Comparison
Weight-loss drugs 2026 compared: injections and pills
19 drugs from Wegovy to retatrutide: what is approved, what is in trials and what the data show.
5 min read updated November 14, 2026
The short answer
Four weight-loss medicines are approved in the EU: semaglutide (Wegovy, also as a tablet since September 2026), tirzepatide (Mounjaro), liraglutide (Saxenda) and orlistat. Among the approved drugs, tirzepatide shows the largest weight loss: up to 20.9 percent after 72 weeks, and more than semaglutide in the head-to-head SURMOUNT-5 trial. Even larger numbers come from drugs still in trials: retatrutide reached 25 percent in TRIUMPH-1. The first non-peptide GLP-1 pill, orforglipron, is approved in the US and UK and recommended in the EU, but not yet available there (as of 14 November 2026).
All drugs at a glance
| Drug | Status | Key trial result | BK-Score |
|---|---|---|---|
| Approved in the EU | |||
| Semaglutide (Wegovy / Ozempic)GLP-1 · injection, tablet | EU-approved; Wegovy tablet in German pharmacies since 1 Sep 2026 | STEP 1: 14.9% vs 2.4% on placebo after 68 weeks | Well supported |
| Tirzepatide (Mounjaro / Zepbound)GLP-1 + GIP · injection | EU-approved since 2022 (Mounjaro) | SURMOUNT-1: up to 20.9% vs 3.1% after 72 weeks | Well supported |
| Liraglutide (Saxenda)GLP-1, daily · injection | EU-approved since 2015 (Saxenda) | SCALE: 8.4 vs 2.8 kg after 56 weeks | Well supported |
| Orlistat (Xenical / alli)blocks fat absorption · capsule | EU-approved since 1998 | meta-analysis: 2.9 kg more than placebo after one year | Well supported |
| Approved outside the EU | |||
| Orforglipron (Foundayo)GLP-1, non-peptide · tablet | approved in the US (April 2026) and UK; EU: CHMP recommended approval on 15 Oct 2026 | ATTAIN-1: 11.2% vs 2.1% after 72 weeks | Well supported, heavily overhyped |
| MazdutideGLP-1 + glucagon · injection | approved in China (2025) | GLORY-1: 11.0 to 14.0% after 48 weeks | Well supported, heavily overhyped |
| EcnoglutideGLP-1 · injection | approved in China (2026) | phase 3: 9.1 to 13.2% vs +0.1% after 40 weeks | Well supported |
| In clinical trials | |||
| CagriSema (cagrilintide + Semaglutide)amylin + GLP-1 · injection | US approval application filed (Dec 2025) | REDEFINE 1: 20.4% vs 3.0% after 68 weeks | Well supported, heavily overhyped |
| RetatrutideGLP-1 + GIP + glucagon · injection | phase 3, US filing planned for early 2027 | TRIUMPH-1: 25.0% vs 3.9% after 80 weeks | Well supported, heavily overhyped |
| MariTide (Maridebart Cafraglutide)GLP-1 + GIP blocker · injection | phase 3 | phase 2: 12.3 to 16.2% vs 2.5% after 52 weeks | Supported, with limitations |
| SurvodutideGLP-1 + glucagon · injection | phase 3 | SYNCHRONIZE-1: 12.2 to 13.0% vs 5.4% after 76 weeks | Well supported, heavily overhyped |
| Eloralintideamylin · injection | phase 3 | phase 2: 9 to 20% vs 0.4% after 48 weeks | Supported, with limitations |
| Petrelintideamylin · injection | phase 3 | phase 2: 7.9 to 9.8% vs 1.7% after 28 weeks | Supported, with limitations |
| Amycretin (zenagamtide)GLP-1 + amylin · injection, tablet | phase 3 | early trial (125 participants): up to 24.3% after 36 weeks | Thin human evidence |
| VK2735GLP-1 + GIP · injection, tablet | phase 3 | phase 2: 9.1 to 14.7% vs 1.7% after 13 weeks | Thin human evidence |
| PemvidutideGLP-1 + glucagon · injection | phase 3 in fatty liver disease (MASH) | liver focus: liver fat down 46.6 to 68.5% after 12 weeks | Supported, with limitations |
| Bimagrumabactivin receptor antibody · infusion | phase 2 | type 2 diabetes: fat mass down 20.5%, lean mass up 3.6% after 48 weeks | Supported, with limitations |
| Not approved | |||
| Tesofensinemonoamine reuptake inhibitor · tablet | not approved anywhere | phase 2 (2008): 4.5 to 10.6% vs 2.0% after 24 weeks | Thin human evidence |
| "GLP-3" (sold as retatrutide)supposedly retatrutide · injection | not a medicine, grey market | no studies; retatrutide data do not apply to these products | Hype far ahead of evidence |
How to read the table
- The percentages are not directly comparable. A 13-week trial measures something different from an 80-week trial, and people with type 2 diabetes usually lose less weight on the same drugs.
- Phase 2 numbers are often higher than later phase 3 results. Small trials with selected participants tend to overestimate the effect.
- The BK-Score rates the state of knowledge, not the effect. "Well supported, heavily overhyped" means the data are solid, but the promises online go further.
- All of these drugs are prescription-only or not approved at all. Whether one is suitable is a medical decision. In Germany, statutory health insurance does not pay for weight loss (§ 34 SGB V).
Caution when buying online
Unapproved drugs such as retatrutide are not available as tested medicines outside clinical trials. What is sold online as "GLP-3" or "reta" is untested material with unclear contents; the trial results do not apply to it. Counterfeits of approved drugs are also in circulation.
Head-to-head comparisons
Semaglutide vs tirzepatide · Retatrutide vs tirzepatide · Orforglipron vs semaglutide · Mazdutide vs retatrutide
Frequently asked questions
Which weight-loss injection works best?
Among the drugs approved in the EU, tirzepatide (Mounjaro) shows the largest weight loss: up to 20.9 percent after 72 weeks in SURMOUNT-1, and 20.2 versus 13.7 percent with semaglutide in the head-to-head SURMOUNT-5 trial. Retatrutide, not yet approved, reached 25.0 percent in TRIUMPH-1.
Which weight-loss pills are there?
In Germany, the Wegovy tablet (semaglutide) has been available since 1 September 2026, alongside orlistat. Orforglipron (Foundayo) is approved in the US and UK; in the EU, the CHMP recommended approval on 15 October 2026, and the European Commission decision was still pending on 13 November 2026.
Does health insurance pay for weight-loss injections in Germany?
Not for weight loss: medicines for weight reduction are excluded from reimbursement under § 34(1) SGB V. For type 2 diabetes, however, GLP-1 drugs such as Ozempic or Mounjaro can be prescribed and reimbursed.
What is the difference between GLP-1, GIP and amylin?
All three are the body's own satiety and metabolic hormones. GLP-1 drugs such as semaglutide act on one receptor, tirzepatide also on the GIP receptor, retatrutide on three receptors. Amylin drugs such as eloralintide and petrelintide use a second satiety system and are also combined with GLP-1, for example in CagriSema.
Information only, not medical advice and no usage or dosage recommendation. Prescription and unapproved drugs belong in medical hands.