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Weight, glucose, and body composition.
The one category where the science actually delivered.
14 compounds tracked in this category
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In theory, this class is designed to make your body behave as though it has just eaten, signalling fullness to the brain, slowing gastric emptying, and prompting insulin release in response to glucose rather than continuously. Newer agents add glucagon activity to raise energy expenditure on top of appetite suppression. This is the one category where the theory has been tested at full scale and held up.
Unmarked, FDA approved° legal over the counter† under FDA review, not yet permitted* not FDA approved‡ documented safety concern
| Compound | What is known |
|---|---|
| Semaglutide | Approved for diabetes and obesity. Large cardiovascular outcome trials. Failed in early Alzheimer's (EVOKE, 2026). |
| Tirzepatide | Approved. Removed from the shortage list in April 2026, which largely closed the compounding route. |
| Dulaglutide | Approved for type 2 diabetes. |
| Retatrutide* | Phase 3. Roughly 28% mean weight loss at 80 weeks in TRIUMPH-1. Gray-market versions are not the trial drug, 37 samples failed independent testing. |
| Cagrilintide / CagriSema* | Investigational. Phase 3 data reported. No approval. |
| Mazdutide* | Approved in China. Not approved in the United States. |
| Survodutide* | Phase 3 investigational. No approval, and no results outside the trial programme. |
| MOTS-c† | Advisory panel voted favorably July 2026 for obesity and osteoporosis. Not yet listed. Human data is thin. |
| AOD-9604* | Removed from Category 2 in April 2026 but never moved to Category 1. No human efficacy evidence. |
| HGH Fragment 176-191* | Unapproved. No controlled human trials. |
| Adipotide (FTPP)‡ | Development stopped after kidney toxicity and dehydration in primate studies. This is a known harm signal, not an open question. |
| 5-Amino-1MQ* | Preclinical research compound. |
| Lipo-C / MIC blends* | Compounded lipotropic mixtures. Evidence for injectable fat loss is weak. |
| Lemon Bottle‡ | Subject of specific FDA and state warnings as an unapproved injectable lipolytic. |
The science behind this category
Your gut releases hormones when you eat. GLP-1 and GIP are the two that matter most. They signal satiety to the brain, slow gastric emptying, and prompt insulin release in response to glucose rather than continuously. Glucagon does something different, raising energy expenditure. The whole modern metabolic drug class is built on making synthetic versions of these signals last far longer than the natural ones, which clear in minutes.
This category is the exception on this site: the evidence is genuinely strong. Semaglutide and tirzepatide went through full FDA approval with large cardiovascular outcome trials, not just weight endpoints. That happened because pharmaceutical companies spent a decade and billions of dollars running the trials. The peptides in other categories have not had that, and mechanism alone has never been sufficient.
There is a sharp divide. On one side sit the approved incretins with real trial data. On the other sit compounds like AOD-9604, HGH fragment 176-191, and 5-Amino-1MQ, which have essentially no human efficacy evidence and are grouped with the first tier only because they are marketed for the same goal. Sharing a goal is not sharing an evidence base.
Tirzepatide came off the FDA shortage list in April 2026, and semaglutide before it. That closed most of the legal compounding route, because compounding a copy of a commercially available drug is not permitted outside a shortage. This is why so much grey-market GLP-1 activity moved online, and why FDA enforcement concentrated there.
Retatrutide has the most impressive trial data of anything not yet approved, roughly 28% mean weight loss at 80 weeks. It also has the worst grey-market quality record on this site, with 37 samples failing independent analysis. Strong trial data for a molecule tells you nothing about the contents of an unverified vial carrying its name.
Understanding a category is the first step. Whether any of it applies to you is a question for a licensed physician who knows your history.
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