Weight-loss medicines

What is approved, where, and what the trials actually showed — plus an honest account of what is sold online with no evidence behind it at all.

33 programmes 6 in the graveyard 325 logged changes Verified 20 Aug 2026 Next review 3 Sep 2026 Download (JSON)

198 spec cells 119 published 79 nobody published — 40%

one column per programme, in list order · top to bottom: Weight change, Placebo arm, Placebo-adjusted, Pivotal trial, Participants, Duration

40^%

of the spec cells have never been published by anyone

79 of 198 — 6 core fields across 33 programmes. These are not cells we are missing: they are numbers no maker, regulator or customer ever made public. 20 Aug 2026

The comparison

The date is in every cell, not in a footnote: the age of a number is a property of the number, not of the page.

Programme	Brand▲▼	Class▲▼	Route▲▼	Weight change▲▼ %	Placebo arm▲▼ %	Placebo-adjusted▲▼ pp	Pivotal trial▲▼	Participants▲▼	Duration▲▼ weeks	Stopped for side effects▲▼	Randomised human evidence▲
Ipamorelin claimed	never	never	never	never	never	never	never	never	never	never	negative 21.08.26
Why these cells are empty Weight change Two randomised trials, both in postoperative ileus, both unsuccessful; the programme was abandoned. Plus one 1999 pharmacology study in volunteers. No randomised trial for body composition, healing or longevity exists. Placebo arm Two randomised trials, both in postoperative ileus, both unsuccessful; the programme was abandoned. Plus one 1999 pharmacology study in volunteers. No randomised trial for body composition, healing or longevity exists. Placebo-adjusted Two randomised trials, both in postoperative ileus, both unsuccessful; the programme was abandoned. Plus one 1999 pharmacology study in volunteers. No randomised trial for body composition, healing or longevity exists. Pivotal trial Two randomised trials, both in postoperative ileus, both unsuccessful; the programme was abandoned. Plus one 1999 pharmacology study in volunteers. No randomised trial for body composition, healing or longevity exists. Participants Two randomised trials, both in postoperative ileus, both unsuccessful; the programme was abandoned. Plus one 1999 pharmacology study in volunteers. No randomised trial for body composition, healing or longevity exists. Duration Two randomised trials, both in postoperative ileus, both unsuccessful; the programme was abandoned. Plus one 1999 pharmacology study in volunteers. No randomised trial for body composition, healing or longevity exists. Evidence — Two randomised trials, both in postoperative ileus, both unsuccessful; the programme was abandoned. Plus one 1999 pharmacology study in volunteers. No randomised trial for body composition, healing or longevity exists. Regulatory status — Still on the FDA's significant-safety-risk list. FDA cites immunogenicity risk and serious adverse events including death with intravenous administration. It is the only compound here the agency kept on that list in 2026. WADA — Prohibited (S2.2.4, growth hormone secretagogues) Known harms — The only one on this list FDA has affirmatively kept flagged for safety.
BPC-157 claimed	never	never	never	never	never	never	never	never	never	never	none 21.08.26
Why these cells are empty Weight change No completed, published human randomised trial. The registry holds three records: a 2015 Phase 1 whose data were withdrawn before peer review, a Phase 2 hamstring trial still recruiting, and an unrelated study. The roughly 200 PubMed entries are almost all animal work from one research group. Placebo arm No completed, published human randomised trial. The registry holds three records: a 2015 Phase 1 whose data were withdrawn before peer review, a Phase 2 hamstring trial still recruiting, and an unrelated study. The roughly 200 PubMed entries are almost all animal work from one research group. Placebo-adjusted No completed, published human randomised trial. The registry holds three records: a 2015 Phase 1 whose data were withdrawn before peer review, a Phase 2 hamstring trial still recruiting, and an unrelated study. The roughly 200 PubMed entries are almost all animal work from one research group. Pivotal trial No completed, published human randomised trial. The registry holds three records: a 2015 Phase 1 whose data were withdrawn before peer review, a Phase 2 hamstring trial still recruiting, and an unrelated study. The roughly 200 PubMed entries are almost all animal work from one research group. Participants No completed, published human randomised trial. The registry holds three records: a 2015 Phase 1 whose data were withdrawn before peer review, a Phase 2 hamstring trial still recruiting, and an unrelated study. The roughly 200 PubMed entries are almost all animal work from one research group. Duration No completed, published human randomised trial. The registry holds three records: a 2015 Phase 1 whose data were withdrawn before peer review, a Phase 2 hamstring trial still recruiting, and an unrelated study. The roughly 200 PubMed entries are almost all animal work from one research group. Evidence — No completed, published human randomised trial. The registry holds three records: a 2015 Phase 1 whose data were withdrawn before peer review, a Phase 2 hamstring trial still recruiting, and an unrelated study. The roughly 200 PubMed entries are almost all animal work from one research group. Regulatory status — Unapproved drug. Removed from the FDA's significant-safety-risk list around 22 Apr 2026 — which does not make it legal to compound. An advisory panel voted 8–6 to recommend adding it to the compounding list on 23 Jul 2026; that vote is non-binding and rulemaking has not begun. WADA — Prohibited at all times (S0) Known harms — FDA cited immunogenicity risk and impurities. No human safety database exists to characterise the risk.
