutide’s heart-safety trial finished in June 2026, and its results are still to come.^16,17,18

How much weight did people lose in the trials?

In each drug’s main final trial, people lost 11.2% to 25.0% of their body weight on average, while placebo groups lost at most 5.4%. The trials differ too much to rank the drugs exactly.

• Two ways to count. Trials report the average for everyone who started, and often a bigger one for people who stayed on the drug: 25.0% and 28.3% for retatrutide, 20.4% and 22.7% for CagriSema. Company announcements often lead with the bigger number.^3,5,7,33,41
• Two head-to-head results, pointing different ways. At full doses, CagriSema lost to tirzepatide: 20.2% compared with 23.6% over 84 weeks. At low doses, in people with type 2 diabetes, it beat tirzepatide 5 mg: 12.4% compared with 9.1% over 60 weeks, counting people who stayed on treatment. Retatrutide’s trial against tirzepatide is expected to finish in November 2026.^4,42,43
• People with type 2 diabetes lost less. Each drug’s diabetes trial showed less weight loss than its main trial: 18.8% for retatrutide, 13.7% for CagriSema, 9.8% for survodutide and 9.6% for orforglipron.^44,45,46,47
• Earlier trials of other drugs. MariTide, a monthly shot, gave up to 16.2% over 52 weeks, and petrelintide up to 10.2% over 42 weeks. Eloralintide’s 20.1% and aleniglipron’s 12.1% count only people who stayed on the drug, VK2735’s 14.7% came after just 13 weeks, and amycretin’s 24.3% from a small early study.^{48,49,50,51,52,53}

How are the new drugs different from Wegovy and Zepbound?

Most act on more than one hormone. Semaglutide copies GLP-1 and tirzepatide adds GIP; the newer drugs add glucagon or amylin, come as pills, or are taken monthly.

• The starting point. Semaglutide acts on the GLP-1 receptor. Tirzepatide acts on the GLP-1 and GIP receptors.^54,55
• GLP-1 and GIP. VK2735 works like tirzepatide. MariTide, a monthly antibody-peptide shot, activates the GLP-1 receptor but blocks GIP’s.^19,21
• GLP-1 and glucagon. Survodutide and mazdutide.^11,41
• All three. Retatrutide activates the GIP, GLP-1 and glucagon receptors.^5,56
• Amylin. Cagrilintide, eloralintide and petrelintide act on amylin receptors. CagriSema pairs cagrilintide with semaglutide, and amycretin does both jobs in one molecule.^{3,39,49,50,53}
• Pills that aren’t peptides. Orforglipron and aleniglipron are small molecules that act on the GLP-1 receptor and are swallowed rather than injected.^40,51
• Fewer shots. MariTide is given every 4 weeks, and Pfizer is testing monthly doses of berobenatide, a long-acting GLP-1 drug.^48,57,58
• Not a hormone drug. Tesofensine works on brain chemicals instead, as a reuptake inhibitor. Mexico’s regulator didn’t approve it in 2024; Saniona’s partner Medix resubmitted in February 2025 and, as of August 2026, was still seeking approval.^59,60,61,62

Is there a GLP-1 pill?

Two are approved in the US: the Wegovy pill, taken each morning on an empty stomach, and Foundayo, which has no food or water rules. Three more pills are in or entering final trials.

• Wegovy pill. Taken once a day on an empty stomach in the morning, with up to 4 ounces of water. People lost 13.6% of their weight over 64 weeks, compared with 2.4% on placebo.³⁶
• Foundayo. People lost 11.2% of their weight over 72 weeks, compared with 2.1% on placebo; people with type 2 diabetes lost 9.6%. The 36 mg dose in its trials was a capsule; the UK label equates it to the 17.2 mg tablet, the top daily dose.^40,47,63

• Approved uses. In the US, Foundayo is approved for weight loss only so far; Lilly has applied for type 2 diabetes. The UK approved both on August 10, 2026, and an EU committee recommended approval on October 15, 2026.^2,6,63,64
• Pills in final trials. Aleniglipron, expected to finish in September 2028; a pill version of amycretin, in June 2028; and a pill version of VK2735, due to start final trials in late 2026.^22,26,28

When will CagriSema be approved?

Novo Nordisk expects the FDA’s decision in the last three months of 2026. It applied on December 18, 2025, for a weekly shot of cagrilintide and semaglutide.

