Every GLP-1 Drug in Development in 2026: The Full Pipeline, Explained

Five years ago there were two serious prescription options for weight loss and one of them barely worked. Today one drug intelligence platform tracks more than 150 active obesity programs, spanning everything from injectable triple agonists to RNA drugs that change how fat tissue behaves [1].

That is good news, but it also makes the field genuinely confusing. Drugs get renamed halfway through development. Companies report weight-loss percentages from trials that ran for different lengths of time in different kinds of patients. And a lot of what circulates online as a “new weight loss drug” is either years away or not a legal medicine at all.

This guide walks through the whole pipeline in plain English: what is approved, what is close, what is far away, and what each candidate is actually trying to do differently. Nothing here is medical advice, and no drug below should be started or stopped without talking to a healthcare provider.

What is already approved in the United States?

Before getting to the pipeline, it helps to know the baseline the pipeline has to beat.

• Semaglutide (Novo Nordisk) is a GLP-1 receptor agonist. It is sold as Ozempic for type 2 diabetes, Wegovy for weight management, and Rybelsus as a tablet for type 2 diabetes. In March 2026 the FDA approved a higher-dose injection, Wegovy HD at 7.2 mg, after the STEP UP trial reported 20.7% mean weight loss at 72 weeks.
• The Wegovy pill (oral semaglutide 25 mg) was approved on December 22, 2025 and launched in January 2026. It was the first oral GLP-1 approved for weight management [4].
• Tirzepatide (Eli Lilly) activates two receptors, GIP and GLP-1. It is sold as Mounjaro for type 2 diabetes and Zepbound for obesity and for moderate-to-severe obstructive sleep apnea with obesity.
• Foundayo (orforglipron, Eli Lilly) was approved April 1, 2026. It is a small-molecule GLP-1 pill that can be taken at any time of day with no food or water restrictions [3].
• Liraglutide (Saxenda, Victoza) is an older daily GLP-1 injection and the only one with approved US generics.
• Setmelanotide (Imcivree, Rhythm Pharmaceuticals) is not a GLP-1 at all. It targets the MC4R pathway and is approved for several rare genetic obesity disorders. In March 2026 the FDA expanded it to acquired hypothalamic obesity in adults and children aged 4 and up [16].

Everything below is either awaiting an FDA decision or still in trials.

What is closest to reaching the market?

CagriSema (Novo Nordisk)

CagriSema is a fixed-dose combination of semaglutide 2.4 mg and cagrilintide 2.4 mg, an amylin analog. Amylin is a different satiety hormone from GLP-1, so the idea is that two signals do more than one. Novo Nordisk submitted it to the FDA on December 18, 2025 for chronic weight management, based on the REDEFINE 1 trial, which reported 22.7% mean weight loss at 68 weeks on the efficacy estimand, and about 20.4% on the treatment-regimen estimand that counts everyone randomized [5].

As of September 14, 2026 CagriSema remains under FDA review and is not approved. Novo Nordisk has said it expects a decision during 2026, and multiple analyst summaries place it in the fourth quarter, but no FDA action date has been made public, so treat any specific date as unconfirmed [5][21].

If approved, it would be the first GLP-1 plus amylin combination on the market anywhere. It is still a weekly injection and still contains semaglutide, so people who cannot tolerate GLP-1 side effects are unlikely to find it easier.

One caution on expectations. CagriSema was tested directly against tirzepatide in the open-label Phase 3 REDEFINE 4 trial, 809 adults over 84 weeks, and on February 23, 2026 Novo Nordisk reported that it did not meet its primary endpoint of showing non-inferiority. CagriSema produced 23.0% mean weight loss against tirzepatide’s 25.5% on the efficacy estimand, and 20.2% against 23.6% on the treatment-regimen estimand [21][22]. This is one of the few genuine head-to-head comparisons in the field, which makes it more informative than the cross-trial numbers elsewhere in this article.