TB-500 claimed	never	never	never	never	never	never	never	never	never	never	none 21.08.26
Why these cells are empty Weight change The fragment sold as TB-500 has exactly one registered human trial, still recruiting with no results. Full-length thymosin β4 — a different molecule — does have real Phase 2 and Phase 3 trials, none of which led to approval for anything. Conflating the two is the standard marketing move. Placebo arm The fragment sold as TB-500 has exactly one registered human trial, still recruiting with no results. Full-length thymosin β4 — a different molecule — does have real Phase 2 and Phase 3 trials, none of which led to approval for anything. Conflating the two is the standard marketing move. Placebo-adjusted The fragment sold as TB-500 has exactly one registered human trial, still recruiting with no results. Full-length thymosin β4 — a different molecule — does have real Phase 2 and Phase 3 trials, none of which led to approval for anything. Conflating the two is the standard marketing move. Pivotal trial The fragment sold as TB-500 has exactly one registered human trial, still recruiting with no results. Full-length thymosin β4 — a different molecule — does have real Phase 2 and Phase 3 trials, none of which led to approval for anything. Conflating the two is the standard marketing move. Participants The fragment sold as TB-500 has exactly one registered human trial, still recruiting with no results. Full-length thymosin β4 — a different molecule — does have real Phase 2 and Phase 3 trials, none of which led to approval for anything. Conflating the two is the standard marketing move. Duration The fragment sold as TB-500 has exactly one registered human trial, still recruiting with no results. Full-length thymosin β4 — a different molecule — does have real Phase 2 and Phase 3 trials, none of which led to approval for anything. Conflating the two is the standard marketing move. Evidence — The fragment sold as TB-500 has exactly one registered human trial, still recruiting with no results. Full-length thymosin β4 — a different molecule — does have real Phase 2 and Phase 3 trials, none of which led to approval for anything. Conflating the two is the standard marketing move. Regulatory status — Unapproved. Same April 2026 list removal and same July 2026 advisory vote as BPC-157, with the same legal effect: none. WADA — Prohibited (S2.3, growth factors) Known harms — No human safety dataset for the fragment.
CJC-1295 claimed	never	never	never	never	never	never	never	never	never	never	none 21.08.26
Why these cells are empty Weight change One registered trial, in HIV-associated visceral obesity, terminated. Nothing else. There is no positive human efficacy evidence for any marketed use. Placebo arm One registered trial, in HIV-associated visceral obesity, terminated. Nothing else. There is no positive human efficacy evidence for any marketed use. Placebo-adjusted One registered trial, in HIV-associated visceral obesity, terminated. Nothing else. There is no positive human efficacy evidence for any marketed use. Pivotal trial One registered trial, in HIV-associated visceral obesity, terminated. Nothing else. There is no positive human efficacy evidence for any marketed use. Participants One registered trial, in HIV-associated visceral obesity, terminated. Nothing else. There is no positive human efficacy evidence for any marketed use. Duration One registered trial, in HIV-associated visceral obesity, terminated. Nothing else. There is no positive human efficacy evidence for any marketed use. Evidence — One registered trial, in HIV-associated visceral obesity, terminated. Nothing else. There is no positive human efficacy evidence for any marketed use. Regulatory status — Unapproved; no approved medical use anywhere. WADA — Prohibited (S2.2.4, GHRH analogues) Known harms — Sustained growth hormone and IGF-1 elevation is the mechanism of concern.
MOTS-c claimed	never	never	never	never	never	never	never	never	never	never	none 21.08.26
Why these cells are empty Weight change No randomised trial of administered MOTS-c in humans. One Phase 2 in prediabetes is recruiting with no results. Every other hit measures naturally occurring MOTS-c or studies exercise. Placebo arm No randomised trial of administered MOTS-c in humans. One Phase 2 in prediabetes is recruiting with no results. Every other hit measures naturally occurring MOTS-c or studies exercise. Placebo-adjusted No randomised trial of administered MOTS-c in humans. One Phase 2 in prediabetes is recruiting with no results. Every other hit measures naturally occurring MOTS-c or studies exercise. Pivotal trial No randomised trial of administered MOTS-c in humans. One Phase 2 in prediabetes is recruiting with no results. Every other hit measures naturally occurring MOTS-c or studies exercise. Participants No randomised trial of administered MOTS-c in humans. One Phase 2 in prediabetes is recruiting with no results. Every other hit measures naturally occurring MOTS-c or studies exercise. Duration No randomised trial of administered MOTS-c in humans. One Phase 2 in prediabetes is recruiting with no results. Every other hit measures naturally occurring MOTS-c or studies exercise. Evidence — No randomised trial of administered MOTS-c in humans. One Phase 2 in prediabetes is recruiting with no results. Every other hit measures naturally occurring MOTS-c or studies exercise. Regulatory status — Unapproved. Removed from the safety-risk list Apr 2026; advisory vote 7–5 in Jul 2026; not compoundable. WADA — Prohibited (S0; classed as a metabolic modulator in some national renderings) Known harms — Nothing characterised — there is no human exposure dataset.