• What it is. 2.4 mg of cagrilintide and 2.4 mg of semaglutide in one weekly shot.³
• The main trial. In REDEFINE 1, 3,417 adults without diabetes lost 20.4% of their weight on average over 68 weeks, compared with 3.0% on placebo.³³
• Against tirzepatide: one loss, one win. In REDEFINE 4, people lost 20.2% on CagriSema and 23.6% on tirzepatide 15 mg over 84 weeks, so it failed to show it was at least as good.⁴² In REIMAGINE 5, adults with type 2 diabetes on a low 1 mg + 1 mg dose lost 12.4% over 60 weeks, compared with 9.1% on tirzepatide 5 mg, counting people who stayed on treatment.⁴
• Lower and higher doses. In people without diabetes, the 1 mg + 1 mg dose gave 21.0% over 68 weeks among people who stayed on it, compared with 2.0% on placebo. A trial of cagrilintide with the 7.2 mg semaglutide dose is expected to report in the first half of 2028.^4,14

When will retatrutide be available?

Not before 2027. Lilly plans to apply to the FDA in the first quarter of 2027, and until it’s approved it can’t legally be sold, and FDA says pharmacies can’t compound it.

• The main trial. In TRIUMPH-1, 2,339 adults without diabetes lost 25.0% of their weight on average over 80 weeks on 12 mg, 23.7% on 9 mg and 17.6% on 4 mg, compared with 3.9% on placebo.⁵
• Other trials. 18.8% over 80 weeks in people with type 2 diabetes, and 23.7% over 68 weeks in people with knee osteoarthritis.^44,56,65
• Drug or biologic? Lilly calls its planned application a Biologics License Application. In an October 2, 2026 letter in Lilly’s lawsuit, the FDA said retatrutide isn’t a biological product and would be filed as a new drug instead.^6,66 The lawsuit
• Before approval. Lilly lists an expanded-access program through which a doctor can ask for retatrutide for one patient with severe obesity.⁶⁷

What’s coming for weight-loss drugs in the next year?

The FDA’s decision on CagriSema, survodutide’s heart-safety results and retatrutide’s trial against tirzepatide by the end of 2026, then Lilly’s retatrutide application in early 2027.

1. By the end of 2026

   CagriSema: the FDA’s decision, as Novo Nordisk expects it.⁴

2. Later in 2026

   Survodutide: results of its heart-safety trial, which finished in June 2026.^16,17

3. November 2026

   Retatrutide: TRIUMPH-5, its trial against tirzepatide, expected to finish.⁴³

4. Late 2026

   VK2735: its pill version is expected to start final trials, and Lilly plans final trials of eloralintide combined with tirzepatide.^22,68

5. January 2027

   MariTide: its two main final trials expected to finish.¹⁸

6. Early 2027

   Retatrutide: Lilly plans to apply to the FDA. Wegovy pill: FDA decision on treating MASH, a fatty liver disease.^6,14

7. First half of 2027

   CagriSema: results of REDEFINE 11, a trial of its full weight-loss potential.⁴²

8. No date yet

   Foundayo: the FDA’s decision on type 2 diabetes, and the European Commission’s on approval in the EU.^6,64

Can you get retatrutide or CagriSema before they’re approved?

Not legally, outside a clinical trial or a doctor’s request to the drug maker. FDA says retatrutide and cagrilintide can’t be compounded, and it has warned companies selling “research” versions.

• Not from a pharmacy. FDA says retatrutide and cagrilintide can’t be used in compounding under federal law.⁸
• Not as a “research” product. FDA has warned companies illegally selling unapproved drugs containing semaglutide, tirzepatide, retatrutide, survodutide or mazdutide labeled “for research purposes” or “not for human consumption”.⁸ What “research use only” means
• Lilly’s word on retatrutide. It’s investigational and can’t legally be sold or marketed for human use.¹⁵
• Joining a trial. ClinicalTrials.gov lists each drug’s trials and whether they’re recruiting. Survodutide’s trial in MASH, for one, was recruiting as of October 2026.⁶⁹

Sources

Approvals come from FDA and other regulators; results from the published trials, or company announcements where a trial isn’t published yet; dates from ClinicalTrials.gov and company reports. Tap a number anywhere on this page to see its source.