Retatrutide (Eli Lilly)

Retatrutide is the one that gets the most attention, and the numbers explain why. It activates three receptors at once: GIP, GLP-1 and glucagon. In the Phase 3 TRIUMPH-1 trial, people on the 12 mg dose lost an average of 70.3 lbs, or 28.3% of body weight, over 80 weeks, and 45.3% of them lost at least 30% of their starting weight. Two further Phase 3 trials reported in July 2026: up to 20.8% weight loss in people who also had type 2 diabetes, and up to 22.6% in people with severe obesity and established cardiovascular disease [2].

Lilly said it plans to submit retatrutide to the FDA in the first quarter of 2027. That means approval, if it comes, is unlikely before late 2027 at the earliest. Retatrutide is still a weekly injection, and its side effect profile is real: in the cardiovascular trial, 13.5% of people on the 12 mg dose stopped because of adverse events, compared with 4.8% on placebo [2].

Survodutide (Boehringer Ingelheim and Zealand Pharma)

Survodutide combines GLP-1 with glucagon. In the Phase 3 SYNCHRONIZE-1 trial it produced sustained weight loss of up to 16.6% at 76 weeks versus 3.2% on placebo [7]. Its distinctive result is not the headline weight number but where the fat went: a prespecified analysis showed 34% reduction in visceral fat and 63% reduction in liver fat, out of proportion to total pounds lost. Boehringer is also developing it for metabolic liver disease.

Which injectable candidates are in Phase 3 behind them?

MariTide (maridebart cafraglutide, Amgen) deliberately inverts tirzepatide’s design. It activates the GLP-1 receptor while blocking the GIP receptor, and it is dosed monthly or less often. Phase 2 data showed mean weight loss in the range of 12% to 20% at 52 weeks with no plateau. The Phase 3 MARITIME program now includes trials in obesity, obesity with type 2 diabetes, obstructive sleep apnea, cardiovascular outcomes, heart failure, and a switch study for people moving off weekly semaglutide or tirzepatide [9].

Berobenatide (Pfizer) is the asset Pfizer paid about $10 billion for when it bought Metsera in late 2025. It is an ultra-long-acting GLP-1 given weekly at first and then monthly for maintenance. In Phase 2b, the two monthly regimens chosen for Phase 3 produced 10% and 12.3% placebo-adjusted weight loss at week 28. Pfizer said in June 2026 it would run more than 20 obesity trials during the year, including 10 Phase 3 studies of berobenatide, and is targeting a first approval in 2028 [8].

Enicepatide (Roche), previously known as CT-388, is a GLP-1/GIP dual agonist with what Roche calls biased signaling. Phase 2 data showed about 22.5% placebo-adjusted weight loss at 48 weeks with no plateau, and Roche started two Phase 3 obesity trials in the first quarter of 2026 [13].

VK2735 (Viking Therapeutics) is the leading candidate from an independent biotech. The injectable version is a GLP-1/GIP dual agonist with both Phase 3 VANQUISH trials fully enrolled as of mid-2026. Viking is unusual in developing the same molecule as both a weekly shot and a daily tablet [12].

Ribupatide (Hengrui Pharma and Kailera Therapeutics) is a GLP-1/GIP dual agonist that reported 19.2% mean weight loss at the 6 mg dose over 48 weeks in a Chinese Phase 3 trial [20]. Kailera holds rights outside Greater China and is running the global Phase 3 KaiNETIC program.

What is happening with weight loss pills?

This is the most contested part of the field, because pills are cheaper to make, easier to ship and less intimidating to start.

Two are already approved: the Wegovy pill and Foundayo. The difference between them matters. Oral semaglutide is a peptide and has to be taken on an empty stomach with a small sip of water, then nothing else for at least 30 minutes. Orforglipron is a small molecule, so it survives digestion on its own and can be taken any time of day with or without food [3].

Three more oral small molecules are in or entering Phase 3:

• Aleniglipron (Structure Therapeutics) reported up to 15.3% weight loss at 36 weeks and up to 16.3% at 44 weeks in Phase 2, with an overall 10.4% discontinuation rate. The Phase 3 ACCOMPLISH program began dosing in August 2026 [11].
• Elecoglipron (AstraZeneca), licensed from China’s Eccogene, produced 10.5% weight loss at 26 weeks and 11.8% at 36 weeks in the Phase 2b VISTA trial. AstraZeneca moved it into Phase 3 in June 2026 [10].
• Oral VK2735 (Viking Therapeutics) reached up to 12.2% weight loss at 13 weeks in Phase 2 and was expected to enter Phase 3 in the fourth quarter of 2026. If it succeeds it would be the first oral dual GLP-1/GIP agonist [12].