Epitalon claimed	never	never	never	never	never	never	never	never	never	never	none 21.08.26
Why these cells are empty Weight change Zero registered human trials on ClinicalTrials.gov. The supporting literature is largely older Russian-language work outside mainstream registries. Placebo arm Zero registered human trials on ClinicalTrials.gov. The supporting literature is largely older Russian-language work outside mainstream registries. Placebo-adjusted Zero registered human trials on ClinicalTrials.gov. The supporting literature is largely older Russian-language work outside mainstream registries. Pivotal trial Zero registered human trials on ClinicalTrials.gov. The supporting literature is largely older Russian-language work outside mainstream registries. Participants Zero registered human trials on ClinicalTrials.gov. The supporting literature is largely older Russian-language work outside mainstream registries. Duration Zero registered human trials on ClinicalTrials.gov. The supporting literature is largely older Russian-language work outside mainstream registries. Evidence — Zero registered human trials on ClinicalTrials.gov. The supporting literature is largely older Russian-language work outside mainstream registries. Regulatory status — Unapproved; not compoundable. WADA — Prohibited (S0) Known harms — Nothing characterised.
AOD-9604 claimed	never	never	never	never	never	never	never	never	never	never	none 21.08.26
Why these cells are empty Weight change Zero registered trials and zero randomised trials in PubMed. Obesity development was abandoned. The literature that exists consists of doping-detection methods papers. Placebo arm Zero registered trials and zero randomised trials in PubMed. Obesity development was abandoned. The literature that exists consists of doping-detection methods papers. Placebo-adjusted Zero registered trials and zero randomised trials in PubMed. Obesity development was abandoned. The literature that exists consists of doping-detection methods papers. Pivotal trial Zero registered trials and zero randomised trials in PubMed. Obesity development was abandoned. The literature that exists consists of doping-detection methods papers. Participants Zero registered trials and zero randomised trials in PubMed. Obesity development was abandoned. The literature that exists consists of doping-detection methods papers. Duration Zero registered trials and zero randomised trials in PubMed. Obesity development was abandoned. The literature that exists consists of doping-detection methods papers. Evidence — Zero registered trials and zero randomised trials in PubMed. Obesity development was abandoned. The literature that exists consists of doping-detection methods papers. Regulatory status — Unapproved. WADA — Prohibited (S2.2.3, growth hormone fragments) Known harms — Nothing characterised.
Semax / Selank claimed	never	never	never	never	never	never	never	never	never	never	none 21.08.26
Why these cells are empty Weight change Semax: zero registered trials; one Russian motor-neurone-disease paper from 2007. Selank: zero registered trials, and no English-language randomised trial exists at all. Placebo arm Semax: zero registered trials; one Russian motor-neurone-disease paper from 2007. Selank: zero registered trials, and no English-language randomised trial exists at all. Placebo-adjusted Semax: zero registered trials; one Russian motor-neurone-disease paper from 2007. Selank: zero registered trials, and no English-language randomised trial exists at all. Pivotal trial Semax: zero registered trials; one Russian motor-neurone-disease paper from 2007. Selank: zero registered trials, and no English-language randomised trial exists at all. Participants Semax: zero registered trials; one Russian motor-neurone-disease paper from 2007. Selank: zero registered trials, and no English-language randomised trial exists at all. Duration Semax: zero registered trials; one Russian motor-neurone-disease paper from 2007. Selank: zero registered trials, and no English-language randomised trial exists at all. Evidence — Semax: zero registered trials; one Russian motor-neurone-disease paper from 2007. Selank: zero registered trials, and no English-language randomised trial exists at all. Regulatory status — Unapproved; not compoundable. WADA — Captured by S0 Known harms — Nothing characterised.
GHK-Cu (injected) claimed	never	never	never	never	never	never	never	never	never	never	topical only 21.08.26
