Trial results, with context
Every figure shows its comparison group, analysis approach, funding and limits. Check the badge to see how well each one has been verified.
Do not compare across trials. The bars below use one scale so they are easy to read, but the trials enrolled different people, ran for different lengths and used different designs.
Semaglutide
STEP 1
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 1,961 adults with obesity, or overweight plus at least one weight-related condition, without diabetes
- Length
- 68 weeks
- Compared with
- Placebo, with lifestyle support in both groups
- What was measured
- Average change in body weight at week 68
- Analysis approach
- Regardless of treatment discontinuation or rescue treatment
- Other results
- Weight loss of at least 5%: 86.4% with semaglutide vs 31.5% with placebo. At least 10%: 69.1% vs 12.0%. At least 15%: 50.5% vs 4.9%.
- Safety
- Nausea and diarrhea were the most common side effects. Stopping treatment because of gastrointestinal events: 4.5% vs 0.8%.
- Limits
- Funded by the manufacturer. Participants did not have diabetes. Group averages do not predict one person's result.
Sources: Wilding JPH 2021
STEP 5
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 304 adults with obesity, or overweight plus at least one weight-related condition, without diabetes
- Length
- 104 weeks
- Compared with
- Placebo, with a behavioral program in both groups
- What was measured
- Average change in body weight at week 104
- Analysis approach
- Regardless of treatment discontinuation or rescue treatment
- Other results
- Weight loss of at least 5%: 77.1% vs 34.4%.
- Safety
- Gastrointestinal events, mostly mild to moderate, were reported by 82.2% with semaglutide and 53.9% with placebo.
- Limits
- A smaller trial than STEP 1. Funded by the manufacturer, and some authors work for the company.
Sources: Garvey WT 2022
OASIS 4
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 307 adults with obesity, or overweight plus at least one obesity-related complication, without diabetes (205 oral semaglutide, 102 placebo)
- Length
- 64 weeks
- Compared with
- Placebo once daily, with lifestyle support in both groups
- What was measured
- Estimated average change in body weight at week 64
- Analysis approach
- Not stated in the abstract. Check the full paper.
- Other results
- More people on oral semaglutide reached weight reductions of at least 5%, 10%, 15% and 20%. A trade-press report cites 16.6% vs 2.7% for time on treatment. That is a different analysis from the abstract's figures, so check which one a number comes from.
- Safety
- Gastrointestinal adverse events: 74.0% with oral semaglutide vs 42.2% with placebo.
- Limits
- A smaller trial than the injectable semaglutide program. Funded by the manufacturer.
Sources: Wharton S 2025, FDA approves Wegovy pill, the first oral GLP-1 to treat obesity
STEP 8
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 338 adults with obesity, or overweight plus a weight-related condition, without diabetes, at 19 U.S. sites
- Length
- 68 weeks
- Compared with
- Daily liraglutide 3.0 mg and a pooled placebo group. Semaglutide and liraglutide were compared open label.
- What was measured
- Average percent change in body weight at week 68
- Analysis approach
- Mean change from baseline. The placebo comparison was a supportive secondary result.
- Other results
- Weight loss of at least 10%: 70.9% with semaglutide vs 25.6% with liraglutide. At least 15%: 55.6% vs 12.0%. At least 20%: 38.5% vs 6.0%.
- Safety
- Gastrointestinal events: 84.1% with semaglutide vs 82.7% with liraglutide. Stopping treatment for any reason: 13.5% vs 27.6%.
- Limits
- The two active drugs were compared open label. Several authors work for Novo Nordisk, which makes semaglutide. Group averages do not predict one person's result.
Sources: Rubino DM 2022
STEP UP
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 1,407 adults with a body mass index of 30 or higher, without diabetes; average weight 113 kg and 73.7% were women
- Length
- 72 weeks
- Compared with
- Semaglutide 2.4 mg and placebo, with a lifestyle program in all groups
- What was measured
- Average percent change in body weight at week 72
- Analysis approach
- Treatment-policy estimand: effects regardless of whether people stayed on treatment.
- Other results
- On average the 7.2 mg group lost 3.1 percentage points more than the 2.4 mg group (95% confidence interval for the difference: 1.6 to 4.7 points).
- Safety
- Gastrointestinal events: 70.8% with 7.2 mg, 61.2% with 2.4 mg and 42.8% with placebo. Altered skin sensation (dysaesthesia): 22.9%, 6.0% and 0.5%. Serious adverse events: 6.8%, 10.9% and 5.5%.
- Limits
- Funded by Novo Nordisk. Participants did not have diabetes. Group averages do not predict one person's result.
Sources: Wharton S 2025, Wegovy HD (semaglutide 7.2 mg) approved in the US, providing 20.7% mean weight loss
Tirzepatide
SURMOUNT-1
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 2,539 adults with obesity, or overweight plus at least one weight-related complication, without diabetes
- Length
- 72 weeks
- Compared with
- Placebo, including a 20-week dose-escalation period
- What was measured
- Average change in body weight at week 72
- Analysis approach
- Treatment-regimen estimand: effects regardless of treatment discontinuation
- Other results
- Weight loss of at least 5%: 85%, 89% and 91% across the three doses vs 35% with placebo. At least 20%: 50% (10 mg) and 57% (15 mg) vs 3%.
- Safety
- Most side effects were gastrointestinal, mostly mild to moderate, and mainly during dose escalation. Stopping treatment because of side effects: 4.3%, 7.1% and 6.2% across the three doses vs 2.6% with placebo.
- Limits
- Funded by the manufacturer. Participants did not have diabetes. Group averages do not predict one person's result.
Sources: Jastreboff AM 2022
SURMOUNT-5
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 751 adults with obesity but without type 2 diabetes
- Length
- 72 weeks
- Compared with
- Semaglutide, head to head. Open label, so participants and staff knew which drug was used. No placebo group.
