Weight Loss Pipeline • 2026-2027

The GLP-1 Pipeline: What's Coming Next

📄 13 PubMed citations

By , HighPeptides Editor

Last updated:

The next wave of weight loss drugs — oral small molecules, dual GLP-1/amylin agonists, and dual GLP-1/glucagon compounds. Orforglipron has now cleared the FDA as Foundayo (April 2026); the rest are in late-stage trials or under regulatory review.

5
New Drugs
In Pipeline
20+
% Weight Loss
Top Candidates
2026
First FDA
Approval (Foundayo)

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Why This Matters

The GLP-1 Revolution Is Just Getting Started

Semaglutide (Wegovy) and tirzepatide (Zepbound) changed obesity treatment — but the next wave of drugs could be even more powerful, more convenient, or both.

📢 The Pipeline Is Evolving Rapidly

This guide covers the 5 most advanced GLP-1 pipeline drugs with published Phase 2+ data. Clinical trial timelines shift — check ClinicalTrials.gov for current status. Data shown is from published trials; individual results vary.

🗓️ Status Update — October 2026
  • Orforglipron is approved. The FDA approved it as Foundayo (Eli Lilly, NDA 220934) on April 1, 2026, for chronic weight management in adults with obesity, or overweight with at least one weight-related condition. It is a once-daily tablet taken with or without food.
  • Wegovy tablets are approved. Oral semaglutide 25 mg once daily (Novo Nordisk, NDA 218316) was approved on December 22, 2025. Unlike Foundayo, the label says to take it on an empty stomach and wait at least 30 minutes before eating.
  • Retatrutide's phase 3 results are published. TRIUMPH-1 (NEJM, September 2026; 2,339 participants) reported a −25.0% mean change in body weight at 12 mg over 80 weeks vs −3.9% with placebo (PMID 42814954). Lilly says it plans to submit to the FDA in the first quarter of 2027. It is not approved.

Sources: Drugs@FDA NDA 220934 · Foundayo label (DailyMed) · Drugs@FDA NDA 218316 · Wegovy label (DailyMed) · TRIUMPH-1, NEJM 2026 · Lilly Q2 2026 results (SEC 8-K)

Orforglipron
Eli Lilly
💊 Oral
11.2% Weight Loss
72 Weeks
Apr 2026 FDA Approved

Oral small-molecule GLP-1 agonist, FDA-approved as Foundayo on April 1, 2026 for chronic weight management. Unlike peptide-based oral semaglutide (Rybelsus, Wegovy tablets), the label says it can be taken with or without food.

Mechanism: Once-daily oral small molecule GLP-1 receptor agonist. Direct GLP-1 binding with high selectivity.
Cagrisema
Novo Nordisk
💉 Injection
20.4% Weight Loss
68 Weeks
Late 2026 FDA Decision Expected

Combined GLP-1 + amylin agonist. Combines cagrilintide (long-acting amylin analog) with semaglutide. Targets both pathways for enhanced satiety and glucose control.

Mechanism: Dual agonist: GLP-1 receptor + amylin receptor. Enhanced satiety signaling through amylin pathway, slower gastric emptying.
Survodutide
Boehringer Ingelheim / Zealand Pharma
🔬 Phase 3
62% MASH Improved (Ph 2)
13.0% Weight Loss (Ph 3)
2026-27 Timeline

Dual GLP-1/glucagon agonist. Phase 3 obesity results published in 2026 (−13.0% at 76 weeks); in phase 2, 62% at 4.8 mg had MASH improvement vs 14% on placebo.

Mechanism: Dual GLP-1 + glucagon receptor agonist.
Pemvidutide
Altimmune
🔬 Phase 3
52% MASH Resolved (1.8 mg)
Ph 3 MASH (recruiting)
24 wk IMPACT

Liver-focused dual GLP-1/glucagon agonist. In the IMPACT phase 2b trial, MASH resolved in 52% at 1.8 mg vs 20% on placebo after 24 weeks. Also tested in a completed phase 2 alcohol use disorder trial (RECLAIM).