Why these cells are empty Weight change The human evidence that exists is topical and thin: one small facial-skin study and one wound-gel trial still recruiting. There is no randomised trial of injected GHK-Cu in humans. Placebo arm The human evidence that exists is topical and thin: one small facial-skin study and one wound-gel trial still recruiting. There is no randomised trial of injected GHK-Cu in humans. Placebo-adjusted The human evidence that exists is topical and thin: one small facial-skin study and one wound-gel trial still recruiting. There is no randomised trial of injected GHK-Cu in humans. Pivotal trial The human evidence that exists is topical and thin: one small facial-skin study and one wound-gel trial still recruiting. There is no randomised trial of injected GHK-Cu in humans. Participants The human evidence that exists is topical and thin: one small facial-skin study and one wound-gel trial still recruiting. There is no randomised trial of injected GHK-Cu in humans. Duration The human evidence that exists is topical and thin: one small facial-skin study and one wound-gel trial still recruiting. There is no randomised trial of injected GHK-Cu in humans. Evidence — The human evidence that exists is topical and thin: one small facial-skin study and one wound-gel trial still recruiting. There is no randomised trial of injected GHK-Cu in humans. Regulatory status — Injectable routes removed from the safety-risk list Apr 2026; not compoundable. Topical cosmetic use is a separate regulatory category. WADA — Injectable use captured by S0 Known harms — Copper load with repeated injection is an unstudied hazard.
Tesamorelin claimed	never	never	never	never	never	never	never	never	never	never	yes 21.08.26
Why these cells are empty Weight change The exception on this list. Real Phase 3 evidence, N=412 plus an extension, and an FDA approval — for one narrow indication only: reduction of excess abdominal fat in people with HIV-associated lipodystrophy. Placebo arm The exception on this list. Real Phase 3 evidence, N=412 plus an extension, and an FDA approval — for one narrow indication only: reduction of excess abdominal fat in people with HIV-associated lipodystrophy. Placebo-adjusted The exception on this list. Real Phase 3 evidence, N=412 plus an extension, and an FDA approval — for one narrow indication only: reduction of excess abdominal fat in people with HIV-associated lipodystrophy. Pivotal trial The exception on this list. Real Phase 3 evidence, N=412 plus an extension, and an FDA approval — for one narrow indication only: reduction of excess abdominal fat in people with HIV-associated lipodystrophy. Participants The exception on this list. Real Phase 3 evidence, N=412 plus an extension, and an FDA approval — for one narrow indication only: reduction of excess abdominal fat in people with HIV-associated lipodystrophy. Duration The exception on this list. Real Phase 3 evidence, N=412 plus an extension, and an FDA approval — for one narrow indication only: reduction of excess abdominal fat in people with HIV-associated lipodystrophy. Evidence — The exception on this list. Real Phase 3 evidence, N=412 plus an extension, and an FDA approval — for one narrow indication only: reduction of excess abdominal fat in people with HIV-associated lipodystrophy. Regulatory status — APPROVED in the US as Egrifta, NDA 022505, for HIV-associated lipodystrophy only. WADA — Prohibited (S2.2.4) Known harms — Its own label states it is not indicated for weight loss and is weight-neutral. Contraindicated in active malignancy. In trials, 5% developed an HbA1c of 6.5% or above versus 1% on placebo — a hazard ratio of 3.3 for developing diabetes.
No published Randomised human evidence — 23 programmes
Semaglutide 2.4 mg Novo Nordisk strong	Wegovy 21.08.26	GLP-1 receptor agonist 21.08.26	Injection, weekly 21.08.26	-14.9 % 21.08.26	-2.4 % 21.08.26	-12.5 pp 21.08.26	STEP 1 21.08.26	1 961 21.08.26	68 weeks 21.08.26	6.8% vs 3.2% placebo 21.08.26	never
Outcomes — SELECT (N=17,604, mean 40 months) showed a real cardiovascular benefit in people with established heart disease and no diabetes: major adverse cardiac events 6.5% vs 8.0%, HR 0.80. This is the strongest outcome evidence for any medicine on this page. Boxed warning — Thyroid C-cell tumours (rodent finding). Contraindicated with a personal or family history of medullary thyroid carcinoma or MEN 2. Harms — Nausea 44%, diarrhoea 30%, vomiting 24%, constipation 24%. Serious: pancreatitis, gallbladder disease, acute kidney injury, pulmonary aspiration under anaesthesia. Generics — First generics for weight management have arrived, but not in the US. Health Canada authorised Apotex's Sevmia on 29 Jun 2026 — the first generic semaglutide indicated for chronic weight management, though other generic semaglutide products were already listed in Canada. Trade reporting attributes the early entry to a lapsed patent maintenance fee; Health Canada does not say so. Brazil approved locally-made generics (EMS, Germed) on 17 Aug 2026. Price — US list $1,349.02 per 28-day package; manufacturer cash-pay $299/month. Covered under the Medicare GLP-1 Bridge from 1 Jul 2026 at roughly $50 to the beneficiary. No verifiable EU or Brazilian list price exists in a primary source. Supply — Shortage resolved 21 Feb 2025. Sources for this row FDA — Wegovy label, rev. 03/2026 1 Mar 2026 SELECT trial summary, NEJM 2023;389:2221 11 Nov 2023
Semaglutide 7.2 mg Novo Nordisk strong	Wegovy HD 21.08.26	GLP-1 receptor agonist 21.08.26	Injection, weekly 21.08.26	-19.5 % 21.08.26	-3.8 % 21.08.26	-15.7 pp 21.08.26	STEP UP 21.08.26	undisclosed	72 weeks 21.08.26	never	never
Why these cells are empty Participants The trial's sample size has not been disclosed. Stopped for side effects Not published for this dose Outcomes — None specific to this dose. Boxed warning — Thyroid C-cell tumours, as for 2.4 mg. Harms — Same profile as 2.4 mg; dose-specific incidence not published. Generics — None. Price — US manufacturer cash-pay $399/month for new patients. Supply — No shortage reported. Sources for this row ClinicalTrials.gov NCT05646706 — posted results including the placebo arm 20 Aug 2026
Semaglutide 25 mg, oral Novo Nordisk strong	Wegovy tablets 21.08.26	GLP-1 receptor agonist 21.08.26	Tablet, daily 21.08.26	-14.0 % 21.08.26	-2.0 % 21.08.26	-12.0 pp 21.08.26	OASIS 4 21.08.26	307 21.08.26	64 weeks 21.08.26	7% vs 6% placebo 21.08.26	never
