Semaglutide vs Tirzepatide vs Retatrutide
Semaglutide, tirzepatide, and retatrutide work through different receptor combinations which affect fat loss, muscle preservation, and metabolic breadth. This tool compares the compounds through clinical trial data — select a compound below.
Semaglutide
Ozempic, Wegovy
The gentle starter
Pure GLP-1 agonist — reduces appetite and slows digestion. Strongest cardiovascular outcome data (SELECT trial), extensive trial and safety data, and only incretin with an oral option.
GLP-1 only: satiety and insulin sensitivity
STEP-1 DXA substudy, non-diabetic obesity, 68 wk
Tirzepatide
Mounjaro, Zepbound
The fast track
GIP-dominant dual agonist — directly engages fat cells via GIP receptors. 47% more weight loss than semaglutide head-to-head. Body-comp advantage narrows in T2D where GIP is impaired.
GLP-1 + GIP: deeper metabolic rebalancing with improved nutrient partitioning
SURMOUNT-1 DXA substudy, non-diabetic obesity, 72 wk
Retatrutide
Investigational (Phase 2)
The heavy hitter
Triple-agonist with redesigned receptor profile — stronger GIP (2×), plus glucagon for direct liver fat mobilization. Currently in Phase II trials. Requires meticulous muscle protection.
GLP-1 + GIP + Glucagon: whole-system metabolic rewiring with enhanced fat oxidation
*T2D population only, 48 wk (not directly comparable)
How It Works
Mid-range dose — appetite suppression and gastric slowing, balanced against two stronger receptor channels
Double-strength fat cell activation — Lilly engineered this to overcome the blunted GIP response seen in type 2 diabetes
Unique to retatrutide — tells the liver to mobilize stored fat directly, increasing energy expenditure
Stronger GIP + glucagon means retatrutide hit ~17% weight loss in T2D at 36 weeks — vs tirzepatide's ~13% at 40 weeks. The glucagon channel works regardless of diabetic status. But glucagon is inherently catabolic and raises heart rate (+2–7 bpm). Non-negotiable anabolic support required.
*Body composition data comes from a Phase 2 DXA substudy in a T2D population (48 weeks). Semaglutide and tirzepatide ratios are from non-diabetic populations over longer durations (68–72 weeks). Metabolic differences between T2D and non-diabetic subjects affect how fat and lean mass respond to treatment, so these ratios are not directly comparable across compounds. Non-diabetic retatrutide body composition data does not yet exist.
What % of People Hit Each Milestone?
Based on Phase 2 (NEJM 2023) trial data (48 weeks, non-diabetic obesity (weight loss); t2d substudy (body comp, 36-wk dxa))
Expected Weight Loss by Dose
| Dose | Weeks | Expected Loss | Notes |
|---|---|---|---|
| 0.5–1 mg | 0–4 | ~3% | Activation phase |
| 2 mg | 4–8 | 5–7% | Early response |
| 4 mg | 8–12 | 10–12% | Similar to full sema |
| 8 mg | 12–24 | 18–20% | Large effect |
| 12 mg | 24–48 | 22–24% | Maximum; no plateau |
Complete Protocol Guide
Start
Build
Maintain
Do not exceed this dosage. Always follow your healthcare provider's guidance.
Glucagon boosts energy expenditure but can catabolize muscle and increase need for carbohydrate intake if training too hard - slow titration essential.
Advantages
- Highest fat loss potential of any available option.
- Impacts metabolism and drives fat oxidation with glucagon.
Watch Out For
- Side effects highly sensitive to dose escalation.
- Elevated heart-rate during initial titration phases.
Retatrutide: Deep Dives
Clinical Monitoring Framework
Clinical Evidence
Medical Disclaimer
The content in this GLP-1 comparison guide is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before beginning any new protocol, supplement, or medication.