Next Weight Loss Drugs Pipeline (2026): Retatrutide 28.7%, CagriSema 22.7%, MariTide Monthly

Updated May 2026: At least 5 next-generation obesity drugs are in late-stage clinical trials. Retatrutide (Eli Lilly, triple-agonist) achieved 28.7% weight loss in Phase 3 TRIUMPH-1 — 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 $149/mo compounded
• •New oral pill approved April 2026: Foundayo (orforglipron) $649/mo — 12.4% loss, no fasting
• •Cheapest semaglutide: Enhance MD $115/mo or Strut Health $149/mo oral
• •Brand Wegovy self-pay: NovoCare $349/mo — 14.9% loss. Or telehealth via Eden Health $249/mo.

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.

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:

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.

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.

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

Survodutide (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

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.