Outcomes — The cardiovascular labelling rests on SOUL, which studied oral semaglutide 14 mg — the diabetes product, not this 25 mg obesity product. No dedicated outcome trial of the 25 mg dose exists. Boxed warning — Thyroid C-cell tumours. Harms — Gastrointestinal adverse events in 74% vs 42% placebo. Generics — None. Price — US manufacturer cash-pay $149/month — the cheapest branded GLP-1 in the United States. Supply — No shortage reported. Sources for this row FDA — Wegovy tablets label, rev. 12/2025 1 Dec 2025 OASIS 4 — PubMed 40934115 1 Sep 2025
Tirzepatide Eli Lilly strong	Zepbound (US) / Mounjaro 21.08.26	Dual GIP + GLP-1 receptor agonist 21.08.26	Injection, weekly 21.08.26	-20.9 % 21.08.26	-3.1 % 21.08.26	-17.8 pp 21.08.26	SURMOUNT-1 21.08.26	2 539 21.08.26	72 weeks 21.08.26	4.8–6.7% vs 3.4% placebo 21.08.26	never
Outcomes — SURPASS-CVOT compared tirzepatide against active dulaglutide, not placebo: non-inferior, superiority not met. SURMOUNT-MMO, the obesity outcomes trial, is still running with no results. Anyone citing SURMOUNT-MMO results today is citing nothing. Boxed warning — Thyroid C-cell tumours (rat finding). Harms — Nausea 28%, diarrhoea 23%, constipation 17%, vomiting 13%, hair loss 5%. Generics — None anywhere. Composition-of-matter patents run into the mid-2030s. Price — US self-pay $299–$449/month depending on dose. Only the Zepbound KwikPen is on the Medicare covered list. Supply — Shortage resolved 19 Dec 2024. Sources for this row FDA — Zepbound label, rev. 01/2026 1 Jan 2026 SURMOUNT-1 — PubMed 35658024 4 Jun 2022
Orforglipron Eli Lilly strong	Foundayo 21.08.26	Small-molecule (non-peptide) GLP-1 receptor agonist 21.08.26	Tablet, daily 21.08.26	-11.1 % 21.08.26	-2.1 % 21.08.26	-9.0 pp 21.08.26	ATTAIN-1 21.08.26	3 127 21.08.26	72 weeks 21.08.26	8% vs 3% placebo — the highest of the GLP-1 agents 21.08.26	never
Outcomes — None. No cardiovascular outcomes trial has reported. Boxed warning — Thyroid C-cell tumours — applied as a class warning even though the label states orforglipron itself produced no tumours in rodents, because human relevance is undetermined. Harms — At the top dose: nausea 35%, diarrhoea 25%, vomiting 24%, constipation 24%. Generics — None. New chemical entity. Price — US self-pay from $149/month; Medicare Part D $50/month from 1 Jul 2026. Supply — No shortage reported. Sources for this row FDA — Foundayo label, rev. 04/2026 1 Apr 2026
Liraglutide 3.0 mg Novo Nordisk; Teva (generic) strong	Saxenda + generics 21.08.26	GLP-1 receptor agonist 21.08.26	Injection, daily 21.08.26	-8.0 % 21.08.26	-2.6 % 21.08.26	-5.4 pp 21.08.26	SCALE Obesity and Prediabetes 21.08.26	3 731 21.08.26	56 weeks 21.08.26	never	never
Why these cells are empty Stopped for side effects Not published Outcomes — LEADER showed cardiovascular benefit at the 1.8 mg diabetes dose. There is no outcome trial at the 3.0 mg obesity dose. Boxed warning — Thyroid C-cell tumours. Harms — Nausea 40%, diarrhoea 21%, vomiting 16%. Generics — The only genericised GLP-1. Teva launched generic liraglutide in the US on 28 Aug 2025. Price — Brand reference around $1,324/month in the US; generic launch price not disclosed. Not on the Medicare covered list. Supply — None current. Sources for this row EMA — Saxenda EPAR 20 Aug 2026 SCALE, NEJM 2015;373:11 2 Jul 2015
Phentermine / topiramate ER Vivus strong	Qsymia 21.08.26	Sympathomimetic + anticonvulsant combination 21.08.26	Tablet, daily 21.08.26	-9.8 % 21.08.26	-1.2 % 21.08.26	-8.6 pp 21.08.26	CONQUER 21.08.26	2 487 21.08.26	56 weeks 21.08.26	Label reports only all-cause withdrawal of 31–40%, which is not comparable to other drugs' figures 21.08.26	never
Outcomes — None. The required post-marketing cardiovascular trial was never completed. Boxed warning — None — but the warnings are extensive. Harms — Embryo-fetal toxicity including cleft lip and palate, suicidal ideation, acute angle-closure glaucoma, cognitive impairment, metabolic acidosis, kidney stones, slowed growth in adolescents. Paraesthesia 20%, dry mouth 19%. Generics — Generic available in the US since 2023–24. Price — As low as about $63/month with coupons. Not Medicare-covered for obesity. Supply — None. Sources for this row FDA — Qsymia label, rev. 09/2024 1 Sep 2024
Naltrexone / bupropion ER Currax; Orexigen Ireland strong	Contrave (US) / Mysimba (EU) 21.08.26	Opioid antagonist + aminoketone antidepressant 21.08.26	Tablet, twice daily 21.08.26	-5.4 % 21.08.26	-1.3 % 21.08.26	-4.1 pp 21.08.26	COR-I 21.08.26	1 074 21.08.26	56 weeks 21.08.26	24% vs 12% placebo — by far the highest of any approved agent 21.08.26	never
Outcomes — The LIGHT cardiovascular outcomes trial was terminated early in 2015 after the sponsor's unauthorised disclosure of interim data, and never produced a valid result. The label states plainly that the cardiovascular effect has not been established. Boxed warning — Suicidal thoughts and behaviours — the antidepressant class warning. Harms — Seizure risk, blood pressure and heart rate increases, hepatotoxicity, angle-closure glaucoma, opioid blockade. Nausea 33%, constipation 19%, headache 18%. Generics — Generic available in the US. Price — About $199/month with coupons. Not Medicare-covered for obesity. Supply — None. Sources for this row FDA — Contrave label, rev. 03/2021 1 Mar 2021
Orlistat Roche; Haleon; many generics strong	Xenical (Rx) / alli (OTC) 21.08.26	Gastrointestinal lipase inhibitor 21.08.26	Capsule, three times daily 21.08.26	-5.2 % 21.08.26	-2.8 % 21.08.26	-2.4 pp 21.08.26	XENDOS 21.08.26	3 305 21.08.26	208 weeks 21.08.26	never	never