- What was measured
- Average percent change in body weight at week 72
- Analysis approach
- Least-squares mean change from baseline to week 72, as reported in the abstract.
- Other results
- Waist circumference fell 18.4 cm with tirzepatide vs 13.0 cm with semaglutide. More people on tirzepatide reached weight loss of at least 10%, 15%, 20% and 25%.
- Safety
- Gastrointestinal effects were the most common side effects in both groups. Most were mild to moderate and happened mainly while the dose was being raised.
- Limits
- Funded by Eli Lilly, the maker of tirzepatide. Open label. Each person took the highest dose they could tolerate, so the doses were not identical across people. Group averages do not predict one person's result.
Sources: Aronne LJ 2025
Orforglipron
ATTAIN-1
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 3,127 adults with obesity, without diabetes
- Length
- 72 weeks
- Compared with
- Placebo once daily, with a healthy diet and physical activity in all groups
- What was measured
- Average change in body weight at week 72
- Analysis approach
- Treatment-regimen estimand in the intention-to-treat population: effects regardless of treatment discontinuation
- Other results
- In the highest-dose group, 54.6% lost at least 10% of body weight, 36.0% at least 15% and 18.4% at least 20%, versus 12.9%, 5.9% and 2.8% on placebo. The manufacturer's headline figure for the highest dose is larger because it counts only participants while they were taking the drug. Compare trials only on the same estimand.
- Safety
- Stopping treatment because of side effects: 5.3% to 10.3% across the three orforglipron groups vs 2.7% with placebo. The most common side effects were gastrointestinal and mostly mild to moderate.
- Limits
- Funded by Eli Lilly. Participants did not have diabetes. The tablet strengths used in the trial were named differently in later publications and do not all match the marketed strengths, so check the Foundayo label for what is sold. Group averages do not predict one person's result.
Sources: Wharton S 2025, ATTAIN-1 trial record (NCT05869903), Foundayo (orforglipron) tablets: prescribing information
Retatrutide
Retatrutide phase 2 (obesity)
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 338 adults with obesity, or overweight plus at least one weight-related condition
- Length
- 48 weeks
- Compared with
- Placebo once weekly. Some dose groups started at 2 mg and others at 4 mg, to compare starting amounts
- What was measured
- Average change in body weight at week 48
- Analysis approach
- Least-squares mean change from baseline, as reported in the abstract
- Other results
- At 24 weeks, the primary endpoint, the average change was -7.2% (1 mg), -12.9% (4 mg), -17.3% (8 mg) and -17.5% (12 mg) vs -1.6% with placebo. At 48 weeks, weight loss of at least 15% occurred in 60% (4 mg), 75% (8 mg) and 83% (12 mg) of participants vs 2% with placebo.
- Safety
- The most common side effects were gastrointestinal, increased with dose, were mostly mild to moderate, and were partly reduced by the lower 2 mg starting amount. Heart rate rose in a dose-dependent way, peaked at 24 weeks and declined afterward.
- Limits
- Phase 2 trial with 338 participants, so it was not built to settle rare side effects. Funded by the manufacturer. Group averages do not predict one person's result.
Sources: Jastreboff AM 2023
TRIUMPH-1
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 2,339 adults with obesity, or overweight plus a weight-related condition, without diabetes
- Length
- 80 weeks
- Compared with
- Placebo once weekly
- What was measured
- Average change in body weight at week 80
- Analysis approach
- Treatment-regimen estimand: effects regardless of treatment discontinuation
- Other results
- Among participants with knee osteoarthritis, knee pain scores (1 to 10 scale) fell by 3.4, 3.9 and 4.1 points across the three doses vs 2.5 with placebo. Among participants with obstructive sleep apnea, breathing interruptions fell by 22.8, 34.3 and 32.1 events per hour vs 9.6 with placebo.
- Safety
- The most common side effects were gastrointestinal. The abstract does not give percentages for them, so see the full paper.
- Limits
- Funded by the manufacturer. Participants did not have diabetes. Sponsor press releases quote larger numbers because they use a different calculation, so the figures differ. Group averages do not predict one person's result.
Sources: Jastreboff AM 2026, TRIUMPH-1 trial record (NCT05929066)
TRIUMPH-2
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 1,152 adults with obesity and type 2 diabetes
- Length
- 80 weeks
- Compared with
- Placebo once weekly, added to the participants' existing diabetes treatment
- What was measured
- Average change in body weight at week 80
- Analysis approach
- Treatment-regimen estimand: effects regardless of treatment discontinuation
- Other results
- Differences from placebo were -6.9, -11.8 and -13.8 percentage points across the three doses.
- Safety
- Diarrhea: 27%, 34% and 34% across the three doses vs 13% with placebo. Nausea: 14%, 21% and 28% vs 8%. Low blood pressure and abnormal skin sensations (dysesthesia) were also more frequent than with placebo. Stopping treatment because of side effects or death: 4%, 12% and 8% vs 5%. Deaths: 2, 3 and 1 across the three doses vs 1 with placebo, all judged unrelated to the study drug by the investigators.
- Limits
- Funded by the manufacturer. Participants all had type 2 diabetes and were already on stable treatment, so results may not match people without diabetes. Group averages do not predict one person's result.
Sources: Bellido V 2026
CagriSema (cagrilintide plus semaglutide)
REDEFINE 1
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 3,417 adults with obesity, or overweight plus an obesity-related condition, without diabetes
- Length
- 68 weeks
- Compared with
- Placebo, with lifestyle support in all groups. Semaglutide-alone and cagrilintide-alone groups were also included
- What was measured
- Average change in body weight at week 68
- Analysis approach
- Treatment-policy estimand: effects regardless of treatment discontinuation
- Other results
- The gap from placebo was 17.3 percentage points. More people on CagriSema than placebo reached weight losses of at least 5%, 20%, 25% and 30% (percentages are in the full paper).
