Key takeaways:
There are several incretin-based medications in clinical development for weight management.
Upcoming therapies target GLP-1, glucagon, and/or GIP, with many dual and triple agonist options.
Many of these medications are self-administered subcutaneously, although a few oral options are in development. Less frequent dosing is also under investigation.
Treatment for weight loss has evolved quite a bit in recent years with the approval of new injectable peptides and oral weight-loss medications. And it doesn’t seem like the growing market is slowing down anytime soon.
In addition to those already on the market, there are also several new weight-loss drugs in clinical trials. This article highlights 10 candidates to watch and reviews their mechanism of action, route and dosing frequency, and efficacy data. The list isn’t exhaustive, and results shouldn’t be compared directly across trials, as study populations, duration, and doses vary.
1. Aleniglipron
What it is: Aleniglipron (GSBR-1290) is an oral small molecule glucagon-like peptide-1 (GLP-1) receptor agonist, similar to Foundayo (orforglipron), which was FDA approved in April 2026.
Route and dosing frequency: oral, daily
Effectiveness: Aleniglipron helped study participants lose 8% to 11% of their initial body weight after 36 weeks of use (depending on the dose) in a phase 2b study. According to 56-week open label extension results reported by the manufacturer, people taking higher doses lost about 16% of their body weight, with continued weight loss beyond 1 year and no clear plateau.
Status: Aleniglipron’s manufacturer, Structure Therapeutics, plans to start phase 3 studies in the second half of 2026.
2. Amycretin
What it is: Amycretin (NNC0487-0111) is a unimolecular long-acting GLP-1 and amylin receptor agonist.
Route and dosing frequency: both oral (daily) and subcutaneous (weekly) formulations under study
Effectiveness: In a phase 1b/2a study, participants taking subcutaneous amycretin at various doses lost significantly more weight than those taking placebo at 36 weeks.
Status: Novo Nordisk has launched a series of phase 3 studies, which are currently recruiting participants.
3. Berobenatide
What it is: Berobenatide (also PF-08653944 or MET-097) is a cAMP-biased GLP-1 receptor agonist, which leverages selective cyclic AMP signaling to enhance metabolic effects while reducing receptor desensitization. Its longer half-life may support less frequent, monthly dosing.
Route and dosing frequency: subcutaneous, monthly
Effectiveness: In a phase 2b study, adults received weekly injections for the first 12 weeks and then switched to monthly dosing through week 28. Adults treated with berobenatide lost up to 12% of their body weight at 28 weeks, and weight loss continued even after switching to monthly shots and didn’t appear to stall. The study concludes at 64 weeks.
Status: Phase 3 clinical trials are ongoing. These studies will further evaluate berobenatide’s efficacy and safety across different dosage schedules and patient groups.
4. CagriSema
What it is: CagriSema (cagrilintide / semaglutide) combines cagrilintide, an amylin analog, with GLP-1 receptor agonist semaglutide.
Route and dosing frequency: subcutaneous, weekly
Effectiveness: CagriSema demonstrated meaningful weight-loss effects in two phase 3 studies. In REDEFINE-1 adults without diabetes lost about 20% of their body weight on average. In REDEFINE-2, adults living with Type 2 diabetes saw about 14% weight loss at 68 weeks.
Status: Novo Nordisk applied for the medication's FDA approval in December 2025. An approval decision will likely come sometime in 2026.
5. Ecnoglutide
What it is: Ecnoglutide (also called XW003) is also a cAMP-biased GLP-1 receptor agonist, similar to berobenatide, but without the extended half-life.
Route and dosing frequency: both oral (daily) and subcutaneous (weekly) formulations under study
Effectiveness: In a phase 3 trial, participants with and without diabetes who received different doses of ecnoglutide had average body weight loss of 9% to 13% at 40 weeks. A comparator trial against semaglutide is ongoing; interim results indicate people taking ecnoglutide have experienced more weight loss at 20 weeks compared with semaglutide (12.8% versus 9.5%).
Status: Ecnoglutide was approved for use in China in March 2026. The manufacturer has a partnership with Pfizer, suggesting expansion ambitions.
6. MariTide
What it is: MariTide, or maridebart cafraglutide, is a peptide-antibody conjugate that combines a GLP-1 agonist and GIP antagonist. The conjugate approach is intended to increase half-life and thus decrease dosing frequency. Animal studies suggest that glucose-dependent insulinotropic polypeptide (GIP) antagonism could lead to less fat storage.