Why these cells are empty Stopped for side effects Not stated as an AE-specific figure Outcomes — No cardiovascular outcome trial. XENDOS showed a 42% reduction in progression to type 2 diabetes over four years, and that endpoint is in the label. Boxed warning — None. Harms — Oily spotting 27%, flatus with discharge 24%, faecal urgency 22%, faecal incontinence 8%. Post-marketing: severe liver injury; kidney stones and oxalate nephropathy warning added to alli. Generics — Extensively genericised worldwide, off patent. Price — Brand about $430 per fill; alli about $87; generics cheaper. Supply — None. Sources for this row FDA — Xenical label, rev. 11/2022 1 Nov 2022
Phentermine Multiple strong	Adipex-P, Lomaira, Duromine 21.08.26	Sympathomimetic amine anorectic 21.08.26	Tablet, daily 21.08.26	never	never	never	never	undisclosed	never	never	never
Why these cells are empty Weight change Approved in 1959, before modern trial standards. There is no contemporary placebo-controlled pivotal trial with a percentage body-weight endpoint in the label. Literature suggests roughly 3–5 kg placebo-subtracted loss over 12–36 weeks, which is not a label-confirmed figure. Placebo arm Approved in 1959, before modern trial standards. There is no contemporary placebo-controlled pivotal trial with a percentage body-weight endpoint in the label. Literature suggests roughly 3–5 kg placebo-subtracted loss over 12–36 weeks, which is not a label-confirmed figure. Placebo-adjusted Approved in 1959, before modern trial standards. There is no contemporary placebo-controlled pivotal trial with a percentage body-weight endpoint in the label. Literature suggests roughly 3–5 kg placebo-subtracted loss over 12–36 weeks, which is not a label-confirmed figure. Pivotal trial The sponsor has not named the pivotal trial. Participants The trial's sample size has not been disclosed. Duration The trial's duration has not been published. Stopped for side effects Not published Outcomes — None. Boxed warning — None, but the label warns of primary pulmonary hypertension — described in the label as a rare, frequently fatal lung disease — and serious regurgitant cardiac valvular disease. Harms — Abuse and dependence potential; tolerance develops. Generics — Long off patent, extremely cheap. Price — As low as about $16/month in the US. Supply — None. Sources for this row FDA — Adipex-P label, rev. 01/2012 1 Jan 2012
Setmelanotide Rhythm Pharmaceuticals strong	Imcivree 21.08.26	MC4R agonist 21.08.26	Injection, daily 21.08.26	-15.8 % 21.08.26	2.6 % 21.08.26	-18.4 pp 21.08.26	TRANSCEND 21.08.26	142 21.08.26	52 weeks 21.08.26	never	never
Why these cells are empty Stopped for side effects Not published Outcomes — None; the populations are too small. Boxed warning — None. Harms — Skin hyperpigmentation, nausea, vomiting, headache in over 20%. Depression and suicidal ideation monitoring; spontaneous penile erections. Generics — None; orphan exclusivity. Price — About $3,706 per vial in the US. Annual cost widely reported in the high six figures but not corroborated by a primary source. Supply — None. Sources for this row EMA — Imcivree EPAR 20 Aug 2026
Metreleptin Amryt / Chiesi strong	Myalept (US) / Myalepta (EU) 21.08.26	Recombinant leptin analogue 21.08.26	Injection, daily 21.08.26	never	never	never	NIH open-label cohort 21.08.26	107 21.08.26	never	never	never
Why these cells are empty Weight change No randomised placebo-controlled trial exists, by design — the condition is too rare. A placebo-adjusted figure cannot exist for this product. Placebo arm No randomised placebo-controlled trial exists, by design — the condition is too rare. A placebo-adjusted figure cannot exist for this product. Placebo-adjusted No randomised placebo-controlled trial exists, by design — the condition is too rare. A placebo-adjusted figure cannot exist for this product. Duration The trial's duration has not been published. Stopped for side effects Not published Outcomes — None. Boxed warning — Two components: neutralising anti-metreleptin antibodies that can cause loss of efficacy and severe infection; and risk of T-cell lymphoma. Available only through a restricted programme. Harms — Headache, hypoglycaemia, abdominal pain. Generics — None. Price — Not disclosed in any primary source. Widely reported above $700,000 a year. Supply — None. Sources for this row FDA — Myalept label 24 Feb 2014
Mazdutide Innovent Biologics partial	Xin Er Mei (信尔美)~ 21.08.26	Dual glucagon + GLP-1 receptor agonist~ 21.08.26	Injection, weekly~ 21.08.26	-14.8 % 21.08.26	-0.5 % 21.08.26	-14.3 pp 21.08.26	GLORY-1 21.08.26	undisclosed	48 weeks 21.08.26	never	never
Why these cells are empty Participants The trial's sample size has not been disclosed. Stopped for side effects Not published Outcomes — None. Boxed warning — Not established in an accessible label. Harms — Gastrointestinal effects predominate. Glucagon agonism raises theoretical questions about heart rate and hepatic effects. Incidence figures not in an accessible primary source. Generics — None. Price — Not corroborated. Supply — Not known. Sources for this row Mazdutide: First Approval, Drugs 2025 — PubMed 41028652 1 Sep 2025 Innovent — NMPA approval for chronic weight management 27 Jun 2025
Ecnoglutide Sciwind Biosciences partial	Ecnoglutide (brand not disclosed)~ 21.08.26	cAMP-biased GLP-1 receptor agonist~ 21.08.26	Injection, weekly~ 21.08.26	-15.4 %~ 21.08.26	-0.3 %~ 21.08.26	-15.1 pp~ 21.08.26	SLIMMER~ 21.08.26	undisclosed	48 weeks~ 21.08.26	never	never