Mechanism: Dual GLP-1 + glucagon receptor agonist, developed for MASH.
Mazdutide (IBI362)
Innovent Biologics / Eli Lilly
✅ Approved (China)
16.65% Weight Loss (9 mg, 60 wk)
2025 Approved
GLORY Phase 3 Program

Approved in China for chronic weight management in June 2025. GLORY-2 (JAMA 2026) showed −16.65% at 9 mg over 60 weeks vs −1.50% with placebo.

Mechanism: Dual GLP-1 + glucagon receptor agonist.
Latest Data — 2025–2026

Trial Updates: The Numbers Keep Moving

Published data from 2024–2026 trials across all five drugs, with the source for each number.

Orforglipron — ATTAIN Program

Published phase 3 readouts in obesity, with and without type 2 diabetes (treatment-regimen estimand):

  • ▸ ATTAIN-1 (NEJM 2025): −11.2% body weight at 36 mg over 72 weeks vs −2.1% with placebo, in 3,127 adults with obesity. At 36 mg, 54.6% lost ≥10% and 36.0% lost ≥15% (PMID 40960239).
  • ▸ ATTAIN-2 (Lancet 2026): −9.6% at 36 mg over 72 weeks vs −2.5% with placebo, in 1,613 adults with obesity and type 2 diabetes (PMID 41275875).
  • ▸ FDA approval April 1, 2026, as Foundayo (NDA 220934) for chronic weight management.
CagriSema — REDEFINE Program

Cagrilintide (a long-acting amylin analog) plus semaglutide, both phase 3 trials published in NEJM:

  • ▸ REDEFINE 1 (NEJM 2025): −20.4% at 68 weeks vs −3.0% with placebo, 3,417 participants with overweight or obesity (PMID 40544433).
  • ▸ REDEFINE 2 (NEJM 2025): −13.7% at 68 weeks vs −3.4% with placebo in 1,206 adults with type 2 diabetes (PMID 40544432).
  • ▸ FDA status Novo Nordisk submitted it to the FDA in December 2025 and expects a decision by late 2026; REDEFINE 11 is expected to report in the first half of 2027 (Novo Nordisk 6-K, Feb 2026).
Survodutide — Phase 2 and Phase 3

Phase 2 obesity trial: −14.9% at 4.8 mg over 46 weeks vs −2.8% with placebo (PMID 38330987). Phase 3 results are now publishing:

  • ▸ SYNCHRONIZE-1 (NEJM 2026): −13.0% at 6.0 mg over 76 weeks vs −5.4% with placebo, 725 adults with obesity (PMID 42253238).
  • ▸ MASH phase 2 (NEJM 2024): MASH improved without fibrosis worsening in 62% at 4.8 mg vs 14% with placebo (PMID 38847460).
  • ▸ LIVERAGE Phase 3 MASH program (see ClinicalTrials.gov for status).
Pemvidutide — IMPACT

The IMPACT phase 2b trial in MASH was published in The Lancet (2025):

  • ▸ IMPACT (24 weeks) : MASH resolution without fibrosis worsening in 58% (1.2 mg) and 52% (1.8 mg) vs 20% with placebo; fibrosis improvement was not significantly different from placebo (PMID 41237796).
  • ▸ Other indications Altimmune completed a phase 2 trial of pemvidutide in alcohol use disorder (RECLAIM, NCT06987513).
Mazdutide — GLORY Trials and China Approval

Dual GLP-1/glucagon agonist from Innovent (licensed from Eli Lilly):

  • ▸ GLORY-1 (NEJM 2025): −14.0% at 6 mg over 48 weeks vs +0.3% with placebo, 610 Chinese adults (PMID 40421736).
  • ▸ GLORY-2 (JAMA 2026): −16.65% at 9 mg over 60 weeks vs −1.50% with placebo, 461 Chinese adults with obesity (PMID 42251595).
  • ▸ Approved in China June 2025 for chronic weight management; Innovent describes it as the first GCG/GLP-1 dual receptor agonist approved (Innovent release).
Cross-Trial Comparison

Complete Pipeline Comparison

All 5 pipeline drugs alongside semaglutide, tirzepatide and retatrutide. Figures come from separate trials (tirzepatide: SURMOUNT-1, PMID 35658024; semaglutide: STEP 1, PMID 33567185) and are not head-to-head.