Route and dosing frequency: subcutaneous, monthly
Effectiveness: In a phase 2 study, treatment with MariTide resulted in weight loss of up to 16% at 52 weeks and up to 12% with people with Type 2 diabetes. This was an intention-to-treat study with some undergoing dose escalation after the first month.
Status: Multiple phase 3 trials are ongoing, which should indicate more about feasibility of less frequent dosing with MariTide, as well as switching from weekly GLP-1s.
7. Mazdutide
What it is: Mazdutide (also called IBI362) is a dual GLP-1 / glucagon receptor agonist.
Route and dosing frequency: subcutaneous, weekly
Effectiveness: In a phase 3 trial with 461 participants (16% of whom had Type 2 diabetes), mazdutide 9 mg led to an average weight loss of 16.6% over 60 weeks, with no clear plateau during treatment. Nearly half of participants lost at least 20% of their initial body weight.
In a head-to-head phase 3 trial, mazdutide 6 mg outperformed semaglutide 1 mg among people with Type 2 diabetes and obesity. The primary endpoint was the percentage of people who achieved at least 10% weight loss and HbA1c of less than 7 at 32 weeks: 48% in the mazdutide group, compared to roughly 21% in the semaglutide group.
Status: Mazdutide has been approved for use in China after completion of several phase 3 studies in China; more are ongoing. The manufacturer has a licensing agreement with Eli Lilly.
8. Retatrutide
What it is: Retatrutide is a once-weekly injectable peptide that agonizes GIP, GLP-1, and glucagon receptors, making it the first triple hormone receptor agonist in development.
Route and dosing frequency: subcutaneous, weekly
Effectiveness: The results of the pivotal phase 3 trial, TRIUMPH-1 — announced by the manufacturer but not yet peer-reviewed — showed average weight loss over 80 weeks of:
28.3% (~70 lb) on the 12 mg dose
25.9% (~64 lb) on the 9 mg dose
19.0% (~47 lb) on the 4 mg dose
Status: Eli Lilly is expected to submit an application in late 2026 or early 2027. The FDA’s standard review runs about 10 months after that, which puts a realistic approval window in late 2027 to 2028.
9. Ribupatide
What it is: Also known as HRS9531 or KAI-9531, ribupatide is a GLP-1 / GIP receptor dual agonist peptide.
Route and dosing frequency: both oral (daily) and subcutaneous (weekly) formulations under study
Effectiveness: Phase 2 data indicated 18% weight loss from baseline in adults without diabetes taking injectable ribupatide at 32 weeks. Weight loss was maintained up to 52 weeks with Q2W dosing. In another phase 2 study, adults taking oral ribupatide experienced up to 11% (depending on the dose) weight loss from baseline.
Status: Phase 3 studies in people with and without diabetes are underway.
10. Survodutide
What it is: Survodutide is a dual-agonist peptide that targets GLP-1 and glucagon.
Route and dosing frequency: subcutaneous, weekly
Effectiveness: In early clinical trials, people using the highest survodutide dose lost about 19% of their starting body weight over 46 weeks, on average. The mean change in weight from baseline at 76 weeks was 12% to 13% in people without diabetes. Substudy analysis showed a 34% decrease in visceral fat and 63% reduction in liver fat.
Status: The timing of FDA application submission from Boehringer Ingelheim will likely depend on results of additional phase 3 studies, which are ongoing.
The bottom line
The metabolic and weight-loss pipeline is full of promising candidates with varying mechanisms of action. This market will likely see quite a bit of change in the next few years, including different formulations and dosing schedules of incretin-based drugs. Although early and late-stage results are promising, cross-trial efficacy comparisons should be interpreted cautiously, and most of these candidates still require additional safety and efficacy data before they can be considered for FDA approval.
Why trust our experts?
References
ADA Meeting News. (2026). Ultra-long-acting GLP-1 RA improves weight loss in individuals with and without type 2 diabetes.
American College of Cardiology. (2025). REDEFINE 1 and REDEFINE 2: Greater weight loss with combined cagrilintide-semaglutide versus either drug alone or placebo.
American Diabetes Association. (2026). Ultra-long-acting injectable GLP-1 RA shows promise for supporting weight management in individuals with and without type 2 diabetes.
Bi, Y., et al. (2026). Efficacy and safety of oral ribupatide (HRS9531) in adults with obesity: A phase 2 trial. Diabetes.
Boehringer Ingelheim. (2026). Boehringer Ingelheim’s survodutide phase 3 trial showed targeted visceral and liver fat reduction while minimizing lean-mass loss.
