What started with Ozempic has become a new era in weight-loss success with blockbuster GLP-1 drugs like Wegovy and Zepbound helping fight obesity.
But they’re just the beginning. New treatments that are more powerful, mimic more satiety hormones and can be taken in more ways than weekly injections are in the works.
“There’s a huge pipeline of new medications that are coming,” Dr. Melanie Jay, director of the NYU Langone Comprehensive Program on Obesity Research, tells TODAY.com.
The current drugs are making a huge difference, especially as prices drop and more people have access to them, adds Dr. Shauna Levy, medical director of Tulane University’s Bariatric and Weight Loss Center in New Orleans.
Oprah Winfrey is among the high-profile GLP-1 users, and credits the medication with finally helping her find lasting weight loss.
GLP-1 drugs now account for more than 7% of all prescriptions in the U.S., according to Truveta Research, a health data company.
But more options are needed, Levy notes, especially since the drugs need to be taken for the long term. When people stop treatment, “rapid weight regain” can happen, a 2026 review of studies found.
“Not everybody responds to GLP-1,” she tells TODAY.com.
“(Other) people are having tolerance to it. … Over time, somebody who responded to Wegovy really well at the beginning, five, 10, 20 years from now, probably will need some other more powerful or different acting medication.”
Hundreds of medications are needed for the treatment of a chronic disease like obesity, says Dr. Ania Jastreboff, director of the Yale Obesity Research Center.
“Just as there are many classes of medications for diabetes or for blood pressure, there will be many different classes that target different mechanisms of the disease of obesity,” she notes. Jastreboff is on the scientific advisory boards of several pharmaceutical companies that make weight-loss medications. She’s also co-author of a new book about obesity with Oprah Winfrey, called “Enough.”
Patients may have more choices than ever with these new drugs under development or already here:
Amylin Analogs
Wegovy and Zepbound work by mimicking at least one hormone, GLP-1, which is released by the intestine when a person eats. It signals fullness and acts in parts of the brain that control appetite.
The next generation of weight-loss drugs will also mimic another natural gut hormone — amylin, which is released by the pancreas in response to food.
“They are all hormones that communicate to our brain,” Jastreboff notes. “How hungry are we? How full are we?”
The effect is similar to what GLP-1 does, Levy says. She’s done consulting work for Novo Nordisk, the pharmaceutical company that makes Ozempic and Wegovy.
Levy describes the hormones as working “synergistically.”
“Both of them slow stomach emptying. Both of them decrease appetite. Both of them work at the level of the pancreas and at the level of the brain and other organs in the body,” adds Jay, who has also done consulting work for Novo Nordisk.
Some people might tolerate amylin analogs better than GLP-1 drugs, or the new option could help people overcome a weight-loss plateau, Jay notes. Mixing amylin with a GLP-1 could make a powerful new combination.
Jay believes it will be the next hot thing in the weight-loss drug space.
No amylin analogs are approved for weight loss right now by the U.S. Food and Drug Administration, but that may change in the next year or two with these candidates:
CagriSema
The once-weekly injection from Novo Nordisk combines cagrilintide, an amylin analog, with semaglutide — the active ingredient in Ozempic and Wegovy.
In a late-stage trial funded by the pharmaceutical company, people lost 20% of their body weight on average after taking the drug for a year and four months. That compares to a 15% average weight loss with a Wegovy injection. The side effects were similar.
Novo Nordisk filed for FDA approval of CagriSema in December 2025.
Amycretin
This drug from Novo Nordisk also mimics both GLP-1 and amylin, and is being tested as a daily pill and a weekly injection. A phase 3 trial is scheduled to start in early 2026.
An earlier trial funded by the company showed people with Type 2 diabetes lost up to 14% of their body weight with the injection at 36 weeks, while those who took the daily pill lost 10%. The most common side effects were gastrointestinal.
Eloralintide
This amylin drug from Eli Lilly is injected once a week.
In a phase 2 trial funded by the pharmaceutical company, people lost up to 20% of their body weight after taking the medication for almost a year. That compares to about 21% average weight loss for Zepbound, Eli Lilly’s GLP-1 drug.
The most common side effects were nausea and fatigue. The medication now moves to a phase 3 trial.
Retatrutide, the Triple-Action Weight-Loss Drug
Wegovy mimics one gut hormone the body produces after eating, GLP-1; and Zepbound mimics two, GLP-1 and GIP.
But retatrutide also simulates a third: glucagon.
Known as a triple-agonist, this medication from Eli Lilly is not yet approved by the FDA but has produced powerful results in clinical trials.
In the latest study, sponsored by the pharmaceutical giant, people with obesity lost almost 29% of their body weight, or 71 pounds on average, after taking the highest dose of the drug for a year and four months, the company announced in December 2025.
The most common side effects were nausea, diarrhea, constipation and vomiting.
Some trial participants slimmed down so dramatically that they stopped taking retatrutide over “perceived excessive weight loss,” Eli Lilly noted in the news release.
A previous clinical trial, funded by Eli Lilly, found people lost 24% of their body weight after 48 weeks on the drug. Additional phase 3 trials are expected to be completed in 2026, according to the company.
“It is a blockbuster in the works,” Jay says. The weight loss it produces is “profound” and might be a good fit for people with a very high BMI, Levy added.
But both experts say not everyone needs to lose that much weight.
“For somebody who has a lower BMI of 30, this might be overpowering,” Levy noted.
She expects retatrutide to become available on the market in 2027, but some online companies have been selling what they claim is the medication, prompting warning letters from the FDA.
“Who knows what you’re injecting yourself with?” Jay says about the products advertised as retatrutide online. They could be an experimental grade peptide or a counterfeit, she notes. Levy calls the notion of people buying unapproved weight-loss drugs “scary.”
GLP-1 in Pill Form
The once-daily Wegovy pill is already approved and became available in the U.S. in January 2026. It must be taken first thing in the morning on an empty stomach.
The lowest doses cost $149 a month for people paying out of pocket, a cheaper alternative to the injectable Wegovy.
FDA’s decision on whether to approve Orforglipron, Eli Lilly’s daily pill, is expected in April, Reuters reported. It can be swallowed at any time of day without restrictions on food, “so it’s easier to take,” Jay notes.
The pill versions are especially good for “needle phobic” people, Levy says.
“At least 25% of the patients I see don’t want anything to do with needles,” she notes. “They are really thrilled to have an option that is not a needle.”
Once-a-Month Injection
People trying to lose weight may opt for long-acting monthly shots instead of weekly injections in the future. “A lot of people are going to like that,” Levy says.
The candidates being investigated include MariTide, a drug from Amgen that targets GLP-1 and GIP hormones and is “administered monthly or less frequently,” the company says.
In a phase 2 trial funded by Amgen, people lost 20% of their body weight on average after a year of the injections and didn’t reach a weight-loss plateau, meaning they could slim down more. The most common side effects were gastrointestinal.
Metsera, a company that was recently bought by Pfizer, is also investigating monthly GLP-1 and amylin analog drugs.
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