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Moderate Human Evidence

Retatrutide

An investigational triple GLP-1 / GIP / glucagon receptor agonist showing the largest weight-loss effects yet seen in mid-stage trials.

In plain English

Retatrutide is an investigational peptide from Eli Lilly that activates three receptors at once: GLP-1, GIP, and glucagon. In a Phase 2 trial published in 2023, adults with obesity lost an average of 24.2% of body weight on the highest dose over 48 weeks — the largest mean weight loss reported with any non-surgical drug at that timepoint. Retatrutide is not FDA-approved and is still in Phase 3 trials for obesity, type 2 diabetes, MASH (liver disease), and other indications. Cardiovascular outcome data are still being collected.

What it is

Retatrutide is a single synthetic peptide engineered to activate the GLP-1 receptor, the GIP receptor, and the glucagon receptor simultaneously — a 'triple agonist.'

Mechanism (summary)

Combined GLP-1 + GIP activity is similar to tirzepatide and drives appetite and glucose effects. The added glucagon receptor activity may increase basal energy expenditure and contribute to lipolysis in adipose and liver tissue.

Why people research it

  • Chronic weight management in obesity
  • Type 2 diabetes
  • Metabolic dysfunction-associated steatohepatitis (MASH)
  • Hypertension related to obesity

Human evidence

Phase 2 trial in adults with obesity (n=338) showed mean weight loss of 24.2% at 12 mg over 48 weeks vs. 2.1% on placebo. Phase 2 trial in T2D showed HbA1c reductions on par with or exceeding tirzepatide. Phase 3 trials are ongoing.

Animal / lab evidence

Rodent and primate work showed that adding glucagon receptor activity to GLP-1/GIP could produce additional weight loss and improvements in liver fat.

Key studies

Each summary explains the design, what was found, and what it doesn't prove.

Human RCT2023·338 adults with BMI ≥30 or ≥27 with comorbidity, without diabetes
Triple-Hormone-Receptor Agonist Retatrutide for Obesity — A Phase 2 Trial

In a mid-stage trial, adults with obesity lost roughly a quarter of their body weight on the highest dose of retatrutide over about a year.

Finding: Mean weight loss of 24.2% at 12 mg over 48 weeks vs. 2.1% on placebo.
Limitations: Phase 2 sample size, no long-term follow-up, no cardiovascular outcomes yet.
Human RCT2023·281 adults with type 2 diabetes
Retatrutide for Type 2 Diabetes — A Phase 2 Trial

In adults with type 2 diabetes, retatrutide produced large drops in HbA1c and substantial weight loss in a Phase 2 trial.

Finding: Retatrutide produced large HbA1c reductions (up to ~2.0%) and weight loss (up to ~17%) over 36 weeks.
Limitations: Mid-stage trial; cardiovascular safety data not mature.
Human RCT2024·Adults with obesity and MASLD
Effect of Retatrutide on Liver Fat in Patients with MASLD

In people with fatty liver and obesity, retatrutide dramatically reduced fat in the liver as measured by MRI.

Finding: Retatrutide produced large reductions in liver fat content (~80%+ relative reductions at higher doses) over 48 weeks.
Limitations: Imaging biomarker only; histologic endpoints pending Phase 3.

History

Developed by Eli Lilly. Phase 2 obesity results published in NEJM in 2023. Phase 3 TRIUMPH program initiated 2023–2024.

Important:

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