ClinicalTrials.gov. (n.d.). Search results: Phase 3 studies of amycretin (NNC0487-0111). National Library of Medicine.
ClinicalTrials.gov. (n.d.). Search results: Phase 3 studies of berobenatide (PF-08653944). National Library of Medicine.
ClinicalTrials.gov. (n.d.). Search results: Phase 3 studies of maridebart cafraglutide. National Library of Medicine.
ClinicalTrials.gov. (n.d.). Search results: Phase 3 studies of mazdutide (IBI362). National Library of Medicine.
ClinicalTrials.gov. (n.d.). Study results: Phase 3 studies of ribupatide. National Library of Medicine.
ClinicalTrials.gov. (2026). A study comparing XW003 injection and semaglutide injection in Chinese adults with obesity (NCT07073417). National Library of Medicine.
ClinicalTrials.gov. (2026). A study of retatrutide in participants who have obesity or overweight (NCT05929066). National Library of Medicine.
Dahl, K., et al. (2025). Amycretin, a novel, unimolecular GLP-1 and amylin receptor agonist administered subcutaneously: Results from a phase 1b/2a randomized controlled study. The Lancet.
Eli Lilly and Company. (2026). Lilly’s triple agonist, retatrutide, delivered powerful weight loss in pivotal Phase 3 obesity trial.
Gao, L., et al. (2026). Treatment with 9-mg mazdutide for weight reduction in Chinese adults with obesity: The GLORY-2 randomized clinical trial. JAMA.
Innovent Biologics. (2026). Innovent Biologics presents results of DREAMS-3: the first globally approved GCG/GLP-1 dual receptor agonist versus semaglutide in a head-to-head phase 3 randomized controlled trial.
Jastreboff, A. M., et al. (2022). Tirzepatide once weekly for the treatment of obesity. The New England Journal of Medicine.
Jastreboff, A. M., et al. (2025). Once-monthly maridebart cafraglutide for the treatment of obesity: A phase 2 trial. The New England Journal of Medicine.
Ji, L., et al. (2025). Efficacy and safety of a biased GLP-1 receptor agonist ecnoglutide in adults with overweight or obesity: A multicenter, randomized, double-blind, placebo-controlled phase 3 trial. The Lancet Diabetes & Endocrinology.
Karlsson, C. (2026). Boehringer Ingelheim awaits additional data before submitting application for Zealand Pharma drug. MedWatch.
Killion, E. A., et al. (2020). Chronic glucose-dependent insulinotropic polypeptide receptor agonism desensitizes adipocyte GIPR activity, mimicking functional GIPR antagonism. Nature Communications.
le Roux, C. W., et al. (2024). Glucagon and GLP-1 receptor dual agonist survodutide for obesity: A randomized, double-blind, placebo-controlled, dose-finding phase 2 trial. The Lancet Diabetes & Endocrinology.
le Roux, C. W., et al. (2026). Survodutide once weekly for the treatment of adults with obesity. The New England Journal of Medicine.
Napitupulu, J. (2026). Ecnoglutide shows greater weight loss than semaglutide in trial. Clinical Trial Vanguard.
Novo Nordisk. (2025). Novo Nordisk files for FDA approval of CagriSema, the first once-weekly combination of GLP-1 and amylin analogues for weight management.
Rosenstock, J., et al. (2026). Oral small-molecule GLP-1 receptor agonist aleniglipron in people with overweight or obesity: A randomized, double-blind, placebo-controlled phase 2b trial. Nature Medicine.
Sciwind Biosciences. (2026). Ecnoglutide injection approved by China’s National Medical Products Administration for chronic weight management.
Structure Therapeutics. (2026). Structure Therapeutics reports positive topline data from phase 2 ACCESS II trial with once-daily oral small-molecule GLP-1 receptor agonist aleniglipron.
Waldron, J. (2026). Structure touts 16% weight loss for aleniglipron as ‘highest efficacy’ for an oral GLP-1 yet. Fierce Biotech.
Wilding, J. P. H., et al. (2021). Once-weekly semaglutide in adults with overweight or obesity. The New England Journal of Medicine.
Yie, J., et al. (2026). Design and therapeutic rationale of antibody-peptide conjugates: Insights from maridebart cafraglutide (AMG 133) and emerging applications. Antibody Therapeutics.
Zhao, L., et al. (2025). 853-P: Efficacy and safety of a novel dual GLP-1/GIP receptor agonist (HRS9531) in adults with obesity without diabetes: Up to 52-week treatment. Diabetes.
