Next Weight Loss Drugs Pipeline (2026): Retatrutide 28.7%, CagriSema 22.7%, MariTide Monthly
Updated May 2026: 5 next-gen obesity drugs in Phase 3. Retatrutide (Lilly) 28.7% weight loss. CagriSema (Novo): REDEFINE-1 22.7% (obesity), REDEFINE-2 15.7% (T2D), PDUFA expected October 2026. MariTide (Amgen, monthly), survodutide, Foundayo approved April 2026. FDA approvals 2026-2028.
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In this article
- 01CagriSema (Novo Nordisk), Semaglutide + Amylin Analog
- 02Retatrutide (Eli Lilly), The Triple Agonist
- 03Foundayo / Orforglipron (Eli Lilly), Just Approved
- 04MariTide (Amgen), The Monthly Injection
- 05Survodutide (Boehringer Ingelheim), Obesity + Liver Disease
- 06The Full Pipeline Comparison
- 07What This Means for You
Updated May 2026: At least 5 next-generation obesity drugs are in late-stage clinical trials. Retatrutide (Eli Lilly, triple-agonist) delivered 28.3% weight loss at 80 weeks in the primary TRIUMPH-1 trial (2,339 patients), reaching 30.3% at 104 weeks, nearly double semaglutide's 14.9%. CagriSema (Novo Nordisk, semaglutide + cagrilintide) achieved 22.7% in REDEFINE-1 (obesity) and 15.7% in REDEFINE-2 (Type 2 diabetes), with PDUFA expected October 2026. MariTide (Amgen) is a once-monthly injection in Phase 3. Survodutide (Boehringer/Zealand, GLP-1/glucagon dual) is in Phase 3. FDA approvals are expected 2026-2028. Orforglipron (Eli Lilly's oral GLP-1) was already approved as Foundayo in April 2026, the first drug from this pipeline wave to reach patients.
Quick answer: what can you actually get TODAY while waiting for these drugs?
- •Highest approved weight loss right now: Tirzepatide (Zepbound) at 20.9%, LillyDirect $299/mo or Enhance MD from $99 first month compounded
- •New oral pill approved April 2026: Foundayo (orforglipron) from $149/mo, 12.4% loss, no fasting
- •Low-cost semaglutide: Yucca Health $146/mo or Strut Health $149/mo oral
- •Brand Wegovy self-pay: NovoCare $349/mo, 14.9% loss. Or telehealth via Hers $149/mo (cheapest brand Wegovy via the 2026 Novo partnership).
This guide breaks down every major obesity drug in late-stage development, mechanism, trial results, expected approval dates, and anticipated pricing. For drugs already approved, see our GLP-1 beginner's guide and provider rankings.
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Compare all 52GLP-1 providers →CagriSema (Novo Nordisk), Semaglutide + Amylin Analog
CagriSema is Novo Nordisk's answer to the competition from Eli Lilly. It combines two drugs in one once-weekly injection: semaglutide 2.4mg (the same active ingredient in Wegovy) plus cagrilintide 2.4mg, a long-acting amylin analog that enhances satiety through a separate brain pathway.
The REDEFINE 1 trial (published in NEJM, June 2025) enrolled 3,417 adults and showed:
| Arm | Weight Loss at 68 Weeks | Key Thresholds |
|---|---|---|
| CagriSema | -22.7% (on-treatment) | 97.6% lost 5%+, 40.4% lost 25%+ |
| Semaglutide alone | -14.9% | Matches STEP 1 trial results |
| Cagrilintide alone | -11.5% | Amylin alone is less effective |
| Placebo | -3.0% | Control group |
REDEFINE 2 (Type 2 diabetes + obesity comorbidity population, 68 weeks) added a second efficacy readout: CagriSema achieved 15.7% weight loss, lower than REDEFINE 1's 22.7% in the non-diabetic obesity population, consistent with the typical attenuation seen across all GLP-1 drugs in T2D populations vs. pure obesity. Both REDEFINE 1 and REDEFINE 2 datasets support the NDA Novo filed in December 2025.
Novo Nordisk filed the NDA on December 18, 2025. FDA PDUFA date is expected in October 2026 (approximately 10 months from NDA filing under standard review), with commercial launch planned for early-to-mid 2027.
Side effects in REDEFINE 1: nausea 55%, constipation 30.7%, vomiting 26.1%. Higher GI rates than semaglutide alone (79.6% vs 39.9% reporting any GI event), though most were mild-to-moderate and improved over time.
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Retatrutide (Eli Lilly), The Triple Agonist
We covered retatrutide in depth in our dedicated article. The key facts: it's a first-in-class triple agonist (GLP-1 + GIP + glucagon receptor) that achieved 28.7% weight loss in the TRIUMPH-4 Phase 3 trial, the highest ever recorded in an obesity drug trial.
NDA submission is expected Q4 2026 or Q1 2027, with potential FDA approval in late 2027 to early 2028. The unique addition of glucagon receptor agonism promotes fat oxidation and higher resting metabolic rate. One emerging safety signal to watch: dysesthesia (tingling/burning skin) was reported in 20.9% of patients at the 12mg dose.
