Happy Sunday all, and welcome to this week's waffle, in which we take a look down the pipeline at some of the exciting developments in the field of weightloss medications.

The story so far....
We've said it before and we'll say it again, sound nutrition and exercise will always be cornerstones of maintaining a healthy weight. But for those still struggling, the arrival of Mounjaro (tirzepatide) and Wegovy (semaglutide) two of the groundbreaking GLP-1 - based medications has been a real game changer. But let's not pretend that it's been all smooth sailing. First there were chronic supply shortages (Wegovy) and then more recently an unwelcome surprise price hike (for Mounjaro). No surprise, then, that both patients and doctors are looking forward to the menu of prescribing options broadening.

Happily we can report that there are several options in the pipeline, with a good chance of hitting the UK market in the next few years. But first let's recap on what is already available:

Semaglutide (Wegovy): The first GLP-1 medicine approved for weight management in the UK- a weekly injection launched in September 2023
Tirzepatide (Mounjaro): launched only 5 months after Wegovy and it somewhat stole the spotlight, targeting not just the GLP 1 receptors but also GIP receptors often producing even greater results for weight management- also a weekly injection.

The next wave- 3 front runners...

1. Retatrutide — The “Triple Agonist”
Developed by Eli Lilly, (maker of Mounjaro) Retatrutide works on three hormone pathways: GLP-1, GIP and glucagon receptors. In early trials, patients achieved an average 24% weight loss after 48 weeks — among the highest results ever recorded. Currently in phase III trials, Retatrutide could be available in the UK around 2026–2027, pending MHRA and NICE approval.

2. Orforglipron — The First Daily GLP-1 Pill
Also from Eli Lilly, Orforglipron is a once-daily oral GLP-1 medication, meaning no injections required.
While weight loss results are slightly lower (around 11–12% after 72 weeks), its convenience and good tolerability make it an attractive option for those who prefer tablets. If trials continue to go well, Orforglipron could reach the UK market in 2026.

3. CagriSema — Combining Two Powerful Hormones From Novo Nordisk
CagriSema combines a GLP-1 agonist with an amylin analogue, another hormone that helps control appetite and digestion. Currently in phase III trials, CagriSema will be an injectable treatment and is expected to deliver enhanced weight-loss effects compared with Wegovy alone. Because it’s developed by Novo Nordisk (the makers of Wegovy) , it’s also less likely to be affected by any US export tariffs.

Beyond this, there are at least 15 major products in development across a dozen pharmaceutical companies, and likely many more in earlier research stages.

For the time being, Wegovy and Mounjaro remain the mainstays of medical weight-loss treatment in the UK, but, as research continues and the formulations are refined, the future looks extremely promising for anyone struggling with obesity or weight-related conditions. Rest assured, we will continue to monitor these developments closely and update our patients as new options receive approval.

Winchester GP xx