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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.

ClavTides Research Team March 4, 2026 18 min read
Reviewed by Dr. Sarah K., PharmD · Clinical Pharmacology45+ hours of research into published clinical literature8 peer-reviewed sources citedLast verified March 2026

All content is for educational and research purposes only. Peptides discussed are research compounds not approved by the FDA for human use. Nothing on this page constitutes medical advice.

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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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