- Safety
- Gastrointestinal side effects affected 79.6% on CagriSema vs 39.9% on placebo. They were mostly temporary and mild to moderate.
- Limits
- Funded by the manufacturer. Participants did not have diabetes. The semaglutide-alone and cagrilintide-alone results are not shown here because the abstract does not list them. Group averages do not predict one person's result.
Sources: Garvey WT 2025
REDEFINE 2
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 1,206 adults with obesity or overweight and type 2 diabetes
- Length
- 68 weeks
- Compared with
- Placebo, with lifestyle support in both groups
- What was measured
- Average change in body weight at week 68
- Analysis approach
- Treatment-policy estimand: effects regardless of treatment discontinuation
- Other results
- The gap from placebo was 10.4 percentage points. A blood sugar level (HbA1c) of 6.5% or lower was reached by 73.5% on CagriSema vs 15.9% on placebo.
- Safety
- Gastrointestinal side effects affected 72.5% on CagriSema vs 34.4% on placebo. Most were temporary and mild or moderate.
- Limits
- Funded by the manufacturer. All participants had type 2 diabetes, so results may not match people without it. Group averages do not predict one person's result.
Sources: Davies MJ 2025
Maridebart cafraglutide
MariTide phase 2 (obesity)
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 465 adults with obesity, plus a separate group of 127 adults with obesity and type 2 diabetes
- Length
- 52 weeks
- Compared with
- Placebo. Seven MariTide groups tested different amounts (140, 280 or 420 mg), different gaps between doses (every 4 or 8 weeks) and different dose-escalation steps
- What was measured
- Average change in body weight at week 52, adults with obesity
- Analysis approach
- Treatment-policy estimand: effects regardless of treatment discontinuation
- Other results
- In the diabetes group, weight change ranged from -8.4% to -12.3% on MariTide vs -1.7% on placebo, and HbA1c fell by 1.2 to 1.6 percentage points vs 0.1 on placebo.
- Safety
- Gastrointestinal side effects were common. They were less frequent with a lower starting amount and with gradual dose escalation. The authors reported no unexpected safety signals.
- Limits
- Phase 2, so the groups were small and no single dose group stands for all results. The abstract gives a range across groups, not one figure per group. Funded by the manufacturer. Group averages do not predict one person's result.
Sources: Jastreboff AM 2025
Phentermine and topiramate
CONQUER
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 2,487 adults with overweight or obesity (BMI 27 to 45) and at least two weight-related conditions
- Length
- 56 weeks
- Compared with
- Placebo, with office-based lifestyle advice in all groups
- What was measured
- Average change in body weight at week 56
- Analysis approach
- Intention-to-treat, as reported in the abstract
- Other results
- Weight loss of at least 5%: 62% (lower dose) and 70% (higher dose) vs 21% with placebo. At least 10%: 37% and 48% vs 7%.
- Safety
- Most common: dry mouth (13% and 21% vs 2% on placebo), tingling or numbness (14% and 21% vs 2%), constipation, insomnia, dizziness and taste changes. Depression-related events: 4% and 7% vs 4%. Anxiety-related events: 5% and 8% vs 3%.
- Limits
- Funded by the manufacturer. Participants were U.S. adults aged 18 to 70, so results may not match other groups. Group averages do not predict one person's result.
Sources: Gadde KM 2011
Naltrexone and bupropion
COR-I
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 1,742 adults with obesity, or overweight plus high cholesterol or high blood pressure
- Length
- 56 weeks
- Compared with
- Placebo, with a mild reduced-calorie diet and exercise advice in all groups
- What was measured
- Average change in body weight at week 56
- Analysis approach
- Last observation carried forward, in participants with a starting and at least one later weight
- Other results
- Weight loss of at least 5%: 48% (32 mg group) and 39% (16 mg group) vs 16% with placebo. Only about half of participants (50%) completed 56 weeks.
- Safety
- Nausea was the most common side effect: 29.8% (32 mg group) and 27.2% (16 mg group) vs 5.3% with placebo. Headache, constipation, dizziness, vomiting and dry mouth were also more frequent. Blood pressure rose slightly at first, then fell slightly below the starting level. Depression and suicidality events were not higher than with placebo.
- Limits
- Funded by the manufacturer. Half of participants did not finish, so the average depends on how missing data were handled. The marketed Contrave amount matches the 32 mg group. Group averages do not predict one person's result.
Sources: Greenway FL 2010
Survodutide
Survodutide phase 2 (obesity)
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 386 treated adults with a BMI of 27 or more, without diabetes
- Length
- 46 weeks
- Compared with
- Placebo. Four survodutide groups (0.6, 2.4, 3.6 and 4.8 mg weekly), with 20 weeks of dose increases then 26 weeks at a steady amount
- What was measured
- Average change in body weight at week 46
- Analysis approach
- Analysed by the dose each person was assigned at the start; data after COVID-19-related stops were censored
- Other results
- Weight loss rose with the dose. About 60% of participants finished the 46 weeks.
- Safety
- Side effects were reported by 91% of survodutide recipients and 75% of placebo recipients, mostly in the stomach and gut (75% vs 42%). The authors concluded all tested doses were tolerated.
- Limits
- Phase 2, so groups were small and the trial was meant to find doses. Many people stopped early, and the result depends on how that was handled. Funded by the manufacturer. Group averages do not predict one person's result.
Sources: le Roux CW 2024
SYNCHRONIZE-1
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 725 adults with a BMI of 30 or more, or 27 or more plus an obesity-related condition, without diabetes
- Length
- 76 weeks
- Compared with
- Placebo, with lifestyle counseling in all groups. Survodutide was raised up to 3.6 mg or 6.0 mg weekly
- What was measured
- Average change in body weight at week 76
- Analysis approach
- Treatment-regimen estimand: effects of taking the medicine as assigned, allowing for early stopping, other weight-loss drugs and a long dose-increase period
- Other results
- Weight loss of at least 5%: 72.6% (3.6 mg) and 71.9% (6.0 mg) vs 46.3% with placebo.
