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Weight loss medications are evolving at lightning speed. But once you start digging online, it’s easy to feel unsure about what’s real, what’s safe, and what your options actually are if a medication stops working.

In this post, I walk you through what’s genuinely on the horizon between 2026–2028, using the clinical data we have right now. We’ll look at how these medications work, what the research is showing so far, and why this pipeline offers real hope for anyone managing obesity as a chronic disease.

Why This Matters: Obesity Is Chronic

Before we get into what’s coming next, it’s important to remind ourselves that obesity is a chronic disease.

Our bodies are incredibly good at adapting. Over time, they often find ways to push back against treatments, even ones that initially work well. That isn’t a personal failure. It’s simply how a lifelong condition behaves.

And this is exactly why having multiple treatment options matters. When one approach becomes less effective, you need room to pivot. The medications coming over the next few years give us more flexibility, and more hope, than we’ve ever had before.

It’s also why mindset matters so much. Long-term management means holding onto this belief: I will always have options. I can always adjust.

What Makes These New Medications Different

Most obesity cases aren't monogenic, meaning they're not caused by a single gene. They're polygenic, with many genetic and environmental factors contributing. 

When we're able to hit multiple pathways with these newer medications, we're able to help in different ways because not everybody's weight responds the same. Some people struggle with overwhelming hunger, others deal with constant urges and cravings, and some lose muscle more easily than others.

The goal with these combination therapies is to address more of these different pathways at once, which is why we're seeing such impressive results.

Early 2026: Oral Wegovy

Right now, we have oral semaglutide available as Rybelsus, but the dose doesn't go very high and people don't get great results with it. Insurance typically doesn't cover it either.

That's all changing. Early 2026 brings us a much higher-dose oral version of Wegovy (semaglutide) with an average weight loss of 16.6%. That's actually higher than the current subcutaneous Wegovy, which averages 14-15%.

What makes this exciting:

• More affordable pricing (around $100+ monthly with savings card)
• No refrigeration needed for shipping
• Great option for people without insurance coverage for injectables
• Potential for maintaining weight loss achieved through other methods

The downside? You have to take it in the morning, 30 minutes before eating, with a glass of water. That timing can be harder for some people to manage consistently.

2026: Higher-Dose Wegovy Subcutaneous

The injectable version of Wegovy is also getting an upgrade. Currently, it maxes out at 2.4mg weekly in the US. The new version will go up to 7.2mg, with an average weight loss of 21%.

This is huge because I've noticed about 5-10% of patients only respond to these medications at higher doses. They'll get to 1.7mg or 2.4mg and finally start seeing results, but maybe they only lose 5-7%. They need more help, but there's been nowhere to go.

Whenever we break into that 20% weight loss range, it's really amazing. We just haven't been able to do that consistently in the past.

Q2 2026: Orforglipron

This is an oral GLP-1 medication that's a non-peptide, with an average weight loss of 12.4%. The percentage is a bit lower than some other options, it has one major advantage: it doesn't need to be refrigerated.

If this comes out at an affordable price point, it could be a really great option for maintaining weight loss you've already achieved, or for getting started on something when other options aren't accessible.

Late 2026/Early 2027: CagriSema

This combines semaglutide along with an amylin analog, with an average weight loss of 22.7%.

By adding amylin to the mix, we're hitting additional pathways beyond just GLP-1. This is the advantage of combination therapies—we're addressing the disease from multiple angles at once.

Late 2026/Early 2027: Retatrutide

This is the one everyone's talking about, and I really cannot wait until this comes out. Retatrutide is a triple agonist with an average weight loss of 28.7%.

It includes:

• GLP-1 (what we're used to with medications like Wegovy)
• GIP (like what's in Mounjaro/Zepbound)
• Glucagon (which helps release stored energy, particularly fat)

Important warning: Even though everyone's buzzing about Retatrutide, it is NOT FDA-approved yet. People are selling "research grade" versions online, which is incredibly scary. You have no idea what you're actually putting in your body, and many of these medications are centrally acting—they get into your central nervous system. Please don't take unregulated versions of this drug.

Just because you're hearing about something constantly doesn't mean it's actually commercially available.

Later 2027: Survodutide

This combines GLP-1 with glucagon (but not GIP), with an average weight loss of 19%. It's interesting to see them testing different combinations of these pathways to see what works best for different people.

2028: MariTide

From Amgen, this is a really interesting approach. It's a GIP antagonist (blocking rather than activating) combined with a GLP-1 agonist, delivered as an antibody drug conjugate. Average weight loss is around 20%.

