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What did the Phase III trial of Eli Lilly's retatrutide find for weight loss and diabetes?

In Phase III trials, the experimental drug retatrutide produced large weight loss in adults with obesity and substantial blood-sugar reductions in adults with type 2 diabetes.

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Covers: The design, results and safety findings of Eli Lilly's Phase III trials of retatrutide for weight loss and type 2 diabetes, including weight reduction, HbA1c changes and reported side effects. Does not cover Phase I/II data in detail, off-label use, or comparisons with other incretin drugs beyond brief context.

Also answers: Retatrutide Phase III trial results for weight loss and diabetes · How much weight loss did retatrutide show in Phase III trials? · Eli Lilly retatrutide Phase 3 diabetes and obesity findings · Retatrutide Phase III trial outcomes and side effects

The short answer

Evidence-backed AI-prepared starting map

In Phase III testing, Eli Lilly's retatrutide — a triple GLP-1/GIP/glucagon receptor agonist — produced large weight reductions in adults with obesity and substantial HbA1c reductions in adults with type 2 diabetes. In the TRIUMPH-1 obesity trial (2339 participants), mean body-weight change was -17.6% (4 mg), -23.7% (9 mg) and -25.0% (12 mg) versus -3.9%…12

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At a glance

The picture in numbers

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TRANSCEND-T2D-1, adults with type 2 diabetes

490 participants

Participants who completed the treatment period on study drug2

The evidence behind it

4 sources
  • Reviews of many studies1
  • Trials1
  • Other studies and data1
  • Background1

Published in 2026

Sources on this page by kind and year
SourceKindYear
Retatrutide, a Triple Hormone Receptor Agonist, for Treatment of Obesity.Other studies and data2026
Efficacy and safety of retatrutide, a GIP, GLP-1, and glucagon receptor agonist, in people with type 2 diabetes and inadequate glycaemic control with diet and exercise (TRANSCEND-T2D-1): a double-blind, randomised, phase 3 trial.Trials2026
Comparative efficacy and safety of glucagon-like peptide 1 based drugs for weight loss in adults with overweight or obesity without diabetes: network meta-analysis of randomised controlled trials.Reviews of many studies2026
Retatrutide (Wikipedia)BackgroundUnknown

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In brief

  1. In TRIUMPH-1, retatrutide produced mean weight reductions of 17.6% (4 mg), 23.7% (9 mg) and 25.0% (12 mg) versus 3.9% on placebo in 2339 adults with obesity.1

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  2. In TRANSCEND-T2D-1, retatrutide lowered HbA1c by 1.69–1.94% depending on dose versus 0.81% on placebo in adults with type 2 diabetes inadequately controlled by diet and exercise.2

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  3. The adverse-event profile is consistent with GLP-1 agonist activity, and low-certainty evidence suggests higher discontinuation rates with retatrutide than with some comparators.23

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  4. Indirect comparisons rank retatrutide above tirzepatide and CagriSema for weight loss, but confidence intervals overlap and head-to-head evidence is limited.3

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  5. Retatrutide is an experimental triple GLP-1/GIP/glucagon receptor agonist developed by Eli Lilly.4

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What it means for you

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If you have obesity without diabetes and are weighing retatrutide against other incretin drugs

the Phase III obesity trial reported mean weight reductions of 17.6–25.0% across doses, and an indirect network analysis ranked retatrutide highest for weight loss, though that ranking rests on low-certainty, mostly indirect evidence.13

Evidence-backed

If you have type 2 diabetes inadequately controlled by diet and exercise alone

the Phase III diabetes trial reported HbA1c reductions of 1.69–1.94% versus 0.81% on placebo, alongside bodyweight reduction, in a population with mean baseline HbA1c 7.9% and mean diabetes duration 2.5 years.2

Evidence-backed

If you are concerned about tolerability or stopping treatment

the diabetes trial describes an adverse-event profile consistent with GLP-1 agonist activity, and low-certainty evidence suggests higher discontinuation rates with retatrutide than with some comparators; the sources do not give specific side-effect rates.23

Evidence-backed

If you want to know how retatrutide compares directly with tirzepatide or semaglutide

the available comparison is an indirect network meta-analysis, not a head-to-head trial, and its authors caution that confidence intervals overlapped and head-to-head evidence is limited.3

Evidence-backed

The full explanation

Evidence-backed AI-prepared starting map

In Phase III testing, Eli Lilly's retatrutide — a triple GLP-1/GIP/glucagon receptor agonist — produced large weight reductions in adults with obesity and substantial HbA1c reductions in adults with type 2 diabetes. In the TRIUMPH-1 obesity trial (2339 participants), mean body-weight change was -17.6% (4 mg), -23.7% (9 mg) and -25.0% (12 mg) versus -3.9% on placebo. In TRANSCEND-T2D-1 (type 2 diabetes inadequately controlled by diet and exercise), mean HbA1c fell by -1.69% (4 mg), -1.86% (9 mg) and -1.94% (12 mg) versus -0.81% on placebo, with an adverse-event profile consistent with GLP-1 agonist activity.12

What this rests on4 independent sources
  • Evidence 15

The full story · 5 chapters

01

Weight loss in the Phase III obesity trial (TRIUMPH-1)

AI summary:In TRIUMPH-1, 2339 adults with obesity lost more weight on retatrutide than on placebo, with larger reductions at higher doses.

