Metabolic & Weight

Pancreatic Alpha-Cell Hormone

Insulin's counter-regulatory hormone, FDA-approved for emergency hypoglycemia and the basis for the dual/triple agonist drug classes (tirzepatide, retatrutide).

Counter-Regulatory HormoneFDA Approved (emergency hypoglycemia)

The Original Peptide Drug (1922)

The first peptide drug ever used clinically (1922, Banting and Best in Toronto) and the first peptide structurally characterized and synthesized, the foundational proof that small amino-acid chains could be therapeutic drugs.

Metabolic / FoundationalFDA approved. Recombinant human insulin (Eli Lilly Humulin) approved 30 October 1982; many analog and formulation approvals since.

Victoza / Saxenda (GLP-1 Analog)

A once-daily GLP-1 receptor agonist and the direct predecessor to semaglutide, FDA-approved for type 2 diabetes and obesity. Outpaced by newer agents but still widely prescribed and cheaper in some markets.

GLP-1 AgonistFDA Approved (Victoza, Saxenda)

GLP-1 Receptor Agonist · Ozempic / Wegovy

The drug that pulled all of peptide medicine into the mainstream.

Metabolic / GLP-1FDA approved: Ozempic (injection) 2017 for type 2 diabetes, Rybelsus (oral) 2019 for type 2 diabetes, Wegovy (2.4 mg) 2021 for chronic weight management; later cardiovascular and kidney indications added.

Dual GIP/GLP-1 Agonist · Mounjaro / Zepbound

Beat semaglutide head-to-head: 20.2% vs 13.7%. The current peak of incretin medicine.

Metabolic / Dual IncretinFDA Approved (Mounjaro, Zepbound)

Byetta / Bydureon · Gila Monster Peptide

The first FDA-approved GLP-1 agonist (2005), derived from exendin-4 in Gila monster venom, the compound that launched the entire drug class. Now largely displaced by semaglutide and tirzepatide.

GLP-1 Agonist / Exendin-4FDA Approved: Byetta twice daily 28 Apr 2005 (first-in-class GLP-1 RA); Bydureon once weekly 27 Jan 2012

Dual GLP-1 and glucagon receptor agonist

Multiple randomized trials support weight and glycemic effects. Approval is limited by jurisdiction, and the long-term safety record is still developing.

Metabolic / Dual receptor agonistGovernmental and issuer-filed sources record approval for chronic weight management in China and Macau and for glycemic control in adults with type 2 diabetes. No United States or European Union approval was established in the reviewed sources. Approval is indication-specific and jurisdiction-specific.

Symlin / Amylin Analog

A synthetic amylin analog, FDA-approved as an adjunct to insulin in type 1 and type 2 diabetes. Reduces post-meal glucose spikes; underutilized despite approval.

Amylin / AppetiteFDA-approved 2005 (SYMLIN); boxed warning for severe hypoglycemia with insulin

Triple GIP/GLP-1/Glucagon Agonist (Lilly)

Phase 3 hit 28.3% weight loss in May 2026. The biggest number in obesity medicine.

Triple Incretin AgonistNot FDA-approved. Phase 3 obesity trial TRIUMPH-1 topline reported positive May 2026 (n=2,339); TRIUMPH-2, TRIUMPH-3 and the cardiovascular outcomes trial ongoing. NDA submission anticipated but not yet filed as of July 2026.

Dual glucagon and GLP-1 receptor agonist

An experimental dual glucagon/GLP-1 receptor agonist being tested in phase 3 trials for obesity, type 2 diabetes and liver disease.

Metabolic / Dual receptor agonistNo marketing approval was established in the sources reviewed through 2026-09-06. An EMA pediatric-plan decision concerns development and is not marketing authorization. An FDA warning letter described a marketed product bearing this name as an unapproved new drug.

GHRH Analog (Egrifta)

The only FDA-approved GHRH analog. Reduces visceral fat. Widely used off-label.

GH-Releasing / GHRH AnalogFDA approved November 10, 2010 (Egrifta) for excess visceral abdominal fat in HIV-associated lipodystrophy; F8 formulation approved as Egrifta WR. No approval for anti-aging, GH optimization, or body recomposition in healthy adults.

Long-Acting Amylin Analog (Novo Nordisk)

A long-acting amylin analog from Novo Nordisk, studied mostly in fixed combination with semaglutide as CagriSema. In Phase 3 REDEFINE 1 the combination was associated with about 22.7 percent weight loss at 68 weeks, which fell short of its 25 percent target; cagrilintide alone produced about 10.8 percent over 26 weeks in Phase 2. It is investigational and not FDA-approved, and any compounded or research-market cagrilintide sold today is unapproved and outside legal channels.

Amylin / Weight LossInvestigational; CagriSema NDA filed 18 Dec 2025, FDA decision expected late 2026. Not approved as of mid-2026.

Cagrilintide + Semaglutide (Novo Nordisk)

Novo Nordisk's once-weekly fixed combination of cagrilintide (amylin analogue) and semaglutide (GLP-1 agonist). Phase 3 REDEFINE 1 showed 22.7% mean weight loss, among the strongest obesity results reported, but it missed the company's own 25% ambition and sent the stock lower. An FDA NDA was filed in December 2025 with review expected in 2026; it is not yet approved.

