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Weight Loss PeptidesPhase 3 DataEli Lilly

Retatrutide: The Triple-Agonist Revolutionizing Weight Loss

Eli Lilly's LY3437943 delivered -28.7% body weight reduction in Phase 3 trials — the largest mean weight loss ever recorded in a randomized obesity trial. Here's the complete clinical breakdown.

Peptides Looksmaxxing Research Team March 4, 2026 18 min read

Retatrutide at a Glance

-28.7%

Phase 3 Weight Loss

TRIUMPH-4, 68 wks, 12mg

-24.2%

Phase 2 Weight Loss

NEJM 2023, 48 wks, 12mg

-82.4%

Liver Fat Reduction

Nature Medicine 2024

71.2 lbs

Avg Absolute Loss

TRIUMPH-4, 12mg

What Makes Retatrutide Different

Triple GIP/GLP-1/Glucagon receptor agonist — the only one in its class

GLP-1 Receptor

Appetite suppression via hypothalamic satiety centers. Same target as Ozempic/Wegovy.

GIP Receptor

Enhanced insulin sensitivity and fat metabolism. Shared with Tirzepatide.

Glucagon Receptor

Thermogenesis, hepatic fat oxidation, energy expenditure. Unique to Retatrutide.

The glucagon component contributes an estimated additional 2–3% body weight loss beyond dual agonism through thermogenesis and hepatic fat mobilization — compounding across 68+ week treatment periods.

Retatrutide vs Semaglutide vs Tirzepatide

FeatureSemaglutideTirzepatideRetatrutide ★
ReceptorsGLP-1 onlyGLP-1 + GIPGLP-1 + GIP + Glucagon
Max Weight Loss-14.9%-22.5%-28.7%
Key TrialSTEP 1 (NEJM)SURMOUNT-1TRIUMPH-4 Phase 3
Liver Fat ReductionLimited data~50%-82.4%
FDA StatusApproved (Wegovy)Approved (Zepbound)Phase 3
GI Discontinuation5.6%2.7%18.2%
PHASE 2 — NEJM 2023

Phase 2 Trial Results

338 participants · 48 weeks · DOI: 10.1056/NEJMoa2301972

Dose24 Weeks48 Weeks≥5% Loss≥15% Loss
Placebo-1.6%-2.1%27%2%
4 mg-12.9%-17.1%92%60%
8 mg-17.3%-22.8%100%75%
12 mg ★-17.5%-24.2%100%83%

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PHASE 3 — TRIUMPH-4

TRIUMPH-4 Phase 3 Results

445 participants · 68 weeks · December 2025

-28.7%

12mg Weight Loss

68 weeks

-26.4%

9mg Weight Loss

68 weeks

71.2 lbs

Average Absolute Loss

12mg dose

-14.0 mmHg

Systolic BP Reduction

12mg dose

The TRIUMPH-4 results represent the largest mean weight loss ever recorded in a randomized, placebo-controlled obesity trial for any pharmacotherapy. The 5,800+ participant TRIUMPH program has seven additional Phase 3 readouts expected throughout 2026.

Liver Fat Reduction: -82.4%

Phase 2a sub-study · Nature Medicine 2024 · 24 weeks

DoseLiver Fat Change (24 wks)
Placebo+0.3%
1 mg-42.9%
4 mg-57.0%
8 mg-81.4%
12 mg ★-82.4% (p < 0.001)

Among the largest liver fat reductions ever documented with any pharmacotherapy. For reference, dedicated MASLD drugs like resmetirom typically achieve 30–50% reductions. The glucagon receptor component directly drives hepatic lipid mobilization — even the 1mg dose achieved -42.9%, partially independent of systemic weight loss.

Safety & Side Effects

Higher Discontinuation Rate

Retatrutide showed an 18.2% adverse-event discontinuation rate at 12mg (TRIUMPH-4), vs 5.6% for semaglutide and 2.7% for tirzepatide. More receptors = more metabolic disruption. The 9mg dose (12.2% discontinuation, -26.4% weight loss) may be a better balance point.

Side EffectIncidence (8–12mg)
Nausea38–43%
Diarrhea33–35%
Constipation22–25%
Vomiting20–21%
Decreased Appetite18–19%

Frequently Asked Questions

What is retatrutide and how does it work?

Retatrutide (LY3437943) is a first-in-class triple GIP/GLP-1/Glucagon receptor agonist by Eli Lilly. It simultaneously activates GIP (insulin sensitivity), GLP-1 (appetite suppression), and glucagon (thermogenesis, hepatic fat oxidation) receptors — the first compound to do all three.

How much weight loss does retatrutide produce?

Phase 2 (NEJM 2023, n=338): -24.2% at 12mg over 48 weeks. Phase 3 TRIUMPH-4 (Dec 2025, n=445): -28.7% at 12mg over 68 weeks, averaging 71.2 lbs per participant — the highest ever recorded in a randomized obesity trial.

How does retatrutide compare to semaglutide and tirzepatide?

Retatrutide: -28.7%. Tirzepatide: -22.5%. Semaglutide: -14.9%. The glucagon receptor component adds thermogenesis and hepatic fat oxidation that neither competitor has. The tradeoff is higher GI side effects (18.2% discontinuation vs 2.7% tirzepatide).

Is retatrutide FDA-approved?

No. As of March 2026, retatrutide is in Phase 3 trials. The TRIUMPH program has 5,800+ participants across multiple trials. Earliest possible approval: 2027-2028. Available as research-grade peptide only.

What are the most common side effects?

Nausea (38-43%), diarrhea (33-35%), constipation (22-25%), vomiting (20-21%). Most are transient, peaking during dose escalation. Slower titration (starting at 2mg) substantially reduces incidence. The 9mg dose offers a better tolerability profile at -26.4% weight loss.

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