Podcast episode 106 (in German)
Retatrutide – thirty point three percent, and who owns the number
October 14, 2026
30.3 percent weight loss: the Retatrutide figure is everywhere, and it is the largest weight loss ever measured. It is correct — but it applies to a small, selected group without comparison, and so far nobody can look it up.
What it is about
Retatrutide is injected once a week and works at 3 docking sites simultaneously: GLP-1, GIP and glucagon. The episode takes apart the large phase 3 study TRIUMPH-1 and shows that 3 different peak values come from it, depending on the analysis rule and subgroup. Added to this is the price in side effects and dropouts, and the question of where these numbers come from at all: from a manufacturer announcement and a congress presentation, not from a peer-reviewed paper. Finally, it turns to the gray market, because the substance is not approved anywhere, yet it is ordered anyway. At the end is a rule that applies beyond this drug: with every number, first ask whom it applies to.
Key points
- TRIUMPH-1 assigned 2,339 participants double-blind to 3 dose levels and placebo; after 80 weeks they lost 19, 25.9 and 28.3 percent, under placebo 2.2.
- Counting everyone, including those who did not stay the course, it is 17.6, 23.7 and 25.0 percent versus 3.9 — the same people, a second prespecified analysis rule.
- The 30.3 percent comes from an extension to 104 weeks with 532 selected participants, body mass index of 35 or more, without dropouts — and without a placebo group.
- Nausea occurred in 28.6 to 42.4 percent depending on dose level, versus 14.8 under placebo; at the highest level, 11.3 percent dropped out and 12.5 percent reported tingling or numbness of the skin.
- Peer-reviewed and fully readable, by contrast, is the 2023 phase 2 study in 338 adults: minus 24.2 percent at the highest dose level versus minus 2.1 after 48 weeks.
- In 29 million US treatment records, the source could be clarified for 531 people; 71.2 percent had the substance from no study and lost 7.2 percent, study participants 15.5.
- The episode awards human evidence 9, safety 6, use 4, mechanism 8 and hype 4 with a positive direction — spread on the gray market does not count as use.
Where the data stop
Every number on TRIUMPH-1 is second-hand, from the manufacturer’s announcement of May 21 and a congress presentation in early June. The only peer-reviewed paper on the study describes only its design; confidence intervals, the weight curve and individual values are missing. None of these studies has a published value after discontinuation, and none is built for heart attack, stroke or mortality. Where such events were nevertheless counted in people with heart disease, the figures are 27 versus 23 and 44 versus 52 — opposite directions, both numbers too small. That the third lever, glucagon, makes the difference is a narrative; nobody has tested it separately.
The substance is not approved anywhere; the application is expected in the first quarter of next year. What is traded outside the studies is not the substance behind these numbers. The records analysis and an analysis of 148,000 Reddit posts are preprints without peer review; that increased appetite, at 17.1 percent, ranks ahead of nausea there proves nothing and only shows where one would need to look.
Listen (in German)
Listen on Spotify Listen on Apple Podcasts Listen on Amazon Music
Published on October 14, 2026.
The topic in the database
- The strongest weight-loss agent from the studies so far: a triple approach from Eli Lilly that curbs appetite and raises energy expenditure.Retatrutide
All episodes in the app (German)
Information only, not medical advice and not a usage or dosage recommendation. Prescription-only and unapproved substances belong in the hands of a physician. Last updated: 2026-09-22.