What's New & Next For Weight-Loss

Here’s the quick, up-to-date rundown of what’s new & what’s next in weight-loss meds—beyond Wegovy/Ozempic (semaglutide) and Mounjaro/Zepbound (tirzepatide):

What’s coming soon(ish)

1) Potent oral options (no injections)

• Oral semaglutide for obesity (“Wegovy-in-a-pill”): late-stage prep with efficacy near the injection; Novo says it won’t be priced above the injectable. Barron's

• Orforglipron (Lilly): non-peptide oral GLP-1; Phase 3 trials reporting positive results for weight and cardiometabolic markers. New England Journal of Medicine+1

• Danuglipron (Pfizer): program stopped in April 2025 after a potential drug-induced liver injury; Pfizer pivoting to other obesity assets. Pfizer+2Reuters+2

• VK2735 (Viking): oral GLP-1/GIP dual agonist; Phase 2 showed up to ~12% loss at 13 weeks; larger studies planned. appliedclinicaltrialsonline.com+1

2) Combo drugs & new hormone mixes (aiming for >20–25% loss)

• CagriSema (cagrilintide + semaglutide, weekly): Phase 3 programs show meaningful weight-reduction; NEJM data support significant losses vs placebo. New England Journal of Medicine+2pharmaceutical-technology.com+2

• Amycretin (unimolecular GLP-1 + amylin, Novo): early trials show double-digit % weight loss in weeks with no plateau yet—now moving through Phase 2. The Lancet+2Reuters+2

3) Triple- and dual-agonists beyond GLP-1

• Retatrutide (Lilly; GLP-1/GIP/glucagon “triple”): Phase 3 in obesity underway after strong Phase 2; not approved—avoid black-market versions. ClinicalTrials

• Survodutide (Boehringer/Zealand; GLP-1/glucagon): Phase 2 showed up to ~12–15% loss over ~46 weeks; Phase 3 programs progressing. JACC+2pace-cme.org+2

• MariTide (Amgen; maridebart cafraglutide): long-interval dosing concept (monthly or longer) with ~20% average loss in Phase 2; now in Phase 3 (MARITIME). investors.amgen.com+2PR Newswire+2

Key themes to expect next

• More pills: Several oral agents aim to match injections for efficacy with easier access. Barron's+1

• Faster, deeper loss: Multi-agonists (GLP-1 + amylin or + glucagon, or triple agents) are targeting >20–25%average loss in Phase 2/3. The Lancet+1

• Longer intervals & combos: Monthly (or longer) dosing and combination mechanisms to improve durability and adherence. PR Newswire

• Safety scrutiny: Programs can still be halted (e.g., danuglipron) when safety signals appear; stick to regulated products only. Pfizer

Practical takeaways (for patients/clinics)

• Today’s best-in-class remain semaglutide and tirzepatide.

• The next wave (CagriSema, amycretin, retatrutide, survodutide, MariTide, orals like orforglipron) could bring greater weight loss, pill options, and less frequent dosing—but they’re still in trials or early rollout and not yet widely available. New England Journal of Medicine+5New England Journal of Medicine+5The Lancet+5

• Avoid grey/black-market “research” jabs (e.g., retatrutide being sold online). They’re unapproved, potentially fake/contaminated, and risky. The Sun+1

• ✅ Approved & In Use Today

Drug	Class / Mechanism	Typical Use / Notes
Semaglutide (Wegovy / Ozempic)	GLP-1 receptor agonist	Weekly injection; titration schedule; well-studied for obesity & type 2 diabetes
Tirzepatide (Mounjaro / Zepbound)	Dual GLP-1 / GIP agonist	Weekly; excellent weight loss results; careful dose escalation to reduce GI side effects

🔮 Pipeline & Emerging Agents

Candidate / Combo	Mechanism / Innovation	Current Phase / Highlights
CagriSema (cagrilintide + semaglutide)	Amylin + GLP-1 combo	Phase 3; preliminary data show strong additive weight loss beyond GLP-1 alone
Amycretin	Unimolecular amylin + GLP-1 hybrid	Phase 2; potent early losses, aim for durability
Retatrutide	Triple agonist (GLP-1 / GIP / glucagon)	Phase 3 ongoing; promising Phase 2 efficacy
Survodutide	Dual GLP-1 / glucagon	Phase 2 positive results; Phase 3 underway
Maridebart / MariTide	Long-interval GLP-1 variant (monthly or more)	Phase 3 (MARITIME) aims to reduce frequency burden
Orforglipron	Oral non-peptide GLP-1	Phase 2 / 3; offers a pill alternative to injections
VK2735	Oral GLP-1 / GIP dual agonist	Phase 2; promising weight loss in early trials

⚠️ Safety & Monitoring Notes

• New agents still carry unknown long-term risks. Monitor carefully for GI side effects, pancreatitis, gallbladder disease, etc.

• Some pipelines (e.g. Danuglipron) have been halted for safety (potential liver injury). Always check latest regulatory updates.

• Avoid unapproved, off-label, or black-market injections — risks include contamination, dosing error, and no oversight.

• When combining or transitioning therapies, watch for additive side effects, interactions, and patient tolerance.

• Always emphasise complementary lifestyle support (diet, exercise, behavioural therapy) — new drugs are not magic bullets.

• Cost, access, and insurance coverage will continue to be major limiting factors in adoption.