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How it works

Mimics GLP-1, slowing stomach emptying, reducing hunger signals in the brain, and improving blood sugar control.

Most reported

• Less appetite and cravings
• Gradual sustained weight loss
• Better blood sugar control

Evidence level

Strong clinical backing — large human trials published in top journals. STEP-1 trial: 14.9% average weight loss over 68 weeks.

Common side effects

Nausea and digestive issues, especially when increasing dose. Start low and go up slowly.

Combines / avoids

Do not combine with another GLP-1 (Tirzepatide or Retatrutide).

Typical use

1 weekly subcutaneous injection, starting at 0.25 mg, increasing every 4 weeks.

How it works

Where semaglutide activates one pathway, tirzepatide activates two (GLP-1 + GIP), producing more results than a GLP-1 alone.

Most reported

• Notable weight loss
• Less hunger between meals
• Better blood sugar control

Evidence level

Strong clinical backing. SURMOUNT-1 trial: up to 22.5% weight loss at 72 weeks with 15 mg dose. Beat semaglutide head-to-head in SURMOUNT-5.

Common side effects

Nausea and digestive issues when increasing dose (mild to moderate).

Combines / avoids

Do not combine with another GLP-1 (Semaglutide or Retatrutide).

Typical use

1 weekly subcutaneous injection, starting at 2.5 mg, increasing every 4 weeks.

How it works

Activates three metabolic pathways at once; the glucagon component adds an effect on energy expenditure.

Most reported

• High weight loss in trials
• Strong appetite reduction

Evidence level

In human clinical trials (Phase 3); not yet approved.

Common side effects

Nausea and digestive issues; may slightly raise heart rate.

Combines / avoids

Do not combine with another GLP-1.

Typical use

1 weekly injection, starting at 2 mg and titrating every 4 weeks.

How it works

It is the "tail" of growth hormone — the part linked to mobilizing fat — without the part that affects blood sugar or growth.

Most reported

• Supports fat loss
• Without the typical GH side effects

Evidence level

Little human data; small studies.

Common side effects

Generally well tolerated; injection-site reaction.

Combines / avoids

Sometimes used alongside GH-boosting peptides.

Typical use

Daily dose of ~300 mcg.

How it works

Mimics amylin, a hormone the pancreas releases with insulin that promotes fullness and slows gastric emptying. This is a different pathway from GLP-1.

Most reported

• Greater satiety reported in trials
• Weight loss in clinical studies (mostly combined with semaglutide)
• Nausea and digestive discomfort as the most frequent effects

Evidence level

Human clinical trials (Phase 2 as monotherapy; Phase 3 within the REDEFINE program alongside semaglutide). Not approved.

Common side effects

Mainly gastrointestinal: nausea, vomiting, constipation. The full long-term profile is still being studied.

Combines / avoids

In research it is studied combined with semaglutide (CagriSema). Outside trials there is no established combination.

Typical use

We do not publish dosing: this is an investigational compound and doses are only defined inside clinical trials.

How it works

Activates both the GLP-1 receptor (less appetite) and the glucagon receptor (more energy expenditure and liver effects). A different pathway mix than semaglutide or tirzepatide.

Most reported

• Weight loss in Phase 2 and Phase 3 trials
• Liver improvement signals in MASH studies
• Nausea and vomiting during titration

Evidence level

Human clinical trials, including the Phase 3 SYNCHRONIZE-1 obesity results published in NEJM on June 7, 2026. It remains investigational.

Common side effects

Mostly gastrointestinal (nausea, vomiting, diarrhea), more pronounced during dose escalation in trials.

Combines / avoids

No studied combinations outside trials. Stacking it with another GLP-1 makes no sense.

Typical use

We do not publish dosing: survodutide doses only exist inside clinical trial protocols.