Drug Company Mechanism Route Weight Loss Timeline Status
Orforglipron Eli Lilly GLP-1 Oral 11.2% (72w) Approved Apr 2026 FDA Approved (Foundayo)
Cagrisema Novo Nordisk GLP-1 + Amylin Weekly Inj 20.4% (68w) Late 2026 Under FDA review
Survodutide Boehringer/Zealand GLP-1 + GcG Weekly Inj 13.0% (76w); 62% MASH improved (Ph 2) 2026-27 Phase 3 published
Pemvidutide Altimmune GLP-1 + GcG Weekly Inj 52% MASH resolved (24w) — Phase 3 (MASH, recruiting; NCT07795164)
Mazdutide Innovent/Lilly GLP-1 + GcG Weekly Inj 16.65% (60w) Approved China 2025
Retatrutide Eli Lilly GLP-1 + GIP + GcG Weekly Inj 25.0% (80w) FDA filing planned Q1 2027 Phase 3 published
Tirzepatide Eli Lilly GLP-1 + GIP Weekly Inj 20.9% (72w, 15 mg) Approved FDA Approved
Semaglutide Novo Nordisk GLP-1 Weekly Inj 14.9% (68w) Approved FDA Approved
Timeline

When Will They Be Available?

Expected approval timeline for the top 5 GLP-1 pipeline drugs.

December 2025
Cagrisema NDA Submitted
Novo Nordisk submitted a New Drug Application to the FDA; it expects a decision by late 2026.
2025
Mazdutide Approved in China
Innovent's dual GLP-1/glucagon agonist was approved in China for chronic weight management in June 2025.
Wegovy Tablets Approved
FDA approved oral semaglutide 25 mg once daily (Wegovy tablets, NDA 218316). Taken on an empty stomach, at least 30 minutes before food.
Orforglipron Approved as Foundayo
FDA approved Eli Lilly's oral small-molecule GLP-1 (NDA 220934) for chronic weight management. Once daily, with or without food.
Late 2026
Cagrisema Potential Approval
If FDA review goes smoothly, cagrisema could be available by late 2026 — combining semaglutide's mechanism with amylin for enhanced results.
2026-2027
Survodutide & Pemvidutide Phase 3
Survodutide published its first phase 3 obesity results in 2026 (SYNCHRONIZE-1); pemvidutide has phase 2b MASH data (IMPACT). Neither is approved.
Q1 2027 (planned)
Retatrutide FDA Submission
Eli Lilly's triple agonist (GLP-1 + GIP + glucagon). Phase 3 TRIUMPH-1 was published in NEJM in September 2026: −25.0% at 12 mg over 80 weeks. Lilly's Q2 2026 results release says it plans to submit to the FDA in the first quarter of 2027.
What Makes Each Different

Mechanism & Target Population

How each pipeline drug targets different pathways and patient populations.

💊
Oral Convenience
Orforglipron is now FDA-approved as Foundayo (April 2026), a once-daily oral small molecule. No injections, and no empty-stomach rule like Rybelsus or Wegovy tablets.
🫀
Liver-Focused
Survodutide and pemvidutide add glucagon receptor activity aimed at liver fat. In phase 2, survodutide improved MASH in 62% at 4.8 mg vs 14% on placebo; pemvidutide resolved MASH in 52% at 1.8 mg vs 20%.
🔄
Dual Amylin
Cagrisema adds amylin agonism to GLP-1. The amylin pathway adds satiety signaling and slows gastric emptying. Novo Nordisk's bet on differentiation.
🇨🇳
Approved in China
Mazdutide is approved in China for weight management (June 2025). GLORY-2: −16.65% at 9 mg over 60 weeks.
🍷
Addiction Potential
Pemvidutide has completed a phase 2 alcohol use disorder trial. Whether GLP-1-based drugs help addiction is still an open research question.
🏆
Triple Agonist
Retatrutide (triple agonist) reported −25.0% at 12 mg over 80 weeks in phase 3 TRIUMPH-1. CagriSema reported 20.4% (68 weeks) and mazdutide 16.65% (9 mg, 60 weeks) in their own trials. Cross-trial numbers are not head-to-head comparisons.
Who Might Benefit

Which Drug Is Right For You?

