The GLP-1 Pipeline
"Should I wait for the next one?" is a reasonable question when the reported results keep climbing. Here is what is actually in development, what the trials showed, and — the part most coverage skips — why waiting is usually the wrong call.
Read this first
Retatrutide and CagriSema are not available to buy. Retatrutide is investigational, and CagriSema has been filed for FDA approval but not approved. Anything sold to you as retatrutide outside a clinical trial is coming from outside the licensed pharmacy system — it cannot lawfully be compounded, because compounding a copy requires an approved product to copy.
Retatrutide
Eli Lilly
- Mechanism
- Triple agonist — GIP, GLP-1 and glucagon receptors
- What the trials showed
- In the Phase 3 TRIUMPH-1 trial of 2,339 adults, participants on 12 mg lost an average of 28.3% of body weight (70.3 lb) over 80 weeks, with 45.3% achieving at least 30% weight loss. Lower doses produced 19.0% at 4 mg and 25.9% at 9 mg. Reported results extend to 30.3% at 104 weeks.
- What it means
- These are the largest weight-loss figures reported for a medication to date, and commentary has compared them to bariatric-surgery-level outcomes. Adding glucagon-receptor activity to the GIP/GLP-1 combination appears to increase energy expenditure alongside appetite suppression.
CagriSema
Novo Nordisk
- Mechanism
- Semaglutide plus cagrilintide (an amylin analogue)
- What the trials showed
- In REDEFINE-1, CagriSema produced 22.7% weight loss at 68 weeks versus 2.3% on placebo when analysed assuming continued treatment, and roughly 20% in the analysis including treatment discontinuations. In the REDEFINE-4 open-label head-to-head, CagriSema achieved 23.0% at 84 weeks against 25.5% for Zepbound.
- What it means
- Strong results that nonetheless fell short of the ≥25% figure the market had anticipated, and behind tirzepatide in a direct comparison. Novo Nordisk has filed for FDA approval regardless. The amylin mechanism is genuinely novel and may suit patients who respond poorly to GLP-1 alone.
Orforglipron (Foundayo)
Eli Lilly
- Mechanism
- Oral small-molecule GLP-1 receptor agonist
- What the trials showed
- Already on the market. Providers including Klinic, Shapely and Alloy list it with self-pay pricing from around $149/month, and as little as roughly $25/month with savings offers.
- What it means
- The most practically relevant of the three, because you can actually get it. Being a small molecule rather than a peptide removes the food and water timing restrictions that make earlier oral semaglutide awkward, and small-molecule manufacturing is far more scalable than peptide production.
How these compare to what you can get today
| Medication | Reported average weight loss | Status |
|---|---|---|
| Retatrutide (12 mg) | 28.3% at 80 weeks (TRIUMPH-1) | Investigational |
| Tirzepatide (15 mg) | 20.9% at 72 weeks (SURMOUNT-1) | Approved — Zepbound |
| CagriSema | 22.7% at 68 weeks (REDEFINE-1) | Filed for approval |
| Semaglutide (2.4 mg) | ≈15% at 68 weeks (STEP 1) | Approved — Wegovy |
Figures come from separate trials with different populations, durations and analysis methods, so they are not directly comparable. Only head-to-head trials such as SURMOUNT-5 and REDEFINE-4 support direct comparison.
Should you wait?
Almost certainly not, for four reasons.
- Timelines are long and uncertain. Filing is not approval, and approval is not availability at a price you can pay. CagriSema has been filed; retatrutide has not.
- New drugs launch expensive. Today's affordable pricing — $149/mo for approved semaglutide, $299–$449 for Zepbound — exists because these products have been on the market for years and now face competition. A newly approved drug will not start there.
- Averages are not your outcome. A 28.3% trial mean does not mean you would lose 28.3%. Many people reach their goal on semaglutide, which is cheaper, better understood and has the strongest cardiovascular outcomes evidence from the SELECT trial.
- Waiting has a cost. Time spent not treating a chronic condition is not neutral. If treatment is appropriate for you now, starting now and switching later is almost always better than deferring.
The sensible posture is to start on something approved and available, and revisit when something genuinely better is purchasable. See semaglutide vs. tirzepatide for the choice that actually faces you today.
Frequently asked questions
Can I join a retatrutide clinical trial?
Trials in the TRIUMPH program have been recruiting, and ClinicalTrials.gov is the authoritative place to check current status and sites. Eligibility is typically a BMI of 30 or above, or 27 or above with a weight-related condition. Discuss it with your clinician — trial participation has real trade-offs including possible placebo assignment.
Someone is selling me compounded retatrutide. Is that legitimate?
No. Compounding a copy of a drug requires an approved product to copy, and retatrutide has never been approved. Any seller offering it is operating outside the licensed pharmacy system, and the FDA has warned about fraudulent compounded GLP-1 products carrying false label information. See our guide to vetting a provider.
Is CagriSema better than Zepbound?
Not on the head-to-head evidence so far. In the REDEFINE-4 open-label trial, CagriSema achieved 23.0% weight loss at 84 weeks against 25.5% for Zepbound. CagriSema's amylin mechanism is novel and may suit some patients better, but it did not outperform in direct comparison.
What can I actually get today that is new?
Orforglipron, sold as Foundayo — an approved oral GLP-1 available now from around $149/month self-pay. It is the one genuinely new option you can act on. See oral and needle-free providers.
Where to go next
Medical disclaimer
This article is general information, not medical advice, and it is not a recommendation to use, wait for, or seek any investigational medication. Retatrutide is investigational and not FDA-approved; CagriSema has been filed for approval but is not approved. Clinical trial results describe group averages under trial conditions and do not predict individual outcomes. Never obtain an investigational drug outside a registered clinical trial. Discuss any treatment decision with a licensed healthcare professional who knows your medical history.
Date reviewed: August 3, 2026