Two oral programs failed and are worth remembering, because they explain why this category is harder than it looks. Pfizer discontinued danuglipron in April 2025 after a single participant had potential drug-induced liver injury [18]. Terns Pharmaceuticals shelved TERN-601 in October 2025 after weak Phase 2 weight loss and three cases of serious liver enzyme elevations; analysts noted it shared a chemical scaffold with Pfizer’s discontinued molecules [19].

Which drugs work through something other than GLP-1?

Amylin

Amylin is the most crowded non-GLP-1 target. Petrelintide (Zealand Pharma and Roche) is the most watched. In Phase 2 it produced up to 10.7% mean weight loss at 42 weeks, and at the most effective dose Roche reported no vomiting and no discontinuations caused by gastrointestinal side effects, with overall tolerability similar to placebo [6]. That is an unusual claim in this class, and Phase 3 will test whether it holds.

Others in the amylin race: eloralintide (Eli Lilly, Phase 3, up to about 20% weight loss in Phase 2), cagrilintide (Novo Nordisk, the amylin half of CagriSema), AZD6234 (AstraZeneca, Phase 2), ABBV-295 (AbbVie, licensed from Gubra, Phase 2), PF-08653945 (Pfizer, Phase 2), and ACCG-2671 (Structure Therapeutics), which the company describes as the first oral small-molecule amylin receptor agonist to report clinical data [11].

Zenagamtide (Novo Nordisk) sits between the two categories. Formerly called amycretin, it activates GLP-1 and amylin receptors in a single molecule rather than combining two drugs, and is in Phase 3 in both oral and injectable forms [1].

Muscle and body composition

A growing set of programs is not trying to increase weight loss at all. They are trying to change what kind of weight is lost. Bimagrumab (Eli Lilly), apitegromab (Scholar Rock), trevogrumab (Regeneron) and the oral enobosarm (Veru) are all being tested alongside GLP-1 drugs to protect lean tissue [17]. A Phase 2 trial of bimagrumab with semaglutide reported about 22% weight loss at 72 weeks with roughly 92% of it coming from fat. None of these is approved for the lean-mass purpose. Apitegromab did reach market for a different indication on September 11, 2026, when the FDA approved it as Isembyld (apitegromab-mstn) for spinal muscular atrophy — the first approval anywhere for a myostatin inhibitor, and the first regulatory validation of the mechanism behind this whole group [23][24]. Veru’s enobosarm GLP-1 study also moved to “active, not recruiting” on September 4, 2026 with enrollment raised to 239. Combination side effects have been a problem in at least one trial arm. (updated 2026-09-14)

RNA and genetics-driven approaches

Wave Life Sciences, Arrowhead Pharmaceuticals and Alnylam are all developing RNAi drugs aimed at the INHBE and ALK7 pathways, which human genetics links to healthier patterns of fat distribution. Wave reported that a single dose of WVE-007 produced a placebo-adjusted 14.3% reduction in visceral fat at six months while lean mass was maintained, though total weight change was modest [1]. These are Phase 1 and Phase 2 programs. They are scientifically interesting and years from any pharmacy.

Other mechanisms

Corbus Pharmaceuticals is testing CRB-913, an oral CB1 inverse agonist designed to stay out of the brain, reviving a target abandoned two decades ago over psychiatric side effects [1]. Rhythm Pharmaceuticals is developing the oral MC4R agonist bivamelagon and the weekly injectable RM-718 for hypothalamic obesity.

What about drugs approved only in China?

Several GLP-1 drugs are now approved in China and nowhere else. Mazdutide (Innovent, licensed from Eli Lilly) was approved for obesity in June 2025 and for type 2 diabetes in September 2025, making it the first approved GLP-1/glucagon dual agonist anywhere; a higher 9 mg dose reached 20.1% weight loss in the GLORY-2 trial [14]. Ecnoglutide (Sciwind) was approved in China for diabetes in January 2026 and for weight management in March 2026 [15]. Huadong Medicine has both an oral small molecule and an injectable dual agonist in Phase 3 in China.

