Obesity Drug Approval Tracker 2026: Status Hub, NDAs & Pipeline

Which Obesity Drugs Are FDA Approved?

Four GLP-1 receptor agonists are FDA approved for chronic weight management as of April 2026. Wegovy (injectable semaglutide 2.4 mg, approved June 2021) was the first weekly injectable GLP-1 specifically approved for obesity, demonstrating approximately 15% mean weight loss in the STEP 1 trial. Its approval marked the beginning of the modern GLP-1 obesity drug era.

Zepbound (tirzepatide, approved November 2023) raised the efficacy ceiling significantly. As a dual GLP-1/GIP agonist, it showed approximately 22.5% weight loss in the SURMOUNT-1 trial — the highest figure for any approved obesity drug at the time. Tirzepatide demonstrated that multi-receptor agonism could deliver meaningfully greater weight reduction than single-target GLP-1 drugs. For a deeper look at the differences between dual and single agonists, see our weight loss injections comparison guide.

The Wegovy pill (oral semaglutide 25 mg, approved December 2025) became the first oral GLP-1 drug approved for obesity, evolving from the Rybelsus oral semaglutide formulation used for diabetes. The OASIS 4 trial reported 16.6% weight loss with the adherence estimand. Its approval expanded the treatment paradigm beyond injections, though the pill requires fasting conditions and water restrictions at dosing.

Foundayo (orforglipron, approved April 1, 2026) is the newest FDA-approved obesity drug and the first oral GLP-1 that can be taken at any time of day without food or water restrictions. In the ATTAIN-1 Phase 3 trial, Foundayo delivered 12.4% weight loss at 72 weeks. Its approval was historic: the FDA cleared it just 50 days after filing under the National Priority Voucher Program, making it the fastest new molecular entity approval since 2002. As a non-peptide small molecule, Foundayo is meaningfully cheaper to manufacture than injectable biologics. For the direct status answer, use the orforglipron status page; for the pricing, label, and launch-impact analysis, use the Foundayo deep dive.

Which Drugs Have Filed for FDA Approval?

CagriSema is the only obesity drug with a pending NDA at the FDA as of April 2026. Novo Nordisk filed the application in December 2025 based on results from the REDEFINE 1 trial, which showed 22.7% average weight loss. CagriSema combines cagrilintide (an amylin analog) with semaglutide (a GLP-1 agonist) in a single weekly injection.

The FDA decision is expected in late 2026. If approved, CagriSema would be the first combination therapy and the first amylin-based drug approved for obesity. The REDEFINE clinical program includes additional trials evaluating CagriSema in populations with type 2 diabetes and cardiovascular disease. For a head-to-head comparison of CagriSema’s mechanism against tirzepatide, see our CagriSema vs tirzepatide analysis.

CagriSema’s filing is strategically important for Novo Nordisk as the company seeks to defend its position against Eli Lilly’s growing portfolio: Lilly now has both Zepbound (injectable) and Foundayo (oral) on the market, plus retatrutide in Phase 3. The amylin component in CagriSema represents a mechanistically distinct approach that targets satiety through a pathway not addressed by GLP-1 or GIP agonism alone. For a direct comparison between the amylin-based approaches, see our zenagamtide vs CagriSema analysis.

Which Drugs Are in Phase 3 Trials?

Five obesity drugs are in active Phase 3 development as of April 2026, spanning multiple mechanisms and delivery formats. Retatrutide (Eli Lilly) is the most closely watched: this triple agonist targeting GLP-1, GIP, and glucagon receptors showed approximately 24% weight loss in Phase 2 — the highest figure reported for any investigational obesity drug. The Phase 3 TRIUMPH program is ongoing, with readouts expected to define whether triple agonism meaningfully outperforms dual agonism. For details on how retatrutide compares to tirzepatide and CagriSema, see our three-way comparison.

Survodutide (Boehringer Ingelheim), a dual GLP-1/glucagon agonist, showed approximately 18.7% weight loss in Phase 2 and is being evaluated in both obesity and metabolic dysfunction-associated steatohepatitis (MASH). Its glucagon component differentiates it from GLP-1/GIP dual agonists by targeting hepatic lipid metabolism. For a head-to-head breakdown, see our survodutide vs retatrutide analysis.

Zenagamtide (amycretin) advanced to Phase 3 in Q1 2026 after showing approximately 22% weight loss in Phase 1b/2 data. Novo Nordisk’s AMAZE program evaluates this unimolecular GLP-1/amylin agonist in obesity, while the AMBITION program (H2 2026) targets type 2 diabetes. Unlike CagriSema, which co-injects two separate drugs, zenagamtide combines both receptor activities in a single molecule.

Viking Therapeutics’ VK2735 (subcutaneous) entered Phase 3 (VANQUISH) after demonstrating 14.7% weight loss in just 13 weeks of Phase 2 treatment — a rapid onset that drew significant attention. Mazdutide (Innovent/Lilly China), a dual GLP-1/glucagon agonist, was approved in China in November 2024 and continues Phase 3 development for global markets, with approximately 15% weight loss in Chinese Phase 3 data.

Which Drugs Are in Phase 2?

The Phase 2 pipeline highlights the amylin pathway and oral multi-agonists as two emerging frontiers. Petrelintide (Roche/Zealand Pharma) is the first amylin analog tested as a standalone obesity monotherapy, reporting 10.7% weight loss at 42 weeks in the ZUPREME-1 trial. This is notable because it demonstrates that amylin-receptor activation alone can produce clinically meaningful weight loss without combining it with a GLP-1 drug.

Oral VK2735 (Viking Therapeutics) is one of the most watched oral programs after subcutaneous VK2735’s strong Phase 2 results. The oral formulation showed 12.2% weight loss at 13 weeks in the VENTURE-Oral trial, positioning it as a potential competitor to both Foundayo and the Wegovy pill if the oral dual-agonist approach continues to deliver in longer trials. For a broader comparison of all oral candidates, see our oral obesity drugs 2026 analysis.

What Should Researchers Watch Next?

Four developments will shape the obesity drug landscape through the rest of 2026 and into 2027. First, the CagriSema FDA decision (expected late 2026) will determine whether amylin-based combinations enter the US market. Second, retatrutide Phase 3 readouts from the TRIUMPH program will confirm or temper the remarkable ~24% Phase 2 weight-loss figure in a larger population.

Third, watch zenagamtide’s AMAZE Phase 3 data — if its ~22% early signal holds, it could position the unimolecular GLP-1/amylin format as Novo Nordisk’s long-term successor to semaglutide. Fourth, the oral obesity drug race is entering a new phase now that Foundayo is approved alongside the Wegovy pill: Viking’s oral VK2735 will need to demonstrate that a dual-agonist oral can close the efficacy gap with injectables to compete. For the full pipeline timeline, see our obesity drug pipeline timeline.

The broader question for researchers tracking this space is whether oral multi-agonists can match or approach the efficacy of injectable multi-agonists — a gap that current data suggests still exists but is narrowing with each new trial readout. For background on the GLP-1 landscape in the UAE specifically, see our GLP-1 medications UAE guide. For concerns about discontinuation effects, see our analysis of GLP-1 discontinuation and weight regain data.