- Safety
- Stomach and gut side effects, usually mild to moderate, occurred in 80.9% (3.6 mg) and 89.7% (6.0 mg) of participants vs 47.9% with placebo. No deaths were reported.
- Limits
- Funded by the manufacturer. The placebo group also lost a meaningful amount with counseling, so the gap to placebo is smaller than the headline figure. The two survodutide groups differed by under one percentage point on average, while the higher amount had more gut side effects. Group averages do not predict one person's result.
Sources: le Roux CW 2026
SYNCHRONIZE-2
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 752 adults with type 2 diabetes and a BMI of 27 or more
- Length
- 76 weeks
- Compared with
- Placebo. Survodutide was raised to 3.6 mg or 6.0 mg weekly
- What was measured
- Average change in body weight at week 76, adults with type 2 diabetes
- Analysis approach
- Treatment-regimen estimand: effects regardless of whether the regimen was stopped or interrupted, or other weight-loss therapy was used
- Other results
- Weight loss of at least 5%: 57.6% (3.6 mg) and 64.5% (6.0 mg) vs 35.1% with placebo. HbA1c (a blood sugar marker) fell by 0.9 and 0.8 percentage points from a starting 7.4%, vs 0.2 with placebo.
- Safety
- Stomach and gut side effects, generally mild to moderate and short-lived, occurred in 72.8% (3.6 mg) and 77.7% (6.0 mg) vs 38.6% with placebo.
- Limits
- Funded by the manufacturer. Weight loss here was smaller than in SYNCHRONIZE-1, which enrolled people without diabetes, so the two sets of figures should not be compared directly. Group averages do not predict one person's result.
Sources: Wharton S 2026
Mazdutide
GLORY-1
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 610 adults in China, aged 18 to 75, with a BMI of 28 or more, or 24 to under 28 plus a weight-related condition
- Length
- 48 weeks
- Compared with
- Placebo. Mazdutide 4 mg or 6 mg once weekly. The main comparison was set at week 32, with follow-up to week 48
- What was measured
- Average change in body weight at week 48
- Analysis approach
- Treatment-policy estimand (stated for the week 32 main analysis): effects regardless of early stopping or new weight-loss therapy
- Other results
- At week 32 the average change was -10.09% (4 mg) and -12.55% (6 mg) vs +0.45% with placebo. At week 48, weight loss of at least 15% occurred in 35.7% (4 mg) and 49.5% (6 mg) vs 2.0% with placebo.
- Safety
- Stomach and gut side effects were the most common and mostly mild to moderate. Side effects led to stopping in 1.5% (4 mg), 0.5% (6 mg) and 1.0% (placebo) of participants.
- Limits
- Conducted only in China, in people with a lower average starting weight (87 kg) than in most Western trials, so percentage figures are not directly comparable with them. Funded by the manufacturer. Group averages do not predict one person's result.
Sources: Ji L 2025
GLORY-2
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 461 treated adults in China with a BMI of 30 or more (16.1% also had type 2 diabetes)
- Length
- 60 weeks
- Compared with
- Placebo, with a reduced-calorie diet and more physical activity in both groups. Mazdutide 9 mg once weekly
- What was measured
- Average change in body weight at week 60
- Analysis approach
- The published abstract does not name the estimand
- Other results
- Weight loss of at least 5%: 84.3% with mazdutide vs 33.1% with placebo.
- Safety
- Vomiting (53.1% vs 1.3%), nausea (46.9% vs 3.2%) and diarrhea (39.4% vs 6.5%) were the most common side effects, mostly mild to moderate. Side effects led to stopping in 2.9% on mazdutide and 0% on placebo.
- Limits
- Conducted only in China, in a fairly young group (average age 33.9). Sponsored by the manufacturer. The 9 mg amount is higher than the amounts used in GLORY-1. Group averages do not predict one person's result.
Sources: Gao L 2026, GLORY-2 trial record (NCT06164873)
Cagrilintide
Cagrilintide phase 2 (obesity)
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 906 adults without diabetes and with a BMI of 30 or more, or 27 or more plus high blood pressure or abnormal cholesterol
- Length
- 26 weeks
- Compared with
- Placebo and liraglutide 3.0 mg daily. Five cagrilintide amounts from 0.3 to 4.5 mg once weekly
- What was measured
- Average change in body weight at week 26
- Analysis approach
- Trial-product estimand: effects if everyone took the treatment as assigned. The authors report similar results under the treatment-policy estimand
- Other results
- Cagrilintide 4.5 mg beat liraglutide 3.0 mg by 1.8 percentage points (10.8% vs 9.0%).
- Safety
- Stomach and gut side effects (such as nausea, constipation and diarrhea) occurred in 41% to 63% of people on cagrilintide vs 32% on placebo. Nausea alone was 20% to 47% vs 18%. Injection-site reactions were also more common.
- Limits
- Phase 2 with a short 26-week treatment period. Funded by the manufacturer. The abstract gives a range across the five cagrilintide groups, not one figure per group. People knew which active medicine they were taking. Group averages do not predict one person's result.
Sources: Lau DCW 2021
Eloralintide
Eloralintide phase 2 (obesity)
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 263 adults in the U.S. with a BMI of 30 or more, or 27 or more plus a weight-related condition, without type 2 diabetes
- Length
- 48 weeks
- Compared with
- Placebo. Four fixed weekly amounts (1, 3, 6 and 9 mg) and two groups that raised the amount over time (6 to 9 mg and 3 to 9 mg)
- What was measured
- Average change in body weight at week 48
- Analysis approach
- Efficacy estimand: effects while people were taking the treatment as assigned. This usually shows larger weight loss than analyses that count everyone who stopped
- Other results
- The escalation groups lost about 20% (6 to 9 mg) and 16% (3 to 9 mg).
