EASD 2026: The Obesity Drug Readouts That Matter

Why this meeting mattered

For several years, obesity conferences were about one question: how much weight a new drug could take off. EASD 2026 was different. Most of the major results came from trials in people with type 2 diabetes, several compared or combined drugs rather than testing them alone, and the discussion kept returning to side effects and drop-out rates. Those are the questions that matter once the basic efficacy of the class is settled.

This guide covers the readouts with the most bearing on what reaches patients over the next few years. Where a drug has its own page, we link to it for the full evidence picture.

Retatrutide's diabetes trial reaches The Lancet

The full results of TRIUMPH-2 were published in The Lancet on September 29 and presented at EASD the next day. The trial enrolled 1,152 adults with obesity or overweight and type 2 diabetes for 80 weeks. On the 12 mg dose, weight fell by 20.8% using the efficacy estimand, or 18.8% counting everyone randomised, against 4.0% and 5.1% on placebo. The 9 mg and 4 mg doses produced 19.1% and 12.7%.^[1]

Discontinuation because of adverse events was 7.7% on 12 mg and 11.6% on 9 mg, against 4.9% on placebo. The headline numbers match the July topline release, so nothing in our coverage changes, but the peer-reviewed paper is now the citation of record. Lilly continues to guide to a regulatory submission in the first quarter of 2027, which it describes as a Biologics License Application. Whether retatrutide is regulated as a drug or a biologic is the subject of a federal appeal argued on September 24, with no ruling as of mid-October. Our retatrutide page has the full trial programme.

Amylin moves to the centre

Amylin is a satiety hormone released alongside insulin, and drugs that mimic it were the busiest category at the meeting. Four results stood out.

Eloralintide with tirzepatide. Lilly's eloralintide is already in Phase 3 on its own. In a 367-person Phase 2b in obesity with type 2 diabetes, the highest combination dose with tirzepatide produced 23.3% weight loss at 48 weeks, against 14.8% for tirzepatide 15 mg alone. Discontinuation for side effects ran from 10.8% to 27.0% on the combination, against 2.9% on tirzepatide alone, and Lilly plans a co-formulated Phase 3 with slower dose escalation.^[3]

Petrelintide. Zealand and Roche's petrelintide had its Phase 2 published in The Lancet, with about 10% weight loss against 1.7% on placebo. ZUPREME-2, in 220 people with obesity and type 2 diabetes, followed on October 7 with 7.4% to 9.2% weight loss at 28 weeks against 2.0% on placebo. Only 1.9% stopped because of gastrointestinal side effects. A Phase 3 programme of about 7,000 participants has begun dosing.^[6]

ABBV-295. AbbVie's long-acting amylin analog, licensed from Gubra, produced 7.8% to 9.8% weight loss at 12 weeks in Phase 1 and tested every-other-week and monthly dosing. It is early, but monthly dosing is rare in this class.^[7]

Zenagamtide. Novo now uses the name zenagamtide for amycretin, its single molecule that acts on both GLP-1 and amylin receptors. It presented Phase 2b type 2 diabetes data showing up to 14.6% weight loss and a 1.71-point fall in HbA1c at 36 weeks. Its obesity Phase 3 trials began in early 2026.^[12]

The pattern across all four is the same. Amylin on its own produces moderate weight loss with what looks like gentler effects on the gut, and amylin combined with an incretin produces more weight loss with more side effects. Which balance people prefer in practice is still unknown.

CagriSema's tirzepatide win, and the dose that explains it

On September 21, Novo announced that CagriSema had produced superior weight loss to tirzepatide in REIMAGINE 5, a 60-week Phase 3 in adults with type 2 diabetes. CagriSema 1.0/1.0 mg produced 12.4% weight loss against 9.1% for tirzepatide, and its HbA1c reduction of 1.71 points was non-inferior to tirzepatide's 1.67.^[4]

The comparator dose is the important detail. REIMAGINE 5 used tirzepatide 5 mg, its lowest maintenance dose. When the two drugs were compared at their full obesity doses in REDEFINE 4, reported in February 2026, CagriSema produced 23.0% weight loss against 25.5% for tirzepatide 15 mg and missed its non-inferiority endpoint. Both results are real. Read together, they suggest the drugs are closely matched at low doses and that tirzepatide pulls ahead at the top of its range.