These approvals are real, but they apply only in China. None of these drugs is FDA approved or available by prescription in the United States, and anything sold online under these names is not the approved product.

How should you read the weight-loss percentages?

Carefully. Almost every number in this article comes from a different trial, with different participants, different durations, different starting weights and different statistical methods. A drug reporting 22% at 48 weeks and one reporting 16% at 76 weeks are not directly comparable.

Two specific traps:

1. Estimands. Companies report an “efficacy estimand” (what happened in people who stayed on the drug) and a “treatment-regimen estimand” (what happened to everyone randomized, including dropouts). The first number is always larger. For orforglipron, the highest dose produced 12.4% weight loss on the efficacy estimand and 11.1% across all participants [3].
2. Trial length. Weight loss on these drugs usually keeps building for a year or more. A 13-week number and a 72-week number are measuring different things.

Unless two drugs were tested head to head in the same trial, treat any ranking as an estimate.

What should you actually do with this information?

For most people the practical takeaway is narrower than the pipeline suggests. Right now, in the United States, the approved options are semaglutide, tirzepatide, orforglipron, liraglutide and, for specific rare conditions, setmelanotide. Everything else is a future possibility with an uncertain date.

If you are already on a GLP-1 and it is working, the pipeline does not change much for you today. If you have stopped because of side effects, the amylin candidates are the ones worth watching, though none has finished Phase 3. If cost is the barrier, the more relevant near-term developments are the oral pills already on the market and the pricing programs attached to them, not anything in trials.

Whatever you are weighing, the decision belongs in a conversation with a healthcare provider who knows your history. Investigational drugs are investigational for a reason, and the failures in this field, from danuglipron to TERN-601, show up in the safety data before they show up in the headlines.

