The next generation of weight-loss drugs is racing through late-stage trials, and three names stand out: retatrutide, CagriSema, and survodutide. Here is where each stands and how their approaches differ.
Quick answer
Retatrutide (Eli Lilly) is a triple agonist (GLP-1, GIP, and glucagon) in Phase 3, with reported weight loss around 28% to 30% at higher doses, the strongest of the group so far. CagriSema (Novo Nordisk) combines an amylin analog with semaglutide and showed about 22.7% weight loss in Phase 3, with a new drug application reportedly submitted. Survodutide (Boehringer Ingelheim/Zealand) is a GLP-1/glucagon dual agonist showing about 19% in Phase 2 and now in Phase 3. None is FDA-approved yet. Retatrutide leads on reported efficacy, but all three are advancing.
The contenders and how they work
Each takes a different molecular approach to weight loss.
- Retatrutide: A triple agonist hitting GLP-1, GIP, and glucagon receptors. Adding glucagon may boost energy expenditure on top of appetite suppression.
- CagriSema: A combination of cagrilintide (an amylin analog) and semaglutide (a GLP-1 agonist). It pairs two complementary appetite-regulating mechanisms.
- Survodutide: A dual GLP-1/glucagon agonist, combining appetite suppression with glucagon's metabolic effects.
So retatrutide and survodutide both use the glucagon receptor, while CagriSema brings amylin into the mix alongside semaglutide.
Where each stands and what the data shows
The reported results put them in a rough order on efficacy, though cross-trial comparisons are not definitive.
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Take the Assessment →- Retatrutide: Phase 3 (TRIUMPH program). Reported roughly 28% to 30% average weight loss at higher doses, the highest reported in a large Phase 3 obesity trial.
- CagriSema: Phase 3 (REDEFINE program). REDEFINE 1 showed about 22.7% mean weight loss at 68 weeks. A new drug application was reportedly submitted in late 2025, putting it closest to potential approval.
- Survodutide: Phase 3 (SYNCHRONIZE program), after about 19% weight loss in Phase 2. Results are still maturing.
Comparison table
| Drug | Mechanism | Reported weight loss | Stage |
|---|---|---|---|
| Retatrutide | GLP-1 + GIP + glucagon (triple) | ~28% to 30% (Phase 3) | Phase 3 (TRIUMPH) |
| CagriSema | Amylin analog + semaglutide | ~22.7% (Phase 3) | Phase 3, NDA reportedly submitted |
| Survodutide | GLP-1 + glucagon (dual) | ~19% (Phase 2) | Phase 3 (SYNCHRONIZE) |
What about MariTide and others?
The pipeline is broader than these three. MariTide (Amgen) is a once-monthly injectable that acts as a GIP antagonist combined with a GLP-1 agonist, showing roughly 12% to 16% weight loss in Phase 2 and now in Phase 3. Its monthly dosing is a notable differentiator. Other candidates continue to advance, reflecting how active obesity drug development has become. The field is moving quickly, so the leaderboard may shift as more data arrives.
What this means for patients
For now, none of these is available; the approved options remain semaglutide and tirzepatide. The pipeline is exciting because it points toward even more effective treatments and, eventually, more competition that could improve access and cost. CagriSema appears closest to a possible approval given its reported regulatory submission, while retatrutide leads on reported efficacy. Timelines depend on completing trials and regulatory review.
Where FormBlends fits
If you are tracking the obesity drug pipeline, FormBlends keeps plain-language guides on current and emerging treatments and a provider comparison tool so you can understand the options available today, including compounded semaglutide.
Frequently asked questions
What is the difference between retatrutide, CagriSema, and survodutide?
Retatrutide is a triple agonist (GLP-1/GIP/glucagon); CagriSema combines an amylin analog with semaglutide; survodutide is a GLP-1/glucagon dual agonist.
Which has the highest reported weight loss?
Retatrutide, with roughly 28% to 30% at higher doses in Phase 3, ahead of CagriSema (~22.7%) and survodutide (~19% in Phase 2).
Are any of these FDA-approved?
No. All are investigational. CagriSema appears closest, with a reported regulatory submission.
What is CagriSema?
A combination of cagrilintide (an amylin analog) and semaglutide, pairing two appetite-regulating mechanisms.
What is survodutide?
A dual GLP-1/glucagon agonist in Phase 3, with about 19% weight loss reported in Phase 2.
What about MariTide?
MariTide (Amgen) is a once-monthly GIP antagonist/GLP-1 agonist showing about 12% to 16% in Phase 2, now in Phase 3.
When will these be available?
Timelines depend on completing trials and regulatory review. CagriSema is reportedly furthest along with a submission.
Which should I wait for?
For now, talk to a provider about approved options. The pipeline is promising, but availability is not yet set.
Related guides
- Semaglutide vs Tirzepatide vs CagriSema: Current Best vs Next-Gen — How They Stack Up
- Tirzepatide Vs Retatrutide Next Gen Glp1
- Semaglutide vs Phentermine vs Contrave: Three Generations of Weight Loss Drugs Compared
- GLP-1 Drugs vs Bariatric Surgery vs Diet & Exercise: Three Paths to Weight Loss Compared
- Retatrutide vs Cagrisema: Weight Loss Comparison
- All 5 FDA-Approved Weight Loss Drugs Compared: Wegovy vs Zepbound vs Saxenda vs Contrave vs Qsymia
Sources
- AJMC, retatrutide TRIUMPH-1 Phase 3 results: https://www.ajmc.com/view/retatrutide-achieves-up-to-30-3-average-weight-loss-in-phase-3-triumph-1-trial
- Medpace, obesity drug developments and pipeline overview: https://www.medpace.com/blog/world-obesity-day-2025-recent-developments-and-the-road-ahead/
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