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Weight Loss & Metabolic

Peptides used for weight management, insulin sensitivity, and metabolic dysfunction.

Clinical Overview

Weight Loss & Metabolic

Peptides used for weight management, insulin sensitivity, and metabolic dysfunction.

5 peptides1 FDA-approvedSubcutaneous injection (Ozempic · Wegovy) · oral (Rybelsus) · Subcutaneous injection (once weekly) · Subcutaneous injection (oral formulation was also investigated) · Subcutaneous injection in common compounding workflows; no clinically validated prescribing standardLast reviewed · April 22, 2026

Weight-loss and metabolic peptides span several mechanism classes that prescribers commonly combine, stack, or sequence — from FDA-approved GLP-1 receptor agonists to emerging triple agonists, growth-hormone-derived fragments, and mitochondrial peptides.

Mechanism Classes

  • GLP-1 receptor agonists

    Drive appetite suppression, delayed gastric emptying, and improved glycemic control. Semaglutide is the FDA-approved workhorse in this class.

  • Dual GLP-1 / GIP agonists

    Tirzepatide adds GIP receptor activity for greater weight loss than single-target GLP-1s in head-to-head trials.

  • Triple agonists (emerging)

    Retatrutide adds glucagon-receptor activity (GLP-1 + GIP + glucagon) for even greater weight loss in early Phase 2 data.

  • GHRH analogs & GH fragments

    Tesamorelin (GHRH analog, FDA-approved for HIV lipodystrophy) and AOD-9604 (GH fragment) target visceral adiposity and lipolysis.

  • Mitochondrial & metabolic peptides

    MOTS-c, 5-Amino-1MQ (NNMT inhibitor), and cagrilintide (amylin analog, stacks with semaglutide) target insulin sensitivity and adipocyte metabolism through distinct pathways.

Regulatory Status

FDA-Approved

  • Semaglutide
  • Tirzepatide
  • Tesamorelin (HIV lipodystrophy)

Investigational / Off-Label

  • AOD-9604
  • MOTS-c
  • Retatrutide
  • Cagrilintide
  • 5-Amino-1MQ

Compounding eligibility for semaglutide and tirzepatide is tied to FDA drug-shortage status. Verify current status before writing compounded prescriptions.

Evidence Base

Heterogeneous — Phase 3 RCT data for FDA-approved agents; early-phase trials for emerging triple agonists (retatrutide, cagrilintide); preclinical-to-pilot data for compounded peptides (AOD-9604, MOTS-c, 5-Amino-1MQ).

Primary-Literature References

62

Across 5 linked monographs

Prescribing Considerations

  1. 1Verify FDA drug-shortage status for semaglutide and tirzepatide before writing compounded prescriptions.
  2. 2Screen for personal or family history of medullary thyroid carcinoma before starting GLP-1 or dual agonists (contraindication).
  3. 3Titrate GLP-1-based agents gradually to manage GI tolerability during dose escalation.
  4. 4Baseline and periodic monitoring: CMP, HbA1c, lipid panel, thyroid function, body composition.
  5. 5Monitor for gallbladder disease and rare pancreatitis reports on chronic therapy.
  6. 6Set patient expectations on time-to-effect, adherence, and long-term weight maintenance.
Peer-reviewed clinical references · last reviewed April 22, 2026PeptidePrescriber · Clinical Reference

Peptides in this category(5)

Clinical monographs for each agent — dosing ranges, safety profile, evidence, and prescribing considerations.

3 additional monographs in this category are in clinical review and will be published soon.

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