What comes after GLP-1s?

When GLP-1s first started getting FDA-approval for weight loss in 2014, they were considered a medical breakthrough. These medications — semaglutide (Wegovy), tirzepatide (Zepbound), and liraglutide (Saxenda) — transformed how the medical community views and treats obesity and overweight.

But that was then — this is now. In 2026 alone, the FDA has approved several new weight-loss medications, with even more options seemingly in the pipeline. “The number of medications available to treat obesity has expanded rapidly,” says Dr. Ivania Rizo, M.D., DABOM, spokesperson for The Obesity Society and director of obesity medicine at Boston Medical Center. “The growth is exciting because it provides more options to tailor treatment to an individual’s health needs.”

We talked to obesity medicine experts about what new medications they’re excited about — and what all this innovation means for the future of weight care.

Prescribed for weight loss under the brand name Wegovy, semaglutide had been available in various injectable doses, maxing out at 2.4 mg, and an oral option that was approved in late 2025. However, in March 2026 the FDA approved the injectable Wegovy HD, manufactured by Novo Nordisk, that has a 7.2 mg dose — three times higher.  “It’s a huge jump in dose,” says Dr. Matthew Poplin, M.D., DABOM, senior clinician lead at Weight Watchers Clinic. 

People in the clinical trial for Wegovy HD weighed an average of 249 pounds at start and lost an average of 19% of their body weight after 72 weeks compared to 16% with the 2.4 mg dose. But Poplin notes that this higher weight loss comes with an important caveat: “The incidence of gastrointestinal side effects are also higher,” he points out. While all GLP-1s come with the risk of GI side effects like nausea, vomiting, diarrhea, and/or constipation, these can become more common the higher your dose. One group this new medication can help: those who are already taking a GLP-1 and not seeing the desired results.

There had been just one oral GLP-1 option for weight loss — the Wegovy pill — but the FDA just approved a second one in April 2026: Foundayo (orforglipron), manufactured by Eli Lilly and Company. It works similarly to other GLP-1s for weight loss, reducing how much you eat by slowing down gastric emptying and targeting appetite receptors in your brain.

Orforglipron is a once-daily pill that you can take at any time of day, with or without food. (Oral semaglutide must be taken in the morning on an empty stomach.) “Traditional oral GLP-1s, such as oral semaglutide, are broken down quickly in the stomach. What sets orforglipron apart is that it’s a small-molecule, nonpeptide medication making it easier to take and more convenient,” says Poplin. Research on orforglipron found that over 72 weeks, people with obesity lost between 7.5% and 11.2% of their body weight, depending on the dose.

Retatrutide is an investigational weight-loss medication not yet approved by the FDA.  It is a triple receptor agonist, meaning it targets three appetite-regulating hormones in the body: GLP-1 (glucagon-like peptide-1), GIP (glucose-dependent insulinotropic polypeptide), and glucagon. “These hormones play important roles in how the body controls hunger, blood sugar, and energy use,” says Rizo. 

To put this in perspective, semaglutide only targets GLP-1. Tirzepatide (the active ingredient in the weight-loss medication Zepbound) targets GLP-1 plus GIP. So, if FDA-approved, this medication targeting three hormones — GLP-1, GIP, and glucagon — would be new. “Glucagon promotes fat breakdown and improves liver fat metabolism,” Rizo explains. This helps the body burn calories and fat. Glucagon can raise blood sugar, but this effect is countered by the GLP-1, which helps regulate blood sugar. 

It’s not FDA-approved yet, but researchers have already dubbed retatrutide groundbreaking. An early phase 2 trial found the medication may contribute to weight loss of 24.2% of body weight at the 12 mg dose after 48 weeks, with weight loss continuing after the study ended. Other trials show that there will likely be more weight loss at two years. “While these results are very promising, retatrutide is still being studied and is not yet approved for clinical use,” says Rizo.  It’s worth noting that if you are interested in seeing if you qualify for this medication, the safest option is to wait until the FDA has approved it. Retatrutide, manufactured by Eli Lilly, is currently in phase 3 clinical trials, the step before the manufacturer can seek FDA approval, so it may be approved this year or next.

Called CagriSema, this investigational weight-loss drug by Novo Nordisk combines semaglutide and cagrilintide. It is not yet approved by the FDA. Cagrilintide is a peptide that mimics the hormone amylin, which is released alongside insulin when you eat. Known as a “combination GLP-1,” it decreases appetite, regulates blood sugar, and slows stomach emptying. “Amylin works in complementary pathways with semaglutide, particularly in the brain,” says Poplin. 