This is a completely different mechanism than any other medication before it, which shows just how much innovation is happening in this space.

What This Timeline Means for You

To think that we're going to have one, two, three new options coming out per year is incredible.

This pipeline gives real hope if you're someone who:

• Has struggled with current treatments
• Found that a medication worked initially but became less effective over time
• Is losing insurance coverage for your current medication
• Has needle phobia and needs oral options
• Needs a more affordable approach

We're genuinely at the beginning of an explosion in treatment options. 

Although these aren't cures—they're treatments for managing a chronic disease—having this many tools in our toolkit means we can keep pivoting and finding what works for you as your body and circumstances change.

Want to hear more about the upcoming obesity medication pipeline? Listen to the full episode of The Obesity Guide podcast for a deeper dive into each of these treatments and what they mean for managing obesity as a chronic disease.

TRANSCRIPT:

Disclaimer: The transcript below is provided for your convenience and may contain typos, errors, or grammatical inconsistencies, as it has not been professionally edited or proofread. Please enjoy it as-is and read at your own discretion.

Please note: The content shared in this podcast and blog post is for informational and educational purposes only and is not intended as medical advice. Always consult your healthcare provider for personalized medical guidance.  

 Welcome back to another episode of the podcast. I am recording this. Very much so at the end of the year to the point where I've already been on break for a week. I actually ended the year, I was just so tired and exhausted and I had it on my list January the first episode. I had it on there and don't end the workday at the end of the year without doing this.

And the reality is I was just tired and exhausted. So here I am, I'm on break and I feel a lot more rejuvenated and I'm glad I did that. And you know, I talk a lot about this, but we have to start to honor a little bit how we feel. So was it a hundred percent mandatory that I do it ahead of time? No, I can still get it in on time, and the reality is I needed rest.

So I've spent the last few days here doing a lot of coloring. Those of you that aren't as familiar with me, I love these alcohol markers. It's the Oahu brand. I hope I'm saying that right. It's spelled O-H-U-H-U. I'll link to the different sets that I like below. There's one that's the thinner version that's really easy to travel with.

And then there are. Thicker version that it's a soft tip brush, and these blend really well. And so I've just really been building up my coloring skills. I get these coloring books that are, I always say, comfy, cutesy, cozy. I'll link to all the things. My husband's amazing. He gave me, as my Christmas present, a a big set of markers and these coloring books, and , he got all ones that I don't have. So I don't know if he looked at the ones I have or he just knows my style well, but it was such an amazing gift. So I'll link some of the ones that I'm really loving down below.

And I wanna tell you something that's nice about coloring if you haven't gotten into it. Number one, I have no artistic skill. I know some of you might hear me and you're like, no, but you really have to, if you like this. No. The reason, I actually looked at this, actually, let me pull this up.

I wasn't planning to talk about this, but I wanna bring this up. When I've really started to work on my relationship with food, one thing that I've needed to do is have distraction, have hobbies, have other ways to get dopamine. I wrote out here all the different things that I tried this past year, and I wanna read this to you.

These were all the things that I tried. And coloring is the one thing that consistently has stuck around. And again, for me it's alcohol markers. I do not enjoy the pencil type because it's a lot easier with the alcohol markers to blend and a cover, big amounts of space. And anyway, it's a psychological thing.

So coloring, like I just told you, I went through a phase of scratch art. And I enjoyed that, but at times it frustrated me and there's a really intricate version of scratch art. And then there's sort of just a little bit,, less intricate. And I found the thing I didn't like about Scratch art is the little black, trash that it leaves, like the little peelings when you're taking it off the page.

Those of you that don't know, there's a picture underneath and it's covered with think like a black paint and you have this little. Etch device in your hand and you scratch it away and then the color and the pattern emerges and it leaves this little fine black stuff behind. And I just couldn't stand that.

So scratch art was not my thing. Painting I like, but it's just not something that I do every single day. That's every so often I'll bust that out with my son. Puzzles. Love puzzles, but puzzles has to be, I have a full day that I can dedicate to it. It's not like a 30 minutes to one hour at night board games, again, love that, but it usually involves more people and coordination.

And again, don't always have that. I tried a book Nook, which is think a little miniature scene. But it's one that you then would put in your bookshelf, like it would fit where books go. So I'll put more pictures on that. That one I think I might come back to. But again, that is something that's really intricate delicate work.