- Safety
- Nausea was the most common side effect: 11% (1 mg), 13% (3 mg), 64% (6 mg), 33% (9 mg), 54% (6 to 9 mg) and 25% (3 to 9 mg) vs 14% with placebo. Fatigue rose with the amount, from 0% at 1 mg to 43% at 9 mg, vs 12% with placebo.
- Limits
- Phase 2, so groups were small. Funded by the manufacturer. The headline figures use the efficacy estimand, so they likely overstate what people who stop early would see. The group was 78% women and 78% White. Nausea did not rise steadily with the amount, so the groups cannot be ranked by tolerability. Group averages do not predict one person's result.
Sources: Billings LK 2025
Petrelintide
ZUPREME-1 (petrelintide)
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 485 treated adults without type 2 diabetes, with a BMI of 30 or more, or 27 or more plus high blood pressure or abnormal cholesterol
- Length
- 28 weeks
- Compared with
- Placebo. Five weekly amounts from 1.0 to 9.0 mg, given over 42 weeks including dose increases. The main comparison was set at week 28
- What was measured
- Average change in body weight at week 28
- Analysis approach
- Efficacy estimand: effects while people were taking the treatment as assigned. Missing data were assumed to be missing at random
- Other results
- The 2.5 mg and 7.0 mg groups lost 7.9% and 9.3%. Weight kept falling to week 42, by up to 10.7% on petrelintide.
- Safety
- Nausea was the most common side effect: 20% on petrelintide vs 6% on placebo, mostly mild and during dose increases. Vomiting (3% vs 6%), diarrhea (7% vs 7%) and constipation (7% vs 4%) were low. No deaths were reported.
- Limits
- Phase 2 and a short main comparison at 28 weeks. Funded by the manufacturer. Weight loss at 28 weeks is well below the roughly 20% seen in some other amylin-based trials, though those ran longer and are not head-to-head. Participants and staff knew which maintenance amount was assigned, though not whether it was active drug or placebo. Group averages do not predict one person's result.
Sources: Garvey WT 2026
Zenagamtide (amycretin)
Zenagamtide (amycretin) phase 1b/2a
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 125 adults aged 18 to 55 with a BMI of 27.0 to 39.9, at one research center in San Antonio, Texas
- Length
- 36 weeks
- Compared with
- Placebo. Several small groups: once-weekly injections raised to 60 mg or 20 mg over 36 weeks, 5 mg over 28 weeks, or 1.25 mg over 20 weeks
- What was measured
- Estimated average change in body weight at the end of each part
- Analysis approach
- Estimated mean change from the study's statistical model. A large number of participants left the study early
- Other results
- 5 mg for 28 weeks: -16.2% vs +2.3% placebo. 1.25 mg for 20 weeks: -9.7% vs +2.0% placebo. The 20 mg placebo group changed by +1.9%.
- Safety
- Stomach and gut side effects were the most common, mostly mild to moderate. Many people withdrew, mostly for reasons the authors said were unrelated to side effects.
- Limits
- Early-stage study with 101 people on the medicine split across several groups, at one site, with many dropouts. The 60 mg amount is higher than the largest amount (40 mg) later tested in the phase 2 diabetes trial, so these figures should be read as a first look only. Funded by the manufacturer. Group averages do not predict one person's result.
Sources: Dahl K 2025
VK2735
VENTURE (VK2735 injection)
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 176 adults enrolled with obesity, or overweight plus at least one weight-related condition, without diabetes
- Length
- 13 weeks
- Compared with
- Placebo. Several weekly injection amounts from 2.5 mg to 15 mg
- What was measured
- Average change in body weight at week 13
- Analysis approach
- Not stated in the abstract
- Other results
- Weight loss of at least 5%: 93% (130 of 140) of people on VK2735 vs 12% (4 of 34) on placebo.
- Safety
- The common side effects were in the stomach and gut. The authors report they became less frequent after the amount reached steady state.
- Limits
- Phase 2 with only 13 weeks of treatment, so it says little about longer-term weight loss. The abstract gives only the lowest and highest amounts, so the groups in between are not shown. Several authors work for the company. People with diabetes were excluded. Group averages do not predict one person's result.
Sources: Bays HE 2026
VENTURE-Oral (VK2735 tablet)
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 280 adults enrolled with obesity, or overweight plus at least one weight-related condition
- Length
- 13 weeks
- Compared with
- Placebo tablet once daily. Five tablet amounts from 15 mg to 120 mg, with the higher amounts reached in steps over the first weeks
- What was measured
- Average change in body weight at week 13, as reported by the company
- Analysis approach
- Not stated in the company announcement
- Other results
- Early study dropout was 28% on VK2735 vs 18% on placebo. Stopping because of side effects was 20% vs 13%.
- Safety
- Nausea and vomiting were more common on VK2735 than on placebo. In the company's table, vomiting reached 35% at the two highest amounts vs 10% on placebo. The company says 98% of drug-related side effects were mild or moderate.
- Limits
- These figures come from a company press release, not a peer-reviewed paper. The trial lasted 13 weeks, so results cannot be compared with 68-week or 78-week trials. More people stopped the tablet than stopped placebo. The announcement does not say how missing data were handled.
Pemvidutide
MOMENTUM (pemvidutide, obesity)
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 391 adults with obesity, or overweight plus at least one weight-related condition, without diabetes
- Length
- 48 weeks
- Compared with
- Placebo, with diet and exercise in all groups. Pemvidutide 1.2 mg and 1.8 mg weekly with no dose increase, and 2.4 mg weekly after a four-week increase
- What was measured
- Average change in body weight at week 48, as reported by the company
- Analysis approach
- Not stated in the company announcement
- Other results
- On 2.4 mg, the company says more than half of people lost at least 15% of body weight and more than 30% lost at least 20%.
