The next weight loss drugs most likely to reach US patients are Novo Nordisk's CagriSema, which has an FDA decision expected in Q4 2026 according to Novo, and Eli Lilly's retatrutide, which Lilly plans to submit to the FDA in Q1 2027. Behind them, amycretin, MariTide, survodutide, VK2735, CT-388 and several new GLP-1 pills are in Phase 2 or Phase 3 trials, and none of them has a filed US application as of October 31, 2026.
2026 has already been a busy year for approvals. The Wegovy pill was approved on December 22, 2025 and launched in January, Wegovy HD (semaglutide 7.2 mg) was approved on March 19, 2026, and Lilly's Foundayo (orforglipron) pill was approved on April 1, 2026.
One rule applies to every drug in the table below: none of them is FDA-approved for weight loss. They cannot be legally prescribed to you outside a clinical trial, and anything sold online today as "retatrutide", "CagriSema" or "amycretin" is an unapproved product of unknown content. Lilly states that retatrutide "has not been reviewed or approved by the FDA or any regulatory agency in the world, and no one can legally sell it for human use."
The obesity drug pipeline at a glance (as of October 31, 2026)
| Drug (company) | How it works | How it is taken | Best published weight result (trial, length, analysis) | Stage | Company-stated next step |
|---|---|---|---|---|---|
| Retatrutide (Eli Lilly) | GIP, GLP-1 and glucagon "triple agonist" | Weekly injection | TRIUMPH-1, 80 weeks, 12 mg: 28.3% average loss if everyone stayed on drug, efficacy estimand (Lilly); 25.0% counting everyone randomized, treatment-regimen estimand (NEJM) | Phase 3, multiple trials reported | FDA submission planned for Q1 2027 (stated July 23, 2026) |
| CagriSema (Novo Nordisk) | Amylin analog cagrilintide plus semaglutide | Weekly injection | REDEFINE 1, 68 weeks: 20.4% counting everyone, 22.7% if all adhered (Novo) | Filed with FDA December 18, 2025 | US decision expected Q4 2026 (Novo Q2 2026) |
| Amycretin, also called zenagamtide (Novo Nordisk) | GLP-1 and amylin activity in one molecule | Weekly injection and daily pill | Phase 1b/2a, 36 weeks: up to 24.3% at the highest injected doses vs 1.1% on placebo (Novo) | Phase 3 (AMAZE) started early 2026 | No filing or approval timeline given |
| MariTide, maridebart cafraglutide (Amgen) | GLP-1 agonist joined to an antibody that blocks the GIP receptor | Injection monthly or less often | Phase 2, 52 weeks, obesity cohort: 12.3% to 16.2% counting everyone, 16.3% to 19.9% on treatment (NEJM) | Phase 3 (MARITIME) ongoing | No readout date given |
| Survodutide (Boehringer Ingelheim, Zealand) | GLP-1 and glucagon dual agonist | Weekly injection | SYNCHRONIZE-1, 76 weeks, 6.0 mg: up to 16.6% vs 3.2% on placebo, on treatment (Boehringer) | Phase 3 obesity trials reported | No filing date stated |
| CT-388, now enicepatide (Roche) | GLP-1 and GIP dual agonist | Weekly injection | Phase 2, 48 weeks, 24 mg: 22.5% more than placebo on treatment, 18.3% counting everyone (Roche) | Phase 3 planned from Q1 2026 | Roche said Phase 3 would start Q1 2026 |
| VK2735 (Viking Therapeutics) | GLP-1 and GIP dual agonist | Weekly injection; pill version in testing | VENTURE-Oral pill, 13 weeks: up to 12.2% from baseline (Viking) | Injection Phase 3 (VANQUISH-1 and -2) fully enrolled | Oral Phase 3 start expected Q4 2026 (Viking) |
| Petrelintide (Zealand, Roche) | Long-acting amylin analog | Injection | ZUPREME-1, 42 weeks: up to 10.7% vs 1.7% on placebo, on treatment (Roche) | Phase 3 (ZUPREME) started | No filing date stated |
| Eloralintide (Eli Lilly) | Selective amylin agonist | Injection | Phase 2, 48 weeks: 9.5% to 20.1% vs 0.4% on placebo, on treatment (Lilly) | Phase 3 planned | Lilly planned Phase 3 start by end of 2025 |
| Aleniglipron (Structure Therapeutics) | Small-molecule GLP-1 | Daily pill | ACCESS Phase 2b, 36 weeks, 120 mg: 11.3% more than placebo (Structure) | Phase 2b complete | Phase 3 start was expected Q3 2026 (not confirmed) |
| CT-996 (Roche) | Small-molecule GLP-1 | Daily pill | Phase 1, 4 weeks: 6.1% more than placebo (Roche) | Phase 2 ongoing | No Phase 2 results yet |
| Bimagrumab plus semaglutide (Eli Lilly) | Activin type II receptor antibody added to a GLP-1 | Injection | BELIEVE Phase 2b, 72 weeks: 22.1% with high-dose combination vs 15.7% semaglutide alone (Healio) | Phase 2b | No filing date stated |
Two cautions. Every number comes from a separate trial with its own length, doses and population, so the rows are not a ranking. And "on treatment" figures (the efficacy estimand) assume everyone kept taking the drug, so they look larger than "counting everyone" figures (the treatment-regimen estimand).
What this means for you: if you need treatment in the next 12 months, the drugs you can actually get are the ones already approved: Wegovy, Wegovy HD, the Wegovy pill, Zepbound, Foundayo and generic liraglutide. Later sections cover cost, coverage and whether waiting makes sense.








