The Obesity Peptide Pipeline: Status of Every Candidate, September 2026

None of the next wave of obesity peptides is approved in the US as of September 2026. CagriSema is the closest: Novo Nordisk filed it with FDA in December 2025. Lilly says it will file retatrutide in the first quarter of 2027. Mazdutide is approved only in China. Foundayo (orforglipron), which FDA approved in April 2026, is not a peptide at all.

The table

Each row was checked against the sponsor's own announcements, FDA's drug approval database and ClinicalTrials.gov in September 2026.

The table leaves out the approved peptides a reader can get today, semaglutide and tirzepatide, which are covered in the last section.

Which are peptides, and why it matters

Six of the seven rows are peptides or carry peptides. Retatrutide, mazdutide, survodutide and amycretin are single peptide chains that each hit two or three receptors. CagriSema is two peptides in one injection: cagrilintide, an amylin analog, and semaglutide. MariTide is the hybrid. Amgen's own trial report describes it as "a long-acting peptide-antibody conjugate that combines glucagon-like peptide-1 receptor agonism and glucose-dependent insulinotropic polypeptide receptor antagonism"¹. It is dosed every four weeks.

Orforglipron is the exception. It activates the GLP-1 receptor but is a small-molecule pill, and FDA approved it on April 1, 2026, under the brand Foundayo². It belongs on a list of obesity drugs. It does not belong on a list of peptides, and any page selling it as one has the chemistry wrong.

The distinction matters for more than taxonomy. A peptide has to be protected from digestion to work as a pill, and most of these are weekly injections for that reason. It also decides the regulatory lane. Lilly says it will file retatrutide as a Biologics License Application³, which is a different pathway from the drug application Novo used for CagriSema⁴. The mechanism differences between two-receptor and three-receptor drugs are covered in triple agonist versus dual agonist.

Registered, completed, and reported

A trial finishing and a trial reporting are separate events. We counted phase 3 records on ClinicalTrials.gov by intervention name in September 2026 and checked how many completed trials had posted results there.

The zeros are not a sign of trouble on their own. Sponsors have a window after completion before results must be posted, and several of these trials finished within the past year. The control row shows the search can find posted results when they exist: orforglipron, the one approved drug in the set, has five. What the zeros do mean is that the numbers circulating for these drugs come from press releases and journal articles, and nothing yet sits in the public registry where a reader can check the full outcome tables. The same gap is discussed in registered but never reported.

Retatrutide: TRIUMPH status and results posting

Lilly announced topline results from TRIUMPH-2 and TRIUMPH-3 on July 23, 2026. At 80 weeks, adults with type 2 diabetes lost 12.7%, 19.1% and 20.8% of body weight on 4, 9 and 12 mg in TRIUMPH-2. In TRIUMPH-3, adults with obesity and established cardiovascular disease lost 21.6% on 9 mg and 22.6% on 12 mg³. Lilly calls it "five positive Phase 3 studies" and says it plans "to submit a Biologics License Application (BLA) for retatrutide to FDA in Q1 2027"³.

One phase 3 trial has a peer-reviewed paper: TRANSCEND-T2D-1, in people with type 2 diabetes, published in The Lancet in June 2026⁵. The obesity trials TRIUMPH-1 through TRIUMPH-4 are all marked completed on ClinicalTrials.gov, and none has posted results⁶. The registry numbers and the published figures are set side by side on our retatrutide page and in retatrutide vs tirzepatide.

Anything sold today as retatrutide is not Lilly's drug. There is no approved product and no lawful compounding route for an unapproved molecule.

CagriSema: filing status

Novo Nordisk announced on December 18, 2025 that it had submitted a New Drug Application to FDA for once-weekly CagriSema, cagrilintide 2.4 mg with semaglutide 2.4 mg. The filing rests on REDEFINE 1 and REDEFINE 2, both 68-week phase 3 trials, and Novo said FDA "is expected to review the CagriSema application in 2026"⁴. In September 2026, FDA's approval database still listed no product containing cagrilintide.

The published REDEFINE 1 result was a mean weight change of -20.4% with CagriSema against -3.0% with placebo at 68 weeks. Gastrointestinal adverse events affected 79.6% of the CagriSema group and 39.9% of the placebo group⁷.

The head-to-head trial went the other way. On February 23, 2026, Novo reported that REDEFINE 4 "did not achieve its primary endpoint of demonstrating non-inferiority on weight loss for CagriSema compared to tirzepatide after 84 weeks." Weight loss was 23.0% with CagriSema and 25.5% with tirzepatide 15 mg if everyone had stayed on treatment, and 20.2% against 23.6% counting everyone randomized⁸. The amylin side of the combination is covered in amylin analogs after incretins and on the cagrilintide page.

Amycretin, mazdutide, survodutide and MariTide

Amycretin is one molecule that activates both GLP-1 and amylin receptors. In a phase 1b/2a study, weekly injections produced weight changes of -24.3% at 60 mg over 36 weeks against -1.1% on placebo, with smaller losses at lower doses and shorter durations⁹. Its ten phase 3 AMAZE records were all enrolling or active, none completed, in September 2026⁶.

Mazdutide is approved in China. Innovent announced on June 27, 2025 that China's drug regulator approved it "for chronic weight management in Chinese adults with overweight or obesity"¹⁰. The Chinese phase 3 trial reported a mean weight change of -14.01% on 6 mg at 48 weeks, against 0.30% on placebo¹¹. In the US, a Lilly-funded phase 2 trial in 179 adults was published in 2026¹². No US filing has been announced.

Survodutide reached phase 3 results in April 2026. Boehringer Ingelheim reported that SYNCHRONIZE-1 met its co-primary endpoints, with weight loss of up to 16.6% at 76 weeks against 3.2% on placebo, counted as if all participants stayed on treatment¹³. The survodutide page covers the liver-disease program that runs alongside.

MariTide is dosed monthly. Its phase 2 trial reported weight changes of -12.3% to -16.2% at 52 weeks in people with obesity, against -2.5% on placebo¹. Ten phase 3 MARITIME records were registered, none completed⁶.

What you can lawfully get today

For weight loss in the US in September 2026, the approved peptide options are semaglutide (Wegovy) and tirzepatide (Zepbound), plus the older liraglutide. Foundayo is approved as well, but it is a pill, not a peptide². Everything else in the table is available only inside a clinical trial.

Pharmacies may still compound semaglutide and tirzepatide under 503A within FDA's limits on copies, and FDA has proposed barring outsourcing facilities from compounding them from bulk. The details are in compounding status by peptide. The evidence behind each approved drug is on the semaglutide and tirzepatide pages, and the companies that prescribe them are compared on the semaglutide board and the tirzepatide board.