Target populations for each pipeline drug based on mechanism and trial data.

✅ Orforglipron: Best For
  • needle-averse patients who want GLP-1 benefits
  • Those who can't tolerate injections weekly
  • Patients wanting convenience (no food timing)
  • Those preferring oral medication options
  • Anyone with good adherence to daily pills
✅ Cagrisema: Best For
  • Weight loss on an established semaglutide backbone
  • Patients wanting proven dual mechanism
  • Novo Nordisk brand loyalists
  • Those with type 2 diabetes (improved HbA1c)
✅ Survodutide: Best For
  • Adults with biopsy-confirmed MASH and F1–F3 fibrosis (the phase 2 trial population)
  • Adults with obesity (SYNCHRONIZE-1 phase 3 population)
✅ Pemvidutide: Best For
  • Adults with biopsy-confirmed MASH and F2–F3 fibrosis (the IMPACT phase 2b population: 52% MASH resolution at 1.8 mg vs 20% placebo, 24 weeks)
  • People eligible for its phase 3 MASH trial (NCT07795164)
✅ Mazdutide: Best For
  • Patients in China, where it is approved
  • Those wanting proven efficacy data
  • Access to global markets (eventual US/EU)
🔜 Wait for Retatrutide
  • Triple agonist: −25.0% at 12 mg over 80 weeks (TRIUMPH-1)
  • Phase 3 obesity results published (NEJM, 2026)
  • Lilly plans FDA submission in Q1 2027
  • GLP-1 + GIP + glucagon all in one
  • Not FDA-approved yet
Related Resources

Dive Deeper Into GLP-1 Research

💉
Semaglutide Research Results
Complete clinical trial data for Wegovy/Ozempic
→
💉
Tirzepatide Research Results
Mounjaro/Zepbound dual-agonist data
→
🏆
Retatrutide Results
Triple agonist phase 2 and phase 3 data
→
⚖️
Retatrutide vs Semaglutide
Cross-trial comparison (separate trials, not head-to-head)
→
🔄
Ozempic Alternatives Guide
Every weight loss option compared
→
💪
GLP-1 Muscle Loss Prevention
Preserve lean mass on GLP-1s
→

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Bottom Line

Key Takeaways

✅ What We Know
  • 5 advanced GLP-1 pipeline drugs with Phase 2+ data
  • Orforglipron: FDA-approved as Foundayo on April 1, 2026 (oral, with or without food)
  • Wegovy tablets (oral semaglutide 25 mg): FDA-approved December 22, 2025
  • Cagrisema: NDA submitted December 2025, potential late 2026 approval
  • Mazdutide: approved in China for weight management (June 2025)
  • Survodutide: phase 3 SYNCHRONIZE-1 published (−13.0% at 76 weeks); 62% MASH improvement at 4.8 mg in phase 2
  • Pemvidutide: 52% MASH resolution at 1.8 mg vs 20% placebo (24 weeks), also tested in AUD (phase 2)
  • Retatrutide: phase 3 TRIUMPH-1 published, −25.0% at 12 mg over 80 weeks; FDA filing planned Q1 2027
⚠️ What We Don't Know
  • Final FDA approval timelines (subject to change)
  • Pricing and insurance coverage for new drugs
  • Long-term safety data (most trials ongoing)
  • Comparative head-to-head trials between pipeline drugs
  • Real-world efficacy vs clinical trial conditions
  • Optimal sequencing between different mechanisms
  • Combination effects with other medications
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⚠️ Important Disclaimer

This page is for educational and informational purposes only. The drugs discussed are research compounds and pipeline drugs, several of which are not FDA-approved; the approval status of each drug is shown in the comparison table above. All data cited comes from clinical trials and published research. Dosages, timelines, and approval statuses are subject to change. Always consult a qualified, licensed healthcare provider before starting any new medication. Nothing on this page constitutes medical advice. Clinical trial data shown from different studies — direct comparisons should be made with caution.

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