The GLP-1 class is rewriting what's possible in pharmacologic weight loss. Here's every compound with real trial data, projected trajectories, and what the pipeline will bring next.
Approved drugs and emerging candidates with the strongest trial data. Each card links to the full research deep-dive.
Dual GLP-1 + GIP receptor agonist. Larger average weight loss than semaglutide in head-to-head. Currently the best-in-class for most people starting today.
The GLP-1 that started the revolution. STEP-1 trial: 14.9% average loss at 68 weeks. Longest safety track record, broadest insurance coverage.
Triple agonist: GLP-1 + GIP + glucagon. Phase 2 TRIUMPH data shows ~24% average loss — the largest pharmacologic effect ever recorded. Phase 3 reports expected 2026.
When Ozempic isn't available or affordable: compounded semaglutide from 503A/503B pharmacies, tirzepatide alternatives, and the regulatory shifts changing availability.
Interactive trajectory projector. Enter starting weight + protocol; see realistic loss curve with variance bands derived from the STEP, SURMOUNT, and TRIUMPH trials.
~40% of GLP-1 weight loss is lean mass without intervention. Resistance training + protein protocol + supplement stack that reduces sarcopenia risk.
Semaglutide or tirzepatide titration paired with resistance training protocol, adequate protein, and creatine. Reduces lean-mass loss from ~40% to ~20% of total.
See the protocol →When GLP-1 progress stalls (typically weeks 20-40). Dose reassessment, protocol changes, switching classes, and when a plateau signals diminishing returns vs. tolerance.
What to do when it stops working →The metabolic case beyond weight loss. HbA1c reduction, cardiovascular outcomes, and how GLP-1s fit alongside metformin, berberine, and myo-inositol.
The metabolic angle →The average outcomes from each drug's pivotal trial. Variance is real — individuals land within ~±10% of these means.
For approved drugs with robust trial data, tirzepatide produces the largest average weight loss (22.5% at 72 weeks in SURMOUNT-1). Semaglutide is the established first-line option (14.9% at 68 weeks in STEP-1). Retatrutide is in Phase 3 with Phase 2 data showing ~24% — likely to become the leader once approved.
Head-to-head (SURMOUNT-5): tirzepatide outperforms semaglutide on total weight loss by roughly 5-7 percentage points. For most people starting today, tirzepatide is the better choice if cost and availability allow; semaglutide has the longer safety track record and broader insurance coverage.
No — retatrutide is in Phase 3 trials (TRIUMPH-5 expected to report in 2026). It is not FDA-approved for any indication and is not available through US pharmacies. Some research-grade sources exist but carry all the usual research-peptide quality risks.
Most people regain weight after stopping — the STEP-4 and SURMOUNT-4 withdrawal studies show ~2/3 of lost weight returning within a year. GLP-1s work mechanistically while present, not by permanently resetting metabolism. Long-term use is the honest expectation for durable results.
Muscle loss is real and documented — ~40% of total weight lost is lean mass without intervention. Resistance training + adequate protein (0.8-1g/lb bodyweight) substantially reduces the lean-mass loss. See our GLP-1 muscle loss page for protocols.
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18+ related research pages covering specific questions, compounds, and edge cases.
Semaglutide, tirzepatide, and related GLP-1 drugs are prescription medications with real side-effect profiles and contraindications. Retatrutide is not yet approved. Compounded versions have variable quality.
This page is for educational purposes only and is not medical advice. Always work with a qualified healthcare provider for weight-loss therapy. Research use only for anything not FDA-approved.