Why these cells are empty Participants The trial's sample size has not been disclosed. Stopped for side effects Not published Outcomes — None. Boxed warning — Not established in an accessible label. Harms — Not published in an accessible primary source. Generics — None. Price — Not disclosed. Supply — Not known. Sources for this row Sciwind — NMPA approval of ecnoglutide 6 Mar 2026
Retatrutide Eli Lilly partial	never	Triple GLP-1 / GIP / glucagon agonist~ 21.08.26	never	-28.3 %~ 21.08.26	-2.2 %~ 21.08.26	-26.1 pp~ 21.08.26	TRIUMPH-1~ 21.08.26	2 339~ 21.08.26	80 weeks~ 21.08.26	never	never
Filing slipped to Q1 2027 for manufacturing and quality data. The cardiovascular outcomes trial does not complete until Feb 2029. TRIUMPH-2 and -3, in people with diabetes and with cardiovascular disease, came in materially lower at roughly 21% and 23%. A dysesthesia signal appeared in 8.8–20.9% of participants in TRIUMPH-4 versus 0.7% on placebo. Sources for this row Retatrutide — Eli Lilly 20 Aug 2026
CagriSema Novo Nordisk claimed	never	Amylin analogue + GLP-1 agonist 21.08.26	never	-20.4 % 21.08.26	-3.0 % 21.08.26	-17.4 pp 21.08.26	REDEFINE 1 21.08.26	3 417 21.08.26	68 weeks 21.08.26	never	never
US application submitted 18 Dec 2025; no confirmed decision date. No EU submission verifiable from EMA sources. REDEFINE 4, the head-to-head against tirzepatide, MISSED its primary endpoint on 23 Feb 2026 — non-inferiority was not demonstrated. This is the single most under-reported fact in consumer coverage of this drug. Sources for this row CagriSema — Novo Nordisk 20 Aug 2026
Amycretin Novo Nordisk claimed	never	Single molecule acting on GLP-1 and amylin receptors 21.08.26	never	-22.0 % 21.08.26	2.0 % 21.08.26	-24.0 pp 21.08.26	never	125 21.08.26	36 weeks 21.08.26	never	never
Why these cells are empty Pivotal trial The sponsor has not named the trial. Phase 3 announced for Q1 2026, but no Phase 3 obesity trial is findable on ClinicalTrials.gov. Treat any claim of amycretin Phase 3 data as non-existent. The figure here comes from a small early trial and will very likely shrink at scale. Sources for this row Amycretin — Novo Nordisk 20 Aug 2026
Bimagrumab + semaglutide Eli Lilly claimed	never	Anti-activin receptor antibody, muscle-sparing, combined with a GLP-1 21.08.26	never	-22.1 % 21.08.26	never	never	BELIEVE 21.08.26	507 21.08.26	72 weeks 21.08.26	never	never
Why these cells are empty Placebo arm The placebo arm has not been published for this readout. Placebo-adjusted No placebo-adjusted figure can be calculated: the placebo arm has not been published. One Phase 2 in obesity with diabetes was withdrawn before enrolling anyone, for stated strategic reasons. The interesting endpoint here is not the weight number but its composition: 92.8% of the loss was fat, with lean mass preserved. Bimagrumab alone added 2.5 kg of lean mass. Comparator arms in the same trial: semaglutide alone −15.7%. Sources for this row Bimagrumab + semaglutide — Eli Lilly 20 Aug 2026
Aleniglipron Structure Therapeutics partial	never	Oral small-molecule GLP-1 agonist~ 21.08.26	never	-16.3 %~ 21.08.26	never	never	ACCESS II~ 21.08.26	85~ 21.08.26	44 weeks~ 21.08.26	never	never
Why these cells are empty Placebo arm The placebo arm has not been published for this readout. Placebo-adjusted No placebo-adjusted figure can be calculated: the placebo arm has not been published. Phase 3 from H2 2026. Figure quoted is already placebo-adjusted. Small trial; 3.7% discontinued for adverse events among those escalated. Sources for this row Aleniglipron — Structure Therapeutics 20 Aug 2026
MariTide Amgen strong	never	GIP receptor antagonist conjugated to a GLP-1 agonist 21.08.26	never	-16.2 % 21.08.26	-2.5 % 21.08.26	-13.7 pp 21.08.26	never	592 21.08.26	52 weeks 21.08.26	never	never
Why these cells are empty Pivotal trial The sponsor has not named the trial. Phase 3 running; primary completions Jan 2027. Cardiovascular outcomes trial to Jun 2028. Dosed monthly rather than weekly, which is the point of the molecule. No Phase 3 efficacy readout exists — any claim of one circulating now is unsupported. Sources for this row MariTide — Amgen 20 Aug 2026
Survodutide Boehringer Ingelheim / Zealand strong	never	Dual glucagon + GLP-1 agonist 21.08.26	never	-13.0 % 21.08.26	-5.4 % 21.08.26	-7.6 pp 21.08.26	SYNCHRONIZE-1 21.08.26	725 21.08.26	76 weeks 21.08.26	never	never
No regulatory filing announced. A textbook estimand problem. The widely-quoted “16.6%” is the trial-product estimand — people who kept taking it. The NEJM primary analysis, counting everyone randomised, is −13.0% against a −5.4% placebo arm. Both numbers are honest; only one describes real-world use. Sources for this row Survodutide — Boehringer Ingelheim / Zealand 20 Aug 2026
VK2735 (oral) Viking Therapeutics partial	never	Dual GLP-1 / GIP agonist~ 21.08.26	never	-12.2 %~ 21.08.26	-1.3 %~ 21.08.26	-10.9 pp~ 21.08.26	VENTURE-Oral~ 21.08.26	280~ 21.08.26	13 weeks~ 21.08.26	never	never
Phase 3 is running on the injectable formulation, not this one. Only 13 weeks. Short trials flatter weight-loss drugs, because the curve has not yet flattened. Sources for this row VK2735 (oral) — Viking Therapeutics 20 Aug 2026
Petrelintide Zealand Pharma / Roche partial	never	Long-acting amylin analogue~ 21.08.26	never	-10.7 %~ 21.08.26	-1.7 %~ 21.08.26	-9.0 pp~ 21.08.26	ZUPREME-1~ 21.08.26	493~ 21.08.26	42 weeks~ 21.08.26	never	never
Phase 3 to start H2 2026. The headline here is tolerability, not size: discontinuation for adverse events was 4.8% against 4.9% on placebo, with no vomiting at the maximally effective dose. If that holds, it changes who can stay on treatment. Sources for this row Petrelintide — Zealand Pharma / Roche 20 Aug 2026