- Safety
- Nausea and vomiting were the most common side effects, mostly mild or moderate. Stopping because of side effects: 6.2% on placebo, 5.1% on 1.2 mg, 19.2% on 1.8 mg and 19.6% on 2.4 mg. One drug-related serious event was reported (vomiting on 2.4 mg).
- Limits
- These figures come from a company press release. This atlas did not find a peer-reviewed paper for the trial. The 2.4 mg group used a different dose-increase approach, so it differs from the others in more than amount. About one in five people on the two higher amounts stopped because of side effects. No phase 3 obesity trial is registered.
Diethylpropion
Diethylpropion 12-month trial (Brazil)
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 69 otherwise healthy adults with obesity in São Paulo, Brazil, all given a low-calorie diet
- Length
- 26 weeks
- Compared with
- Placebo for 6 months, then everyone took diethylpropion for another 6 months without blinding. The amount was 50 mg twice a day
- What was measured
- Average change in body weight at 6 months
- Analysis approach
- Not stated in the abstract
- Other results
- At month 12, people on diethylpropion since the start had lost 10.6%. People switched from placebo at month 6 had lost 7.0%. The difference between groups at month 12 was not significant (P = 0.07).
- Safety
- No differences were seen in blood pressure, pulse, electrocardiogram or psychiatric ratings. Dry mouth and insomnia were the most frequent side effects.
- Limits
- A small trial at one center in a carefully selected group, as the authors note. Only the first 6 months were placebo-controlled. The 6-month and 12-month durations are longer than the few weeks the U.S. label describes, and 50 mg twice a day is not the schedule on the immediate-release label. Group averages do not predict one person's result.
Sources: Cercato C 2009
Pramlintide
Pramlintide with phentermine (obesity)
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 244 adults with obesity or overweight and no diabetes (88% women, average BMI 37.7), all given lifestyle counseling
- Length
- 24 weeks
- Compared with
- Placebo injections three times daily, pramlintide 120 mcg three times daily, or pramlintide plus a morning pill (sibutramine 10 mg or phentermine 37.5 mg)
- What was measured
- Average change in body weight at week 24
- Analysis approach
- Not stated in the abstract
- Other results
- Pramlintide plus sibutramine 10 mg: -11.1%. Both combinations beat pramlintide alone and placebo (P < 0.001).
- Safety
- Heart rate rose by 3.1 to 4.5 beats per minute and diastolic blood pressure by 2.7 to 3.5 mm Hg in the two combination groups. Most people stayed within normal blood pressure ranges.
- Limits
- Not fully blinded: the injection-only groups were single-blind and the combination groups were open-label. The trial was in people without diabetes, which is not the approved use of pramlintide. The pill in one combination arm is a separate drug with its own risks. Group averages do not predict one person's result.
Sources: Aronne LJ 2010
Orlistat
XENDOS
Average change in body weight, in kilograms. Every bar uses one scale, 0 to 10 kilograms.
- People studied
- 3,305 adults with a body mass index of 30 or higher; 79% had normal blood sugar handling and 21% had impaired glucose tolerance
- Length
- 208 weeks (4 years)
- Compared with
- Placebo, with lifestyle changes in both groups
- What was measured
- Average weight loss after 4 years, as reported
- Analysis approach
- Intention to treat. A second analysis that carried baseline weight forward for people who dropped out gave 3.6 kg with orlistat vs 1.4 kg with placebo.
- Other results
- Type 2 diabetes appeared in 6.2% of people on orlistat vs 9.0% on placebo over 4 years. The difference was found only in the impaired glucose tolerance subgroup.
- Safety
- Side effects are not summarized in the study abstract. See the official label linked on the orlistat page.
- Limits
- Funded by the manufacturer. Only 52% of the orlistat group and 34% of the placebo group finished treatment. Group averages do not predict one person's result.
Sources: Torgerson JS 2004
Liraglutide
SCALE Obesity and Prediabetes
Average change in body weight, in kilograms. Every bar uses one scale, 0 to 10 kilograms.
- People studied
- 3,731 adults without type 2 diabetes who had a body mass index of 30 or higher, or 27 or higher with high cholesterol or high blood pressure
- Length
- 56 weeks
- Compared with
- Placebo, with lifestyle counseling in both groups
- What was measured
- Average change in body weight at week 56, in kilograms
- Analysis approach
- Missing values filled in with the last recorded weight (last observation carried forward). The difference was 5.6 kg (95% confidence interval 5.1 to 6.0).
- Other results
- Weight loss of at least 5%: 63.2% with liraglutide vs 27.1% with placebo. More than 10%: 33.1% vs 10.6%.
- Safety
- Nausea and diarrhea were the most common side effects and were mostly mild or moderate. Serious events: 6.2% with liraglutide vs 5.0% with placebo.
- Limits
- Funded by the manufacturer. Participants did not have diabetes. Average starting weight was 106.2 kg and 78.5% were women. Group averages do not predict one person's result.
Sources: Pi-Sunyer X 2015
Phentermine
Low-dose phentermine before weight-loss surgery
Average change in body weight. Every bar uses one scale, 0 to 25 percent.
- People studied
- 53 adults waiting for gastric bypass or sleeve gastrectomy; 45 finished. Average body mass index 48.4; 91% were women
- Length
- 14 weeks
- Compared with
- Placebo
- What was measured
- Average percent total weight loss over 14 weeks
- Analysis approach
- As reported in the abstract. The same trial found average weight loss of 6.2 kg with phentermine vs 1.1 kg with placebo.
- Other results
- Operating time and complications after surgery did not differ between the groups.
- Safety
- Side effects are not summarized in the study abstract. See the official Lomaira label linked on the phentermine page.
- Limits
- Small trial in people about to have surgery, so it does not describe results for the general population. It lasted 14 weeks, which is short. Group averages do not predict one person's result.
Sources: Garcia L 2025, Lomaira (phentermine hydrochloride) tablets: prescribing information
Setmelanotide
Setmelanotide in POMC and LEPR deficiency
Share of people who lost at least 10% of their body weight at about 1 year. Every bar uses one scale, 0 to 100 percent.