You need glue, you need time, you need patience. And again, it just didn't fit my personality perfectly. And then every so often I do scrapbooking Now, I don't really like doing this all the time. It's fun to think about what different paper am I gonna pick and how am I gonna do this? And the place where I've done this, I have one baby book for my son and I did a good job his first year.

Can any parent relate to this? His first year I did a great job keeping track of things and then after that I kind of fell off. But what I did this break, I. Printed at Walmart, a bunch of photos. And so, I'm gonna get back to that, but the thing that really stuck around is coloring. But listen to this.

It was 1, 2, 3, 4, 5, 6, 7 different things that I tried, and that's probably not even everything. And so I really wanna put this out there. You need to create your dopamine menu. We did this in the December challenge, and I had a whole thing on it. In season two of the Behind the Scenes podcast, I have three episodes where I talk about dopamine.

And dopamine Menu is one of the things that we go through. You need other ways to get joy and relaxation and to do other things, and crafting might not be your thing. You might become someone that loves rock climbing and you join a gym, or you start going on hikes all the time. I don't know, and I don't care what it is that you get into, but you need something that's not food.

So some of you might be good at cooking and baking and if that can work for you, okay? Some of you will be able to parlay it into healthy things and you'll now do healthy meal prep and that will serve you. Okay, fine. But if it's always gonna be baked goods that don't have a bunch of protein in it and that.

Derail you. Every single time you have it around, you're constantly having to manage yourself around it. Maybe we can start to shift those hobbies. Remember, a hobby has no secondary gain. We're not trying to make money on it, we're not trying to be productive. It is just a time where you rest, relax, you tank up.

I didn't mean to spend so much time in the getting of this episode talking about this, but I really wanna encourage you, if you've not done that, find some hobbies, find some things that you can do. Go to a craft store. And just look around. You are gonna be shocked how many things are there, try some different stuff and just see what you like or what you don't like.

I think it really takes trialing a lot of things to figure it out. So today I wanna talk about, I saw here recently a potential timeline of upcoming obesity medicine medications. And I will link. To the reference that I'm looking at. He did a great job putting this together., It actually goes to LinkedIn.

I am not on LinkedIn at all. He posted this in a Facebook obesity medicine groups. That's how it came to my attention, said that it was okay if we shared this, and it's all information that's out there, but it was put into one nice graphic here. I wanna go through this and here's the point.

It's not just to tell you the weight loss percentages that are coming up and what the options are and how they work. It's to give you hope that if you are someone like me that really struggles with this disease and maybe one treatment wasn't enough, or maybe you did that one treatment and now you feel like it's becoming less effective, or you feel like weight's coming back on, I want you to know that there are so many more.

Combinations coming up and we are, but at the beginning of all of this, and so one thing I want you to do, go back to the end of December, the your Friday five. I talked about the five things that I learned this past year. One of them is that you can't farm out your mindset. Part of this disease is that you have to work on your mindset of I will always be able to find something, I will always be able to pivot.

You need to work on that because this is just so chronic. It's just there, there, there your whole life. I don't know that we will ever get to a place with this disease where we completely have a cure and not just treatments to manage it because our body is so exquisite at overcoming. The treatment that we give it, it finds another way to break the system.

And so a lot of these things work. They're treatments, but they're not cures. And so I hope that going through this really gives you some hope for the future here. Alright, so coming out in early 2026, and probably a lot of you have heard about this at this point, they're calling it oral wago Wegovy

so that's semaglutide. Now we have had oral semaglutide, which is rybelsus. It has been on the market. The problem is the dose didn't go very high. People didn't get great results on it. It was not as amazing as when you would do the subq, the wegovy, which is semaglutide, same as ozempic, you didn't get the same results.

Also, insurance didn't cover it, so it ended up being the situation where who cared because it wasn't covered. Unless you had needle phobia, you wouldn't do it. Now, the thing that is also less than ideal with this. Is that when you take oral semaglutide, you have to take it in the morning, 30 minutes before you eat with a glass of water.

And that timing of having to take a medication and then wait and having to do something. Exactly. That's harder for people. But here's the good news they have now. Done trials and they have approval for coming out here in early 2026, and it is a much higher dose. And with this oral wegovy, now, people can reach an average of 16.6% weight loss.

That is phenomenal. Remember. When you have the subq version, it's 14 15%. So to get to the 16.6 is just amazing. The other thing that is amazing that I'm seeing, again, those of you that are in the us, unfortunately we have to care about price and what they're showing is that it's gonna be a hundred something with the savings card monthly, and that is much more in the land of affordable.