Combined Amylin/GLP-1NDA submitted to FDA 18 December 2025 (REDEFINE 1 and REDEFINE 2); FDA review expected 2026; not yet approved

GLP-1 drug plus add-on metabolism peptides

approved drug plus unproven add-ons

Mixed: approved incretin drug plus experimental peptidesThe GLP-1 base drugs are FDA-approved: semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) are cleared for diabetes and/or obesity. GLP-1 means glucagon-like peptide-1, a gut hormone that signals fullness; tirzepatide also hits a second receptor called GIP. The add-on peptides are NOT approved as weight drugs: AOD-9604 has no drug approval (it holds a narrow food-ingredient GRAS notice and the FDA declined to add it to the compounding list in December 2024), and MOTS-c and 5-Amino-1MQ are sold as research chemicals only. The stack as a whole is not an approved regimen.

Ang-(1-7) · ACE2 Downstream Peptide

An endogenous heptapeptide generated by ACE2, angiotensin-(1-7) is the Mas-receptor agonist that forms the protective, counter-regulatory arm of the renin-angiotensin system, opposing the ACE/angiotensin II axis with signals associated with cardioprotective, anti-inflammatory, and anti-fibrotic effects. Its synthetic formulation TXA-127 (talfirastide) reached early-phase human trials, including COVID-19 ICU studies that showed safety but neutral efficacy, and no product is approved.

Cardioprotective / ACE2 AxisNo approval for any indication. TXA127 (talfirastide) holds several FDA orphan-drug designations (pulmonary arterial hypertension, stem-cell engraftment, myelodysplastic syndrome, and rare muscular dystrophies) and a fast-track designation for Duchenne muscular dystrophy, all pre-approval.

APJ Receptor Agonist Tridecapeptide

An endogenous APJ-receptor peptide that is inotropic, vasodilatory, anti-fibrotic, and promotes mitochondrial biogenesis. Plasma levels fall with heart failure and aging.

Cardiac / MetabolicNo approved product; investigational only. Native Apelin-13 has been used solely in short-term human research infusions, and analog programs (Novartis CLR325, BMS-986224, AMG 986) did not advance to approval.

HGH Fragment 176-191

The fat-burning fragment of HGH, no muscle effect. Australian origin. Failed its obesity trial.

Fat Metabolism / HGH FragmentNot FDA approved; no New Drug Application filed and no approval letter for any use. Industry expert-panel GRAS self-affirmation exists for limited food-ingredient use only, which is not FDA endorsement and does not cover drug or compounded use. Removed from Category 2 of the FDA interim 503A compounding bulks list on September 27, 2024 and referred to the Pharmacy Compounding Advisory Committee.

Stabilized MOTS-c Analog

A stabilized synthetic analog of MOTS-c in clinical development to overcome the native peptide's synthesis and stability challenges. Earliest stage of development.

Mitochondrial AnalogNo FDA approval. The one clinically tested analog, CB4211, completed a single Phase 1a/1b study and was discontinued when CohBar dissolved; consumer 'MOTS-c analog' products are sold as research chemicals, not for human use.

HGH C-Terminal Fat Metabolism Fragment

A C-terminal fragment of human growth hormone marketed for fat loss, essentially the same molecule as AOD-9604 aside from a stabilizing N-terminal tyrosine. AOD-9604 failed its pivotal Phase 2b obesity trial against placebo and was discontinued; the fragment itself has no human trials, no FDA-approved product, and is sold as an unapproved research chemical.

Fat Metabolism FragmentNo FDA-approved product. In the near-identical analog AOD-9604, the FDA proposed at the December 4, 2024 PCAC meeting not to include it on the 503A bulk drug substances list, citing insufficient safety and efficacy data, immunogenicity risk, and the absence of an approved application. The fragment itself is sold as an unapproved research chemical.

FNDC5 Cleavage Product · Exercise Myokine

An exercise-induced protein hormone from muscle that promotes fat-tissue browning, improves insulin sensitivity, and crosses the blood-brain barrier. Dubbed a "fountain of youth" protein in popular press.

Exercise Myokine / Metabolic HormoneNot an FDA-approved drug and not a marketed supplement; exists only as a research reagent and preclinical target, with no completed human intervention trials.

Methionine-Inositol-Choline Injectable

Not a true peptide but a staple of weight-loss clinics, a compounded blend of methionine, inositol, and choline (often with B12) marketed to support fat metabolism. Grouped with injectable wellness compounds. Minimal controlled evidence.

Lipotropic / Fat MetabolismUnapproved compounded product; no FDA-approved MIC/lipotropic injection and FDA states no credible evidence that injected fat-dissolving compounds work for fat elimination

Mitochondrial ORF of the 12S rRNA Type-C

A small peptide made from mitochondrial DNA that rises with exercise and falls with age.

Mitochondrial / Exercise MimeticNot FDA approved for any indication; investigational only. First human interventional trial (Phase 2a, NCT07505745) enrolling in 2026; sold elsewhere as a research chemical labeled not for human use.

Lys-Glu-Asp-Trp Pancreatic Bioregulator

A Khavinson tetrapeptide targeting pancreatic tissue and glucose-regulation gene expression in aging. Russian data only.

Pancreatic BioregulatorNot approved by FDA (also not approved by EMA); no registered clinical trials; sold internationally as a research chemical 'not for human consumption,' and in Russia as a registered dietary supplement

NPQ Peptide · Appetite Suppressor

A neuropeptide that suppresses food intake and promotes fat utilization; plasma levels correlate inversely with obesity. A potential weight-management target, still very early.

Metabolic / AppetiteNo FDA status; unapproved research chemical with no drug application and no ClinicalTrials.gov registration for administered spexin