The same announcement reported REDEFINE 9, in which CagriSema 1.0/1.0 mg produced 21.0% weight loss against 2.0% on placebo at 68 weeks in adults with overweight or obesity. That is a large effect for a dose below the 2.4/2.4 mg used in the main obesity trials. Novo expects a US decision on CagriSema in the fourth quarter of 2026.

Survodutide and the type 2 diabetes pattern

Boehringer Ingelheim reported SYNCHRONIZE-2 on October 1, published in the New England Journal of Medicine. In 755 adults with obesity and type 2 diabetes, survodutide produced up to 13.1% weight loss at 76 weeks against 3.1% on placebo, and lowered HbA1c by up to 1.21 points.^[5] That is lower than its result in people without diabetes, which follows a pattern seen across the whole class.

People with type 2 diabetes consistently lose less weight on incretin drugs than people without it, and the reasons are not fully settled. The practical consequence is that results from type 2 diabetes trials should be compared with each other, not with obesity-only trials. The table below gathers the main type 2 diabetes readouts from the meeting. Durations differ widely, so even these comparisons are rough.

The eloralintide and retatrutide figures use the efficacy estimand, which assumes everyone stayed on treatment. The other trials' headline figures were not always labelled by estimand in the releases we reviewed.

Beyond appetite: muscle and localised fat

Two results addressed what kind of weight is lost rather than how much.

Regeneron reported the Phase 2 COURAGE trial on October 1. Adding trevogrumab, an antibody that blocks a muscle-growth inhibitor, to semaglutide prevented about 70% of the thigh-muscle loss seen with semaglutide alone in an MRI substudy. On whole-body DXA scans the effect was smaller, with 21% to 43% of lean-mass loss prevented depending on dose. The results are in press at The Lancet.^[10] Muscle loss during rapid weight loss is one of the most discussed concerns with these drugs, covered in our guide to muscle preservation.

Caliway presented a post hoc analysis suggesting its injectable CBL-514 reduced visceral fat in two Phase 2b trials. CBL-514 is a small molecule designed to remove fat where it is injected, and its pivotal Phase 3 began enrolling in August. The visceral-fat analysis was small and post hoc, and two outlets reported different figures from the same presentation.^[11]

Further readouts from China

Hansoh's olatorepatide, a dual GLP-1/GIP agonist licensed to Regeneron outside China, presented its Phase 3 LIGHTEN data as a late-breaker: 12.5% to 19.3% weight loss at 48 weeks against 2.7% on placebo, with low reported rates of nausea and vomiting. A Chinese approval filing was accepted in June.^[8]

Kailera announced that its global Phase 3 of ribupatide, the dual agonist formerly known as HRS9531, completed enrollment on September 30.^[9] Results from trials run only in China need care when compared with Western trials, because obesity is defined at lower body-mass thresholds there and baseline weights tend to be lower.

What to watch next

• The CagriSema decision. Novo expects a US decision in the fourth quarter of 2026. It would be the first approval of an amylin-based obesity combination.
• Retatrutide's filing route. A ruling in the federal appeal over whether retatrutide is a biologic could affect how and when Lilly files.
• EloraTZP's Phase 3 design. Whether the co-formulation and slower escalation bring discontinuation down is the main question for the amylin combinations.
• ObesityWeek in November. Several programmes, including non-incretin approaches, are expected to present there.

Where the field is heading

EASD 2026 confirmed that the next generation of obesity drugs will be judged less on peak weight loss than on the trade-offs around it. Amylin combinations can now match or exceed tirzepatide on weight, at a cost in tolerability that is still being worked out. Trials in type 2 diabetes have become the main proving ground. The newer programmes are asking whether the weight lost is fat or muscle, and where on the body it comes from. For anyone choosing a treatment today, the approved options have not changed. What changed is the shape of the choices likely to arrive over the next three years.