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They differ by: receptor profile approval status trial design tolerability and how much real-world evidence exists today That is why the most honest ranking is not “1st, 2nd, 3rd.” It is: semaglutide is the proven single-agonist benchmark tirzepatide is the current approved leader retatrutide is the Phase 3 investigational drug most likely to reshape the market if the remaining data hold Sources New England Journal of Medicine / PubMed: STEP 1 semaglutide trial FDA: Wegovy cardiovascular-risk indication and current indication summary FDA: Zepbound approval for chronic weight management Eli Lilly: SURMOUNT-5 complete results Eli Lilly: TRIUMPH-4 Phase 3 retatrutide results Eli Lilly: retatrutide Phase 3 diabetes results and dysesthesia signal Lilly FAQ: what to know about retatrutide

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Changes appeared within 11 to 28 days in mouse studies