Foundayo / Orforglipron (Eli Lilly), Just Approved
Foundayo was FDA approved on April 1, 2026, a once-daily oral pill that can be taken anytime, with no food or water restrictions. It achieved 12.4% weight loss at 72 weeks (less than injectables, but the most effective oral option). Starting at $149/month self-pay through LillyDirect. See our full breakdown for details.
Editor's Top Pick
Yucca Health
$146/mo · 7.7/10 · Compounded
Online weight-loss program by Yucca Health, Inc. (Beverly Hills, CA). Two named board-certified doctors, Dr. Michael Wasef MD and Dr. Andrew Sakla DO, handle prescribing. 20,000+ patients, 4.6 stars across 1,065 verified Trustpilot reviews. Starts at $146/mo for compounded semaglutide (custom-made version, not the FDA-approved brand) on the 6-month plan. Buy-now-pay-later via Klarna, Affirm, or Afterpay spreads the upfront commitment.
MariTide (Amgen), The Monthly Injection
MariTide (maridebart cafraglutide) takes a completely different approach. It's an antibody-peptide conjugate that combines GLP-1 agonism with GIP antagonism (the opposite of tirzepatide, which uses GIP agonism). Its 21-day half-life enables once-monthly dosing, a major convenience advantage over weekly injections.
Phase 2 data (presented at ADA June 2025, 592 participants) showed up to 20% weight loss at 52 weeks in patients without Type 2 diabetes, and up to 17% in those with T2D.
- •Dosing: Once monthly subcutaneous injection (vs weekly for all competitors)
- •Mechanism: GLP-1 agonist + GIP antagonist, novel dual mechanism
- •Status: Phase 3 (MARITIME program) actively enrolling
- •Timeline: FDA approval unlikely before 2028-2029
- •Key advantage: Monthly dosing could significantly improve adherence
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Take the 60-sec QuizSurvodutide (Boehringer Ingelheim), Obesity + Liver Disease
Survodutide is a glucagon/GLP-1 dual agonist (similar mechanism to retatrutide but without GIP). Phase 2 data showed up to 18.7% weight loss at 46 weeks at the 4.8mg dose, with 55% of patients achieving 15%+ loss.
What makes survodutide unique: it received FDA Breakthrough Therapy Designation in September 2024 for non-cirrhotic MASH (metabolic dysfunction-associated steatohepatitis), formerly called NASH/fatty liver disease. This dual obesity + liver disease potential could differentiate it from pure weight loss drugs. Phase 3 SYNCHRONIZE trials are underway with results expected in 2026.
The Full Pipeline Comparison
| Drug | Maker | Mechanism | Best Weight Loss | Dosing | Status | Expected Approval |
|---|---|---|---|---|---|---|
| Foundayo | Eli Lilly | Oral GLP-1 (non-peptide) | 12.4% | Daily pill | FDA APPROVED Apr 2026 | Available now |
| CagriSema | Novo Nordisk | GLP-1 + amylin | 22.7% | Weekly injection | NDA filed Dec 2025 | Late 2026 / early 2027 |
| Retatrutide | Eli Lilly | GLP-1 + GIP + glucagon | 28.7% | Weekly injection | Phase 3 | Late 2027 / early 2028 |
| MariTide | Amgen | GLP-1 + anti-GIP | 20% | MONTHLY injection | Phase 3 | 2028-2029 |
| Survodutide | Boehringer | GLP-1 + glucagon | 18.7% | Weekly injection | Phase 3 | 2027-2028 |
What This Means for You
If you're considering GLP-1 treatment today, here's the practical takeaway: don't wait for pipeline drugs if you qualify now. Wegovy and Zepbound are effective and available, and Foundayo just added a convenient pill option. Use our cost calculator to see what you'd pay, or take the match quiz to find the best provider.
However, if you're on semaglutide and curious about what's next, the landscape is about to get much more competitive. CagriSema, retatrutide, and MariTide all offer meaningful improvements in efficacy or convenience. We'll update this article as new trial results and approval decisions are announced throughout 2026-2027.
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting any medication. Information is current as of the publication date but may change.
Affiliate Disclosure: Some links in this article are affiliate links. We may earn a commission if you sign up through our links, at no extra cost to you.
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What the doctors say
Verbatim, independently sourced statements from named physicians and medical bodies, real clinicians quoted with their sources, not a single paid reviewer. General clinical context, not an endorsement of any provider.
“Thanks to the latest advancements in obesity management medications, more physicians and patients are witnessing significant weight reduction beyond what they have seen before. The SURMOUNT-5 head-to-head results demonstrated tirzepatide led to greater weight reduction compared to semaglutide, providing further evidence to support tirzepatide as an effective option for obesity.”
“Patients on both medications experienced substantial weight loss, and we observed no difference in the risk of gastrointestinal adverse events. In addition to effectiveness, factors like medication availability and insurance coverage will likely play a role in deciding which medication to initiate.”
“For more than a million people at high risk of heart attack and stroke, this treatment on the NHS could be life-changing – offering a powerful new way to protect their hearts and improve their health.”
Quotes are general medical commentary about GLP-1 medications, independently sourced and not solicited by GLP-1 Picks. They are not an endorsement of any provider, our provider scores are set solely by our published methodology.