Because these two medications have a similar impact on the body, combining them may boost their weight-loss potential. And trials found that CagriSema can lead to an average 20.4% weight loss after 68 weeks compared to 3% for the placebo group, and half of the people in the trial who had obesity at the start of the trial had BMIs less than 30 (the cutoff for obesity classification) by the end of it. CagriSema is currently in phase 3 clinical trials, and the FDA could review its application for approval this year.

This investigational medication (also not yet approved by the FDA) by Eli Lilly works by targeting activin type II receptors, which reduce fat while increasing muscle. This directly addresses a common problem with weight-loss medications, says endocrinologist Dr. Ken Fujioka, M.D., director of the Nutrition and Metabolic Research Centers at Scripps Clinic in San Diego. “If you lose 40 pounds, for example — which is really common with these new drugs — you lose about 10 pounds of bone and muscle and 30 pounds of fat,” he explains. The loss of lean mass can raise your risk for bone issues in the future and predispose you to regaining weight, since muscle is metabolically active tissue that burns calories. 

Newer drugs like bimagrumab hope to fix that issue. “The hope is that they will produce massive weight loss — and it will be the weight loss you want,” says Fujioka. In other words: You’ll lose fat, not bone or muscle. And in early studies, this medication has been found to reduce total body fat and visceral and liver fat while increasing lean mass and lowering A1c levels (a measurement of blood sugar over time). Research is still ongoing, with this medication currently in phase 2 clinical trials. (Phase 2 trials are given to groups of 100 to 300 people to determine its safety and efficacy. Drugs may be approved by the FDA after phase 3 trials and the timing of those depends on how phase 2 goes, so it may be years before this drug is available.)

A dual glucagon receptor/GLP-1 receptor agonist, survodutide is an investigational drug by pharmaceutical company Boehringer Ingelheim that is being studied for the treatment of obesity, type 2 diabetes, and metabolic dysfunction-associated steatohepatitis (MASH). This drug is not yet FDA approved. One phase 3 clinical trial found that survodutide led to an average 12% to 18.7% body weight reduction, depending on dose, in adults with obesity and without diabetes after 76 weeks compared to 5% in the placebo group. The weight loss was accompanied by reduction in visceral and liver fat as well as improvements in cardiometabolic risk factors. What also stands out is survodutide’s potential benefit for metabolic dysfunction-associated steatotic liver disease, or MASLD (informally called “fatty liver”), as seen in another trial. 

Its ability to activate the body’s glucagon receptors is why the medication appears to clear out liver fat better than the current GLP-1 medications available, says Dr. Wayne Ho, M.D., spokesperson for The Obesity Society. “Glucagon activation increases energy expenditure and fat breakdown in the liver, making survodutide a potentially exciting treatment for MASLD,” he says. An additional perk? Ho points out that the research shows that survodutide causes more visceral fat loss and less muscle loss compared to current GLP-1 medications. That’s beneficial for your metabolic health, given visceral fat, which hugs the organs, is the type of fat that is linked to the highest risk of cardiovascular disease, says Ho.

Rounding out the tongue-tying names of medications, the final one to watch for is berobenatide. Berobenatide is a potential new GLP-1 that is currently in clinical trials. This investigational drug is notable because it is a monthly injectable GLP-1, differentiating itself from other injectable GLP-1s which are taken daily or weekly. That’s a huge perk for those who aren’t comfortable with injections, says Ho. Keep in mind, berobenatide is not yet approved by the FDA.

The manufacturer, Pfizer, recently reported results for their Phase 2b trial. “While we cannot directly compare the results of one trial to another, berobenatide’s phase 2b trial results suggest that its weight loss efficacy may be similar to semaglutide for individuals with obesity, both with and without type 2 diabetes,” Ho explains. At the moment, it also appears that berobenatide may be just as tolerable as other GLP-1s, he adds, noting that we have to wait for phase 3 data to see if this shakes out.

There are many new weight-loss medications working their way through clinical trials and FDA approvals — something many experts see as an overwhelmingly positive thing. “As treatment options continue to grow, clinicians can increasingly match medications to a person’s specific health profile and goals,” says Rizo. “Ultimately, the goal of obesity treatment is not only weight loss itself, but improving health outcomes, such as diabetes control, cardiovascular health, liver disease, sleep apnea, osteoarthritis, and quality of life.” With more of these options, you’ll be able to access the treatments and the outcomes you’re looking for. And remember: There’s no need to wait for the next generation of meds to start your weight-loss journey. By joining Weight Watchers Med+, you’ll have access to Clinicians who can talk you through your available options and, if you qualify, prescribe medication and a lifestyle plan tailored to your body and your goals.