Evidence-backed

Evidence-backed: TRIUMPH-1 randomised 2339 participants and reported mean percent change in body weight of -17.6% with retatrutide 4 mg, -23.7% with 9 mg and -25.0% with 12 mg, compared with -3.9% on placebo. The reported treatment differences were -19.8 and -21.0 percentage points. Weight-related endpoints were analysed with a treatment-regimen (intention-to-treat) estimand. The trial also reported reduced pain in participants with knee osteoarthritis and reduced apnea-hypopnea events in participants with obstructive sleep apnea, for which a hybrid-treatment estimand was used.1

02

Glycaemic control in the Phase III diabetes trial (TRANSCEND-T2D-1)

AI summary:In TRANSCEND-T2D-1, adults with type 2 diabetes on retatrutide had significantly greater HbA1c reductions than those on placebo.

Evidence-backed

Evidence-backed: In this double-blind, randomised Phase III trial in adults with type 2 diabetes inadequately controlled by diet and exercise alone, mean change from baseline in HbA1c was -1.69% (4 mg), -1.86% (9 mg) and -1.94% (12 mg) with retatrutide versus -0.81% with placebo. Estimated treatment differences versus placebo were -0.88% (95% CI -1.18 to -0.59) for 4 mg, -1.04% (-1.32 to -0.76) for 9 mg and -1.12% (-1.39 to -0.85) for 12 mg, all statistically significant. The trial also reported bodyweight reduction. 490 (91%) participants completed the treatment period on study drug and 504 (94%) completed the study.2

03

Safety and tolerability

AI summary:Side effects were consistent with GLP-1 activity, and low-certainty evidence suggests higher discontinuation rates than some comparators.

Evidence-backed

Evidence-backed: TRANSCEND-T2D-1 describes an adverse-event profile consistent with molecules that have GLP-1 agonist activity. A network meta-analysis of GLP-1-based drugs in adults with overweight or obesity without diabetes found low-certainty evidence of higher rates of discontinuing treatment with retatrutide (and danuglipron), while mazdutide showed better tolerability. The sources do not give the specific rates or types of side effects for retatrutide in the Phase III trials.23

04

How retatrutide compares with other incretin drugs

AI summary:Indirect rankings put retatrutide above tirzepatide and CagriSema for weight loss, but confidence intervals overlap and head-to-head evidence is limited.

Evidence-backed

Evidence-backed: In a network meta-analysis of randomised trials in adults with overweight or obesity without diabetes, weight loss versus placebo was greatest with retatrutide (-22.10%, 95% CI -25.60% to -18.60%), followed by tirzepatide (-19.28%, -20.39% to -18.16%) and CagriSema (-17.32%, -19.32% to -15.32%), with conventional GLP-1 receptor agonists showing more modest effects. Similar patterns appeared for waist circumference and lipid outcomes. The authors caution that confidence intervals overlapped for several comparisons, head-to-head evidence is limited, and tolerability differs, so the probabilistic ranking should be read with care.3

05

What retatrutide is

AI summary:Retatrutide is an experimental Eli Lilly drug that acts on the GLP-1, GIP and glucagon receptors.

Evidence-backed

Evidence-backed: Retatrutide is an experimental drug for obesity developed by Eli Lilly and Company. It acts as a triple hormone receptor agonist at the GLP-1, GIP and glucagon receptors.4

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What to remember

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  1. In TRIUMPH-, retatrutide produced mean weight reductions of 17.6% (4 mg), 23.7% (9 mg) and 25.0% (12 mg) versus 3.9% on placebo in 2339 adults with obesity.

  2. In TRANSCEND-T2D-, retatrutide lowered HbA1c by 1.69–1.94% depending on dose versus 0.81% on placebo in adults with type 2 diabetes inadequately controlled by diet and exercise.

  3. The adverse-event profile is consistent with GLP- agonist activity, and low-certainty evidence suggests higher discontinuation rates with retatrutide than with some comparators.