●confirmed by a primary source ◑company-stated — the value carries a tilde~ ○claimed — the only source behind it is not a primary one never published not disclosed sources in conflict

Regulator by regulator

Five states, five shapes before five colours. Refused is a decision; not approved is silence.

Programme	FDA	EMA	MHRA	ANVISA	PMDA	NMPA	Canada	TGA	Approved in
Semaglutide 2.4 mg The only weight-loss medicine with proven cardiovascular outcome benefit · First generic anywhere arrived in Canada through an administrative accident									8/8
Semaglutide 7.2 mg Almost every press account quotes −20.7% without the comparison arm; the registry has had it all along									3/8
Semaglutide 25 mg, oral Removes the “there is no pill” argument that drove much grey-market buying									3/8 1 under review
Tirzepatide Largest weight effect of any approved medicine · Its cardiovascular evidence is weaker than semaglutide's, which is the reverse of the popular impression									8/8
Orforglipron First small-molecule oral GLP-1 — no peptide manufacturing constraint, which is what makes global scale plausible · Approved in exactly one country									1/8
Liraglutide 3.0 mg The first GLP-1 to face real generic competition — a preview of where the class goes									5/8 1 withdrawn
Phentermine / topiramate ER The clearest case of two competent regulators reading the same dossier and reaching opposite conclusions									1/8 1 refused
Naltrexone / bupropion ER One in four people stopped it because of side effects · Its outcomes trial was destroyed by the sponsor's own conduct									5/8
Orlistat The only approved obesity drug available without a prescription · Smallest effect of any approved agent, and the longest safety record									8/8
Phentermine Approved 67 years ago and still the cheapest option · The only one not licensed for long-term use, yet often used that way									3/8
Setmelanotide Not a general obesity drug — it treats specific genetic and acquired defects in the melanocortin pathway · Shows what obesity medicine looks like when the mechanism is known precisely									3/8
Metreleptin Routinely miscategorised as an obesity drug — it is a replacement therapy for a hormone people are missing									4/8
Mazdutide “Approved in China” is not “approved” — this is a common grey-market talking point									1/8
Ecnoglutide Approved on data that has never been peer-reviewed and whose sample size is undisclosed									1/8
Retatrutide Triple GLP-1 / GIP / glucagon agonist									0/8
CagriSema Amylin analogue + GLP-1 agonist									0/8
Amycretin Single molecule acting on GLP-1 and amylin receptors									0/8
Bimagrumab + semaglutide Anti-activin receptor antibody, muscle-sparing, combined with a GLP-1									0/8
Aleniglipron Oral small-molecule GLP-1 agonist									0/8
MariTide GIP receptor antagonist conjugated to a GLP-1 agonist									0/8
Survodutide Dual glucagon + GLP-1 agonist									0/8
VK2735 (oral) Dual GLP-1 / GIP agonist									0/8
Petrelintide Long-acting amylin analogue									0/8
BPC-157 Healing, gut health, tendon repair									0/8
TB-500 Recovery, tissue repair									0/8
Ipamorelin Growth hormone release, body composition									0/8
CJC-1295 Growth hormone release									0/8
MOTS-c Metabolic health, longevity									0/8
Epitalon Longevity, telomeres									0/8
GHK-Cu (injected) Skin, healing, anti-ageing									0/8
AOD-9604 Fat loss									0/8
Semax / Selank Cognition, anxiety									0/8
Tesamorelin Abdominal fat reduction									0/8

Semaglutide 2.4 mg The only weight-loss medicine with proven cardiovascular outcome benefit · First generic anywhere arrived in Canada through an administrative accident 8/8