Sources

1. Ozmosi, “The Obesity Drug Pipeline in 2026: Emerging Targets, Companies and Clinical Readouts” — https://www.ozmosi.com/obesity-drug-pipeline/
2. Eli Lilly, “Lilly’s triple agonist, retatrutide, successful in two additional Phase 3 obesity trials” — https://investor.lilly.com/news-releases/news-release-details/lillys-triple-agonist-retatrutide-successful-two-additional
3. Eli Lilly, “FDA approves Lilly’s Foundayo (orforglipron)” — https://investor.lilly.com/news-releases/news-release-details/fda-approves-lillys-foundayotm-orforglipron-only-glp-1-pill
4. Novo Nordisk, “FDA approves Novo Nordisk’s Wegovy pill” — https://www.prnewswire.com/news-releases/fda-approves-novo-nordisks-wegovy-pill-the-first-and-only-oral-glp-1-for-weight-loss-in-adults-302648344.html
5. Novo Nordisk, “Novo Nordisk files for FDA approval of CagriSema” — https://www.prnewswire.com/news-releases/novo-nordisk-files-for-fda-approval-of-cagrisema-the-first-once-weekly-combination-of-glp1-and-amylin-analogues-for-weight-management-302645862.html
6. Zealand Pharma, “Zealand Pharma and Roche to advance petrelintide to Phase 3” — https://www.globenewswire.com/news-release/2026/04/29/3284133/0/en/zealand-pharma-and-roche-to-advance-petrelintide-an-amylin-analog-to-phase-3-trials-for-chronic-weight-management.html
7. Boehringer Ingelheim, “Results from Phase III SYNCHRONIZE-1 obesity trial” — https://www.boehringer-ingelheim.com/us/human-health/metabolic-diseases/results-phase-iii-synchronize-1-obesity-trial
8. Pfizer, “Robust Phase 2b Efficacy and Favorable Tolerability Support Monthly Dosing for Berobenatide” — https://www.pfizer.com/news/press-release/press-release-detail/robust-phase-2b-efficacy-and-favorable-tolerability-support
9. Amgen, corrected release detailing the MariTide Phase 3 program — https://www.biospace.com/press-releases/c-o-r-r-e-c-t-i-o-n-amgen
10. AstraZeneca, “Elecoglipron moves to Phase III programme” — https://www.astrazeneca.com/media-centre/press-releases/2026/elecoglipron-an-oral-small-molecule-glp-1-ra-moves-to-phase-iii-programme.html
11. Structure Therapeutics, “Positive Clinical Data Across Oral Small Molecule Amylin and GLP-1 Programs” — https://www.biospace.com/press-releases/structure-therapeutics-reports-positive-clinical-data-across-oral-small-molecule-amylin-and-glp-1-programs-for-chronic-weight-management
12. Viking Therapeutics, Second Quarter 2026 Financial Results — https://ir.vikingtherapeutics.com/2026-07-29-Viking-Therapeutics-Reports-Second-Quarter-2026-Financial-Results-and-Provides-Corporate-Update
13. Fierce Biotech, “Roche’s GLP-1/GIP drug sees 22.5% weight loss, readies phase 3 push” — https://www.fiercebiotech.com/biotech/roches-glp1gip-drug-carmot-sees-225-weight-loss-readies-phase-3-trial
14. Innovent Biologics, “Mazdutide 9 mg Achieves Up to 20.1% Weight Loss, GLORY-2” — https://www.prnewswire.com/news-releases/mazdutide-9-mg-achieves-up-to-20-1-weight-loss-in-chinese-adults-with-obesity-glory-2-study-meets-primary-and-all-key-secondary-endpoints-302620471.html
15. Sciwind Biosciences, ecnoglutide NMPA weight management approval — https://www.prnewswire.com/news-releases/sciwind-biosciences-announces-ecnoglutide-injection-approved-by-chinas-national-medical-products-administration-nmpa-for-chronic-weight-management-302706442.html
16. Rhythm Pharmaceuticals, FDA approval of IMCIVREE for acquired hypothalamic obesity — https://ir.rhythmtx.com/news-releases/news-release-details/rhythm-pharmaceuticals-announces-fda-approval-imcivreer-1
17. Medscape, “Myostatin Blocker Preserves Muscle With GLP-1 Treatment” — https://www.medscape.com/viewarticle/myostatin-blocker-preserves-muscle-glp-1-treatment-2025a1000qs4
18. Pfizer, “Pfizer Provides Update on Oral GLP-1 Receptor Agonist Danuglipron” — https://www.pfizer.com/news/press-release/press-release-detail/pfizer-provides-update-oral-glp-1-receptor-agonist
19. Reuters, “Terns Pharma shelves obesity drug after mid-stage trial disappoints” — https://www.reuters.com/business/healthcare-pharmaceuticals/terns-pharma-ends-obesity-drug-program-after-mid-stage-trial-data-2025-10-21/
20. Hengrui Pharma and Kailera Therapeutics, additional Phase 3 HRS9531 data — https://www.globenewswire.com/news-release/2025/11/04/3180679/0/en/Hengrui-Pharma-and-Kailera-Therapeutics-Announce-Additional-Data-from-Phase-3-Obesity-Trial-in-China-of-Dual-GLP-1-GIP-Receptor-Agonist-HRS9531.html
21. HCPLive, “CagriSema Demonstrates Weight Loss, Fails to Achieve Primary Endpoint Compared to Tirzepatide” (REDEFINE 4 headline results, February 23, 2026) — https://www.hcplive.com/view/cagrisema-demonstrates-weight-loss-fails-to-achieve-primary-endpoint-compared-to-tirzepatide
22. MPR, “REDEFINE 4: CagriSema Weight Loss Results Compared With Tirzepatide” — https://www.empr.com/news/redefine-4-cagrisema-weight-loss-results-compared-with-tirzepatide/
23. Reuters, “US FDA approves Scholar Rock’s muscle weakness drug,” September 11, 2026 — https://www.reuters.com/business/healthcare-pharmaceuticals/us-fda-approves-scholar-rocks-muscle-weakness-drug-2026-09-11
24. Scholar Rock, “Scholar Rock Announces FDA Approval of ISEMBYLD (apitegromab-mstn)” — https://investors.scholarrock.com/news-releases/news-release-details/scholar-rock-announces-fda-approval-isembyldtm-apitegromab-mstn