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  1. 1
    Retatrutide, a Triple Hormone Receptor Agonist, for Treatment of Obesity.
    The New England journal of medicine (Jastreboff et al.)Published Sep 29, 2026Checked Oct 14, 2026
    “For weight-related end points, intercurrent events were handled by a treatment-regimen estimand (intention-to-treat [ITT]). For end points in participants with knee osteoarthritis or obstructive sleep apnea, a hybrid-treatment estimand was applied, with a hypothetical strategy for intercurrent events suggesting treatment failure; ITT results are also reported.ResultsA total of 2339 participants underwent randomization. The mean percent change in body weight in the retatrutide groups was -17.6% (4-mg dose), -23.7% (9-mg dose), and -25.0% (12-mg dose) versus -3.9% in the placebo group (differences, -19.8 and -21.0 percentage points, respectively; PConclusionsIn adults with obesity, retatrutide resulted in significant weight reduction, reduced pain in participants with knee osteoarthritis, and reduced apnea-hypopnea events in participants with obstructive sleep apnea. (Funded by Eli Lilly; TRIUMPH-1 ClinicalTrials.gov number, NCT05929066.).”
  2. 2
    Efficacy and safety of retatrutide, a GIP, GLP-1, and glucagon receptor agonist, in people with type 2 diabetes and inadequate glycaemic control with diet and exercise (TRANSCEND-T2D-1): a double-blind, randomised, phase 3 trial.
    Lancet (London, England) (Bajaj et al.)Published Jun 6, 2026Checked Oct 14, 2026
    “Baseline mean age was 48·8 years (SD 12·1), mean HbA1c concentration was 7·9% (SD 1·1), mean duration of diabetes was 2·5 years (SD 4·4), and mean BMI was 35·8 kg/m2 (SD 7·0). 490 (91%) participants completed the treatment period on study drug and 504 (94%) completed the study. For the treatment regimen estimand, the mean change from baseline in HbA1c concentration was -1·69% (SE 0·11) with retatrutide 4 mg, -1·86% (0·10) with 9 mg, and -1·94% (0·08) with 12 mg, versus -0·81% (0·12) with placebo, resulting in estimated treatment differences versus placebo of -0·88% (95% CI -1·18 to -0·59) with retatrutide 4 mg, -1·04% (-1·32 to -0·76) with 9 mg, and -1·12% (-1·39 to -0·85) with 12 mg (all pInterpretationRetatrutide showed significant improvements in glycaemic control and bodyweight reduction as a monotherapy in adults with type 2 diabetes that is inadequately controlled with diet and exercise alone, with an adverse event profile consistent with molecules with GLP-1 agonist activity, supporting its potential as an effective treatment for type 2 diabetes.FundingEli Lilly and Company.”
  3. 3
    Comparative efficacy and safety of glucagon-like peptide 1 based drugs for weight loss in adults with overweight or obesity without diabetes: network meta-analysis of randomised controlled trials.
    BMJ medicine (Chen et al.)Published Aug 27, 2026Checked Oct 14, 2026
    “Compared with placebo, weight loss was greatest with retatrutide (-22.10%, 95% confidence interval -25.60% to -18.60%), followed by tirzepatide (-19.28%, -20.39% to -18.16%), and CagriSema (a combination of cagrilintide and semaglutide, -17.32%, -19.32% to -15.32%). Conventional GLP-1 receptor agonists showed more modest effects. Similar patterns were seen for waist circumference and lipid outcomes. Treatment rankings suggested a probabilistic hierarchy favouring next generation incretin based treatments, although confidence intervals overlapped for several comparisons. Low certainty evidence suggested higher rates for discontinuing treatment with danuglipron and retatrutide, whereas mazdutide showed better tolerability.ConclusionsIn adults with overweight or obesity without diabetes, next generation incretin based treatments achieved greater weight loss than conventional GLP-1 receptor agonists. Differences in tolerability, limited head-to-head evidence, and residual uncertainty, however, should be considered when interpreting comparative treatment effects.Study registrationPROSPERO CRD420261279841.”
  4. 4
    Retatrutide (Wikipedia)
    WikipediaPublished Oct 7, 2026Checked Oct 14, 2026
    “Retatrutide is an experimental drug for obesity developed by the American pharmaceutical company Eli Lilly and Company. It is a triple hormone receptor agonist on the GLP-1, GIP, and glucagon receptors.”

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  • “Weight loss in the Phase III obesity trial (TRIUMPH-1)” rests on one independent source

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Open questions

  • What were the specific rates of gastrointestinal and other adverse events, and how many participants discontinued retatrutide because of them in the Phase III trials?

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  • How durable is the weight loss and glycaemic improvement after stopping retatrutide, and what happens to weight and HbA1c on withdrawal?

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  • How does retatrutide compare with tirzepatide and semaglutide in direct head-to-head trials rather than indirect network comparisons?

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  • Do the results hold in people with longer-standing diabetes, higher baseline HbA1c, or cardiovascular disease?

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