The weight-loss revolution that began with Ozempic and Wegovy is entering a more crowded and competitive phase, and the field of late-stage obesity drugs has become the most closely watched area in pharmaceutical research. Two recent milestones show how fast the picture is changing. In December 2025 the US Food and Drug Administration approved the first oral GLP-1 for weight management, oral semaglutide sold as the Wegovy pill, and on 1 April 2026 it approved Lilly’s orforglipron, marketed as Foundayo, the first GLP-1 tablet that can be taken at any time of day without food or water restrictions. Novo Nordisk’s CagriSema has finished its pivotal programme and now sits under FDA review. Behind them, a deep bench of late-stage obesity drugs is moving through phase 3 testing, several of them promising weight loss well beyond what today’s injections deliver. Here are seven to watch in 2026.
Why the obesity pipeline matters now
The commercial stakes are enormous. Analysts expect the global market for obesity medicines to exceed 100 billion dollars within a few years, and the two current leaders, Novo Nordisk and Eli Lilly, are racing to defend their positions against a widening group of challengers. The science is broadening too. The first generation of drugs relied on a single hormone pathway, GLP-1. The late-stage obesity drugs now in development, part of a rapidly expanding GLP-1 drug pipeline, layer in additional targets, amylin, GIP and glucagon among them, in an effort to deliver greater weight loss, better tolerability or more convenient dosing. Several also aim to treat related conditions such as type 2 diabetes, heart failure and fatty liver disease, which could reshape how obesity is managed.
Retatrutide: the efficacy frontrunner
Eli Lilly’s retatrutide is the most potent of the late-stage obesity drugs by the figures reported so far. A once-weekly injection, it activates three hormone receptors at once, GIP, GLP-1 and glucagon, a triple-agonist design intended to push weight loss past the levels seen with dual-acting drugs. In the pivotal TRIUMPH-1 trial, reported in May 2026, adults with obesity or overweight and at least one weight-related complication lost an average of 28.3% of their body weight at 80 weeks on the highest dose, and those with a starting body mass index of 35 or above who stayed on treatment lost up to 30.3% at 104 weeks. An earlier phase 3 study, TRIUMPH-4, had already shown 28.7% weight loss at 68 weeks in patients who also had knee osteoarthritis, alongside marked reductions in joint pain. Lilly expects several further readouts during 2026 and is widely anticipated to file for approval by year end. Retatrutide remains investigational.
MariTide: a once-monthly challenger
Amgen’s maridebart cafraglutide, known as MariTide, takes a different approach. It is a peptide-antibody conjugate that blocks the GIP receptor while activating the GLP-1 receptor, and its long half-life allows dosing as infrequently as once a month, a potential advantage for adherence over weekly injections. In a 52-week phase 2 study published in the New England Journal of Medicine, participants with obesity but without type 2 diabetes lost up to around 20%, with no sign of a weight-loss plateau, while those who also had diabetes lost up to around 17%. Jay Bradner, Amgen’s head of research and development, called the results “a defining advance for the obesity field”. The phase 3 MARITIME programme is now under way across obesity and type 2 diabetes, with further studies planned in cardiovascular disease, heart failure and obstructive sleep apnoea. Pivotal data are expected to read out through 2027.
VK2735: oral and injectable in one programme
Viking Therapeutics has positioned VK2735, a dual GLP-1 and GIP agonist, as a flexible platform offering both an injection and a pill. The subcutaneous version is in two phase 3 trials, VANQUISH-1 in obesity and VANQUISH-2 in patients who also have type 2 diabetes, both now fully enrolled. The oral tablet, which produced up to 12.2% weight loss over just 13 weeks in a phase 2 study, is due to enter phase 3 in the second half of 2026. If both succeed, Viking would become the first company to offer an oral and an injectable form of the same dual agonist, allowing patients to switch between them. Chief Executive Brian Lian has described the oral data as compelling and says the tablet could be the first oral dual agonist of its kind to reach the market.
Survodutide: targeting the liver as well as the waistline
Developed jointly by Boehringer Ingelheim and Zealand Pharma, survodutide is a once-weekly dual agonist of the GLP-1 and glucagon receptors. The glucagon component is thought to increase energy expenditure and act directly on the liver, which has made the drug a leading candidate in metabolic dysfunction-associated steatohepatitis, or MASH, as well as obesity. In its pivotal phase 3 SYNCHRONIZE-1 trial, reported in April 2026 and presented in full at the American Diabetes Association meeting in June, adults with obesity or overweight without type 2 diabetes lost an average of up to 16.6% of their body weight at 76 weeks, alongside substantial reductions in visceral and liver fat. Further readouts, including the LIVERAGE trials in MASH, are expected through 2026. Survodutide illustrates a broader theme among these candidates: the most valuable increasingly aim to treat the conditions that accompany obesity, not weight alone.
Amycretin: Novo Nordisk’s next-generation bet
With CagriSema under review, Novo Nordisk’s longer-term hopes rest heavily on amycretin (recently assigned the international name zenagamtide), a single molecule that activates both the GLP-1 and the amylin receptors. Like Viking’s candidate, it is being developed as both an injection and a tablet. Early-stage data were striking: weekly injections produced about 22% weight loss over 36 weeks, while the oral form delivered around 13% over 12 weeks, in both cases without a clear plateau. On the strength of those results and feedback from regulators, Novo moved both formulations into phase 3 for obesity during the first quarter of 2026. Martin Lange, the company’s head of development, said the feedback had allowed it to take both versions into late-stage testing. Approval, if it comes, is not expected before the end of the decade.
Petrelintide: a bet on tolerability
Not every contender is chasing the highest possible weight loss. Petrelintide, a long-acting amylin analogue from Zealand Pharma and its partner Roche, is designed around tolerability. In the phase 2 ZUPREME-1 trial it produced a mean weight loss of 10.7% at 42 weeks with side effects described as close to those of placebo, a profile its developers argue could improve the long-term adherence that undermines many weight-loss regimens. Roche paid 1.65 billion dollars upfront for the rights, a measure of the interest in amylin-based mechanisms as an alternative or complement to GLP-1 drugs. A phase 3 programme is due to begin in the second half of 2026, and the drug is also being tested in combination with Roche’s own dual agonist.
CagriSema: the most advanced of the next wave
Furthest along of all is Novo Nordisk’s CagriSema, a fixed-dose combination of the amylin analogue cagrilintide and semaglutide given as a single weekly injection. Its REDEFINE phase 3 programme delivered around 23% weight loss in adults with obesity, and Novo filed for FDA approval in December 2025, with a decision expected later in 2026. The data have been scrutinised closely after the drug undershot some analysts’ expectations in earlier trials, but Novo’s chief executive Mike Doustdar has pushed back hard, insisting it is “a fantastic drug”. The full REDEFINE results are examined in our earlier analysis of the CagriSema phase 3 data. If cleared, CagriSema would be the first combined GLP-1 and amylin therapy to reach the market.
What these late-stage obesity drugs mean for patients
Taken together, these late-stage obesity drugs point to a market that is rapidly diversifying. Patients and prescribers will soon be able to choose between weekly and monthly injections, daily tablets, and combinations tuned for diabetes, liver disease or simply for gentler side effects. Competition on this scale is also likely to put pressure on prices, which remain a major barrier to access in many health systems. For now, only orforglipron and the oral and injectable semaglutide products are approved, but the depth of the phase 3 pipeline suggests the choice facing patients in the next few years will be far wider than the one that defined the Ozempic era.