So I can see this being a good option for people that. Number one, have not been on anything and want something that's more affordable and don't wanna go the compounded route. Number two. Someone that maybe has been on a subq medication is losing insurance coverage. And again, maybe they can swing this, but other options were not there.

So this is phenomenal. Also, we're seeing that people are able to keep weight off that they've lost with other methods. So these studies are really incredible that are showing this. Now, I would assume this, but it's always nice. We don't assume everything, right? It's nice to see these things in studies.

That is just really great. , The percentages that we saw are between 13 to 17%. Amazing. Alright. Then you have Wegovy subq that is gonna be in a higher dose. So remember right now Wago V again, which is Semaglutide, I'm saying all the names in case you're not as familiar. Same thing as Ozempic, but with Wago V, which has the FDA indication for weight management.

Right now in the US it's only gone up to 2.4 milligrams. It is going to go up to 7.2 milligrams now, and it will now on average have up to 21% weight loss. That is amazing. So we've added another five, six, 7% to that. Whenever we break into that 20% land, it's really amazing, right? Like we just haven't been able to do that in the past.

So. The fact that not only is the oral medication going up with semaglutide, but also subq just absolutely amazing to have this higher dose injectable. And I think we knew that this was coming because I've always noticed this. There's a certain percentage of patients, it's about five 10% of people where they only respond to these medications at higher doses, and other people don't believe them because.

With Wegovy, it starts at 0.25 and then it goes up to 0.5 milligrams one. 1.7. 2.4. So that's the, the dosage. You take it weekly and monthly. You could go up if you're either not losing weight or not having the results that we would want, like you're not having a bunch of side effects, things like that, and you're not losing weight.

We would go up right. So the point is, I have some patients that they'll be on 1.7 or 2.4, and that's when they start to respond. Okay? The problem is maybe they only lose five, 7% and then they're on this weekly medication. Maybe they're paying a ton for it. And then they say, well, why would I stay on this if it's so little weight loss?

Like, yes, that's great, but , they need potentially a lot more help. And so now if we're able to go higher on that dose, it's gonna be a real game changer. So up to 21%, and again, that's all 2026. And then Q2 of 2026. Think, April to June timeframe. This is one, and this one is always a tongue. This is always a tongue twister to me Orforglipron

So that's an oral GLP one medication, and that is a non peptide. So this is gonna be on average, a weight loss of 12.4%. And what's great about this option is that it doesn't need to be refrigerated. So remember with the subq GLP ones, we needed refrigeration. And so again, with, with these oral medications that don't need refrigeration, it is a game changer.

Now, the weight loss percentage is a little bit lower, 12.4%, but let's have a moment here if this was a affordable. And you either wanted to maintain weight loss that you'd had or again, to get on something, this might be a really great option, so that would be amazing. Then later, 2026, early 27 is gonna come out CagriSema and that is when you have the GLP one semaglutide.

It's gonna be along with amylin, an amylin analog. So we'll go ahead in other episodes and talk more about glucagon and amylin. We'll get into all the mechanisms of everything today. I just wanna tell you what the medications are, the weight loss percentages, and, when they're coming out just so you,, get an overall sense.

But with cre, sema, it's gonna be 22.7% on average weight loss. Again, really great because we've taken the semaglutide and we've added an additional. Way of helping as well, right? So when we're putting together these different, dual or triple, when we're putting all these things together, we're hitting many different pathways.

Remember, with obesity, majority of the cases are not monogenic, meaning one gene, it's polygenic. There are many things that are contributing to it. So there are about 70 plus percent is genetic. So you'll be hitting that with a lot of these different pathways. And then there are other things that come into it like trauma and , environment and other things.

But a lot of this is genetically based and so when we're able to hit a lot of different pathways, we're able to help in a lot of different ways because not everybody's weight responds the same. I think everybody always thinks just eat less and move more. That is not as effective for everyone.

Yes. People are in a calorie deficit, but some people are overly hungry. Some people have a lot of urges and cravings. Other people lose muscle like no other. So it's really interesting when I'm working with patients and we're doing lab testing, genetic testing, body composition testing, we really see these different patterns emerge and I can't wait until we can have more targeted approaches based on who's in front of us.