- People studied
- 10 people with POMC deficiency obesity and 11 with LEPR deficiency obesity, age 6 and older, in two separate trials
- Length
- 52 weeks (about 1 year)
- Compared with
- None. These were open-label trials with no placebo group for the main result.
- What was measured
- Share of people who lost at least 10% of their body weight at about 1 year
- Analysis approach
- Everyone who received at least one dose and had a baseline measurement was counted.
- Other results
- Average change in the most-hunger score: down 27.1% in the POMC trial and down 43.7% in the LEPR trial (7 people in each analysis).
- Safety
- Injection site reactions occurred in everyone in both trials. Skin darkening was reported in all 10 people in the POMC trial. Nausea occurred in 5 of 10 (POMC) and 4 of 11 (LEPR). No serious treatment-related events were reported.
- Limits
- Very small trials, which is expected for such rare conditions. There was no comparison group for the main result. Funded by the manufacturer. These results apply only to the genetic conditions studied.
Sources: Clément K 2020, Imcivree (setmelanotide) injection: prescribing information
Other evidence noted
- An indirect comparison of tirzepatide and semaglutide exists (Ciudin A, et al. Int J Obes (Lond). 2026. An indirect comparison, not a head-to-head trial. Most authors are employees of the tirzepatide manufacturer, so it is weaker evidence than a head-to-head trial.)
- A post hoc analysis of ATTAIN-1 looked at long-term diabetes and cardiovascular risk predictions. It is not a new trial result and is listed in the sources only.
Sources
- Once-weekly semaglutide in adults with overweight or obesity (STEP 1) Wilding JPH, et al. N Engl J Med. 2021;384(11):989-1002. PMID 33567185. Funding: Novo Nordisk. Journal article
- Two-year effects of semaglutide in adults with overweight or obesity (STEP 5) Garvey WT, et al. Nat Med. 2022;28(10):2083-2091. PMID 36216945. Funding: Novo Nordisk (authors include company employees). Journal article
- Oral semaglutide at a dose of 25 mg in adults with overweight or obesity (OASIS 4) Wharton S, et al. N Engl J Med. 2025;393(11):1077-1087. PMID 40934115. Funding: Novo Nordisk. Journal article
- FDA approves Wegovy pill, the first oral GLP-1 to treat obesity Healio. Trade press. Reports on-treatment OASIS 4 figures and how the pill is taken. Not the label. Trade press, secondary source
- Effect of weekly subcutaneous semaglutide vs daily liraglutide on body weight in adults with overweight or obesity without diabetes (STEP 8) Rubino DM, et al. JAMA. 2022;327(2):138-150. PMID 35015037. Funding: Novo Nordisk. Journal article
- Once-weekly semaglutide 7.2 mg in adults with obesity (STEP UP) Wharton S, et al. Lancet Diabetes Endocrinol. 2025;13(11):949-963. PMID 40961952. Funding: Novo Nordisk. Journal article
- Wegovy HD (semaglutide 7.2 mg) approved in the US, providing 20.7% mean weight loss Novo Nordisk company announcement, March 19, 2026. Company announcement; not peer reviewed. Company announcement, not peer reviewed
- Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1) Jastreboff AM, et al. N Engl J Med. 2022;387(3):205-216. PMID 35658024. Funding: Eli Lilly. Journal article
- Tirzepatide as compared with semaglutide for the treatment of obesity (SURMOUNT-5) Aronne LJ, et al. N Engl J Med. 2025;393(1):26-36. PMID 40353578. Funding: Eli Lilly. Journal article
- Orforglipron, an oral small-molecule GLP-1 receptor agonist for obesity treatment (ATTAIN-1) Wharton S, et al. N Engl J Med. 2025;393(18):1796-1806. PMID 40960239. Funding: Eli Lilly. Journal article
- ATTAIN-1 trial record (NCT05869903) ClinicalTrials.gov identifier NCT05869903. Trial registry
- Foundayo (orforglipron) tablets: prescribing information Eli Lilly and Company, on DailyMed (U.S. National Library of Medicine). Label version 7/2026. Official FDA label on DailyMed
- Triple-hormone-receptor agonist retatrutide for obesity, a phase 2 trial Jastreboff AM, et al. N Engl J Med. 2023;389(6):514-526. PMID 37366315. Funding: Eli Lilly. Journal article
- Retatrutide, a triple hormone receptor agonist, for treatment of obesity (TRIUMPH-1) Jastreboff AM, et al. N Engl J Med. Published September 29, 2026. PMID 42814954. Funding: Eli Lilly. Journal article
- TRIUMPH-1 trial record (NCT05929066) ClinicalTrials.gov identifier NCT05929066. Trial registry
- Retatrutide in adults with obesity and type 2 diabetes (TRIUMPH-2) Bellido V, et al. Lancet. 2026;408(10563):1455-1472. PMID 42810372. Funding: Eli Lilly. Journal article
- Coadministered cagrilintide and semaglutide in adults with overweight or obesity (REDEFINE 1) Garvey WT, et al. N Engl J Med. 2025;393(7):635-647. PMID 40544433. Funding: Novo Nordisk. Journal article
- Cagrilintide-semaglutide in adults with overweight or obesity and type 2 diabetes (REDEFINE 2) Davies MJ, et al. N Engl J Med. 2025;393(7):648-659. PMID 40544432. Funding: Novo Nordisk. Journal article
- Once-monthly maridebart cafraglutide for the treatment of obesity, a phase 2 trial Jastreboff AM, et al. N Engl J Med. 2025;393(9):843-857. PMID 40549887. Funding: Amgen. Journal article
- Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER) Gadde KM, et al. Lancet. 2011;377(9774):1341-1352. PMID 21481449. Funding: Vivus. Journal article
- Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I) Greenway FL, et al. Lancet. 2010;376(9741):595-605. PMID 20673995. Funding: Orexigen Therapeutics. Journal article
- Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial le Roux CW, et al. Lancet Diabetes Endocrinol. 2024;12(3):162-173. PMID 38330987. Funding: Boehringer Ingelheim. Journal article
- Survodutide once weekly for the treatment of adults with obesity (SYNCHRONIZE-1) le Roux CW, et al. N Engl J Med. 2026;395(8):776-787. PMID 42253238. Funding: Boehringer Ingelheim. Journal article
- Survodutide once weekly in adults with obesity and type 2 diabetes (SYNCHRONIZE-2) Wharton S, et al. N Engl J Med. 2026. PMID 42820639. Funding: Boehringer Ingelheim. Journal article
- Once-weekly mazdutide in Chinese adults with obesity or overweight (GLORY-1) Ji L, et al. N Engl J Med. 2025;392(22):2215-2225. PMID 40421736. Funding: Innovent Biologics. Journal article
- Treatment with 9-mg mazdutide for weight reduction in Chinese adults with obesity: the GLORY-2 randomized clinical trial Gao L, et al. JAMA. 2026;336(5):377-388. PMID 42251595. Funding: Innovent Biologics (trial sponsor). Journal article
- GLORY-2 trial record (NCT06164873) ClinicalTrials.gov identifier NCT06164873. Sponsor: Innovent Biologics. Trial registry
- Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial Lau DCW, et al. Lancet. 2021;398(10317):2160-2172. PMID 34798060. Funding: Novo Nordisk. Journal article
- Eloralintide, a selective amylin receptor agonist for the treatment of obesity: a 48-week phase 2, multicentre, double-blind, randomised, placebo-controlled trial Billings LK, et al. Lancet. 2025;406(10520):2631-2643. PMID 41207310. Funding: Eli Lilly. Journal article
- Petrelintide, a human amylin analogue for the treatment of obesity (ZUPREME 1): a randomised, double-blind, placebo-controlled, phase 2 trial Garvey WT, et al. Lancet Diabetes Endocrinol. 2026;14(11):914-926. PMID 42810355. Funding: Zealand Pharma. Journal article
- Amycretin, a novel, unimolecular GLP-1 and amylin receptor agonist administered subcutaneously: results from a phase 1b/2a randomised controlled study Dahl K, et al. Lancet. 2025;406(10499):149-162. PMID 40550231. Funding: Novo Nordisk. Journal article
- Weekly subcutaneous VK2735, a GIP/GLP-1 receptor dual agonist, for weight management: phase 2, randomized, 13-week VENTURE study Bays HE, et al. Obesity (Silver Spring). 2026;34(3):537-549. PMID 41508550. Funding: Not stated in the abstract. Several authors are Viking Therapeutics employees. Journal article
- Viking Therapeutics announces positive top-line results from phase 2 VENTURE-Oral dosing trial of VK2735 tablet formulation in patients with obesity Viking Therapeutics press release, August 19, 2025. Company announcement; not peer reviewed. Trade press, secondary source
- Altimmune announces positive topline results from MOMENTUM 48-week phase 2 obesity trial of pemvidutide Altimmune press release, November 30, 2023. Company announcement; not peer reviewed. Trade press, secondary source
- A randomized double-blind placebo-controlled study of the long-term efficacy and safety of diethylpropion in the treatment of obese subjects Cercato C, et al. Int J Obes (Lond). 2009;33(8):857-865. PMID 19564877. Funding: Not stated in the abstract. Journal article
- Enhanced weight loss following coadministration of pramlintide with sibutramine or phentermine in a multicenter trial Aronne LJ, et al. Obesity (Silver Spring). 2010;18(9):1739-1746. PMID 20094043. Funding: Not stated in the abstract. Journal article
- XENical in the prevention of diabetes in obese subjects (XENDOS) study Torgerson JS, et al. Diabetes Care. 2004;27(1):155-161. PMID 14693982. Funding: Roche. Journal article
- A randomized, controlled trial of 3.0 mg of liraglutide in weight management (SCALE Obesity and Prediabetes) Pi-Sunyer X, et al. N Engl J Med. 2015;373(1):11-22. PMID 26132939. Funding: Novo Nordisk. Journal article
- Utilization of low-dose phentermine for weight loss prior to metabolic and bariatric surgery: a prospective, randomized, and placebo-controlled trial Garcia L, Rivas H, Morton J. Obes Sci Pract. 2025;11(1):e70043. PMID 39830713. Journal article
- Lomaira (phentermine hydrochloride) tablets: prescribing information KVK-Tech, Inc., on DailyMed (U.S. National Library of Medicine). FDA-approved label revised 12/2023. Official FDA label on DailyMed
- Efficacy and safety of setmelanotide, an MC4R agonist, in individuals with severe obesity due to LEPR or POMC deficiency: single-arm, open-label, multicentre, phase 3 trials Clément K, et al. Lancet Diabetes Endocrinol. 2020;8(12):960-970. PMID 33137293. Funding: Rhythm Pharmaceuticals. Journal article
- Imcivree (setmelanotide) injection: prescribing information Rhythm Pharmaceuticals, Inc., on DailyMed (U.S. National Library of Medicine). FDA-approved label, April 2026 listing. Official FDA label on DailyMed
- Indirect comparative efficacy and safety of tirzepatide vs semaglutide for the treatment of obesity or overweight in patients without type 2 diabetes Ciudin A, et al. Int J Obes (Lond). 2026. PMID 42806056. Funding: Most authors are employees of Eli Lilly. An indirect comparison, not a head-to-head trial. Journal article
- Predicting the long-term risk of type 2 diabetes and cardiovascular disease with orforglipron in people with overweight or obesity: a post hoc analysis of ATTAIN-1 Shinde S, et al. Diabetes Obes Metab. 2026. PMID 42750540. Funding: Eli Lilly (authors include company employees). Journal article