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