Metabolic / Published 2026-07-25 / 9 min read
The 2026 Obesity Drug Pipeline
Written by Aaron CuhaReviewed 2026-07-25
Obesity drugs have moved far beyond copying one hormone. The new ones work on two, three or four appetite and energy signals at once, and the ones taking off the most weight all do that. Here is every major drug in development, what it works on and where it stands, each linked to its full evidence profile.
The pipeline at a glance
| Compound | Mechanism | Stage | Peak result |
|---|---|---|---|
| SemaglutideNovo Nordisk | Copies GLP-1 | Approved | ~15% |
| TirzepatideEli Lilly | Copies GLP-1 and GIP | Approved | ~21% |
| OrforglipronEli Lilly | GLP-1 pill (small molecule) | Approved April 2026 as Foundayo | Pill |
| RetatrutideEli Lilly | Copies GLP-1, GIP and glucagon (three hormones) | Final-stage studies | Up to 28.3% (80 wk) |
| CagriSemaNovo Nordisk | GLP-1 plus amylin | Sent to the FDA | 20.4% (68 wk) |
| MariTideAmgen | Switches GLP-1 on, blocks GIP | Final-stage studies | ~20% |
| VK2735Viking | Copies GLP-1 and GIP | Final-stage studies | ~15% (13 wk) |
| AmycretinNovo Nordisk | GLP-1 plus amylin in one molecule | Moving to final-stage studies | ~14.5% (36 wk) |
| SurvodutideBoehringer / Zealand | Copies GLP-1 and glucagon | Final-stage studies | Fatty liver and obesity |
| MazdutideInnovent / Lilly | Copies GLP-1 and glucagon | Approved (China) | Substantial |
| PemvidutideAltimmune | Copies GLP-1 and glucagon | Mid-stage studies | Aims to keep muscle |
| EfocipegtrutideHanmi | Copies GLP-1, GIP and glucagon (three hormones) | Mid-stage studies | Fatty liver focus |
| PetrelintideRoche / Zealand | Amylin on its own | Moving to final-stage studies | ~10.7% (42 wk) |
| DanuglipronPfizer | GLP-1 pill (small molecule) | Dropped | Stopped |
| EcnoglutideSciwind | Long-lasting GLP-1 | Final-stage studies (China) | Less frequent shots |
| BimagrumabEli Lilly | Antibody that blocks a muscle brake (activin receptor) | Mid-stage studies | Builds muscle |
Weight-loss numbers are the highest reported in each drug's own studies. No drug was tested against another here. The studies ran for different lengths (some 13 weeks, others 68 weeks), so you can't compare the percentages directly. Numbers are from published results as of the review date.
Triple agonists: the heavy hitters
The biggest results come from drugs that copy three gut hormones at once: GLP-1 for appetite and insulin, GIP for extra effects on how the body handles fuel, and glucagon for burning energy and clearing liver fat. Retatrutide is out in front, with the most weight loss from a drug reported so far. Efocipegtrutide uses the same three-hormone design, aimed at fatty liver disease.
GLP-1 and GIP: activate, or block?
The approved Tirzepatide was the first drug to copy both GLP-1 and GIP. VK2735 does the same, as a shot and as a pill. Then there is the twist. Amgen's MariTide switches GLP-1 on but blocks GIP on purpose, and still takes off about 20% of body weight with one shot a month. Nobody knows yet whether switching GIP on or blocking it works better. It is one of the most interesting open questions in the field.
GLP-1 and glucagon: burning more, not just eating less
Copying glucagon makes the body burn more energy and clears liver fat. That makes these drugs especially interesting for people with fatty liver disease as well as obesity. Survodutide, Mazdutide (already approved in China) and Pemvidutide all take this route. Pemvidutide puts the most weight on keeping muscle.
Amylin: the other appetite pathway
Amylin is a different hormone that makes you feel full, and people may feel less sick on amylin drugs than on GLP-1 drugs. Cagrilintide is the long-lasting amylin copy at the heart of CagriSema, where it is paired with semaglutide for about 23% weight loss. Amycretin puts GLP-1 and amylin into one molecule, and Petrelintide is being developed as amylin on its own. The first, short-acting amylin drug, Pramlintide, has been approved for years.
The oral race, and muscle preservation
A pill would make these drugs far easier to get. Orforglipron was approved in April 2026 as Foundayo, a small-molecule GLP-1 pill. Pfizer's Danuglipron was dropped because people felt too sick on it and one person had a liver problem. Ecnoglutide aims for shots less often. And because weight lost on GLP-1 drugs includes some muscle, Bimagrumab is being studied to build muscle while fat comes off.
Frequently asked questions
What is the most effective obesity drug in the 2026 pipeline?
The three-hormone drug retatrutide reported up to 28.3% weight loss at 80 weeks, the combination CagriSema 20.4% at 68 weeks (22.7% for people who stayed on it), and Amgen's once-a-month MariTide around 20%. All three work on more than one hormone signal, and that is the big trend in the new drugs. These numbers come from separate studies, not head-to-head tests.
Why are the newest drugs targeting multiple receptors?
Drugs that copy only GLP-1 hit a ceiling. Adding GIP, glucagon or amylin works on other appetite and energy-burning signals too. In studies, the extra signals have taken off real extra weight, not just in theory.
Will there be a weight-loss pill instead of an injection?
Orforglipron was approved in April 2026 as Foundayo, the first GLP-1 pill of its kind, and a pill form of VK2735 is being studied. Pfizer dropped its pill, danuglipron, because people felt too sick on it and one person had a liver problem. That shows how hard GLP-1 pills are to get right.
Do these drugs cause muscle loss?
Weight lost on GLP-1 drugs includes some muscle. That is why muscle-focused drugs like bimagrumab, which builds muscle while fat comes off, are being studied alongside GLP-1 drugs. This is for learning, not medical advice.
Educational use only. This database summarizes published research and is not medical advice. Where a dose appears it is a record of what a trial or clinic ran, or what people describe doing, with its source attached. Nothing here is a recommendation for personal use.