Okay, so that's that one. Then this one, I feel like, gosh, it's already, everyone's talking about it all the time. Retatrutide. So Retatrutide again from Eli Lilly as well. That's you have the GLP one that you're used to. GLP one, GIP. So remember, tirzepatide is a GLP one and GIP. But the difference here is that you have glucagon, and remember, glucagon is the one that it says.

Let go of energy. So insulin is the one that says store stuff. Glucagon is the opposite and says release energy. And so it's really helpful with that fat aspect. This is also an injectable. It's a weekly, this has a 28.7% weight loss. So IDE unfortunately is one of those things that even now people are selling.

Research grade equivalence of it, which is by the way, so scary. Do not take this stuff. It is not FDA approved. It is not on the market right now. When people are taking this stuff,, it just really scares me. You have no idea what you're putting in your body, and a lot of these medications are centrally acting.

They're getting into your central nervous system that is very scary when you don't know what you're taking and you're doing that. But I really cannot wait until Reddit Tru Tide comes out. I think that's the one that everyone is. Sitting at the edge of their seat. Not that the other ones are not great, but that is truly an amazing one.

All right. Then we have , another option. You know how we just talked about with Reddit, Tru Tide, having that glucagon aspect, making it a triple agonist or the A Triple G that we would call it. We have in later 20 27 1 potentially coming out. Serva Ide again, I hope like some of these names I can't even pronounce correctly.

And that's 19% weight loss. And so that is gonna have not only GLP one, but glucagon. So interesting, right? 'cause now we know some of these different players and now they're trying to use 'em in different combinations.

The last one that I have on here is 20 28. I hope I'm saying this right. Meritide about a 20% weight loss. And this is really interesting from Amgen. It's a GIP antagonist., So it's an antibody, and then you have a GLP one agonist, which is what you're used to.

So it's an antibody drug conjugate. They're putting these things together. This is interesting, because that's a completely different way of doing things compared to any other medication before it. So this is really interesting. This is really amazing. All the different things that are coming out.

To think that we're gonna have 1, 2, 3 things coming out per year. Fascinating. Right? So I will put again the link to this article so you can look at the names, the percentages, you can see all of it. Again, it was really well written.

And I would love to know if you have questions or you have thoughts about what's coming out or, different scenarios this year we're gonna get a lot more into the science of everything. 'cause I think this stuff is just not understood in a capacity that's easy to understand. I hope that this episode was helpful today just to hear about everything that's coming. I know at least every day when I log on, there's a new study, a new drug name, a new thing to look at, and so just to hear it. The timeline. I think that that's helpful.

I know for me, I guess I just really thought that Retatrutide was coming out a lot sooner, and I think that it's just because there's so many fakes on the market right now that you're hearing about it so often, but it's. Remember, it's not FDA approved, and so just because you're hearing about something doesn't mean that it's actually commercially available.

Right now the big things that are coming out early this year, it's gonna be all the semaglutide land. And then after that we'll move into these other options. Alright, if you have questions, you can always send it. In the fan mail section, we have it underneath. There's a link where you can click on it.

Friendly reminder. It does not subscribe you to an email list. It is just a way for you to, if you want, anonymously to send me in a question. If you want me to answer something on the podcast coming up, I do every so often do this sort of a doctor in the house. I answer the questions that you have. And so if you want that, I need to get the question.

If you ever want a response to something, sometimes someone will say, do you have an episode about, you'll ask about X, Y, Z. Make sure that you give us an email, 'cause then we can get back to you. Other thing is that we have a podcast roadmap, so we'll make sure to link that down below. And we have all the different categories and we hyperlink to episodes in those categories.

So if you just want, one's about medication or you're really struggling with, you're not hungry but you're eating at different times. So emotional eating or there's all these different categories at this point that we've talked about, that podcast roadmap, it is a free source. And it can help you to direct you to the different things.

Alright, I hope you all have an amazing start to the year and I hope that I hear a lot from you all. If you don't follow me on social, make sure to follow me specifically on Instagram.

I do a lot with my stories, but videos are everywhere and I'm gonna try to do more lives this year. If you don't follow me on YouTube, I know I just said a lot of things, but, all right. Last thing, if you don't follow me on YouTube, we'll make sure to put the link in the show notes. Make sure to follow me over there.

I think I'm gonna do more with trying to go live maybe with some meal preps on Sunday, things like that. I'll make sure to let my email list know. So if any of you wanna join me for those things, you can, but I'm looking to do a little bit. More over on YouTube this year, and so if that's something that you're interested in, make sure to follow me over there.

All right, I hope you have a great rest of the day and we'll talk soon.