Retatrutide, Tirzepatide and Semaglutide What is the difference and how to make a choice?

You've probably heard about modern weight loss medications that were originally used for type 2 diabetes. Someone has already tried injections of semaglutide, someone is studying reviews of tirzepatide, and someone is waiting for the release of retatrutide, which is called the most powerful remedy in this group.

But when a patient comes for a consultation, the same question usually sounds: how do they differ and which drug to choose.

There really is a difference. And it concerns the mechanism of action.

Semaglutide: effects on a single receptor

Semaglutide works through GLP-1 receptors. This hormone is involved in regulating appetite and blood sugar levels. Under its influence, the feeling of satiety increases, gastric emptying slows down and spontaneous food intake decreases.

In studies, maximum doses of semaglutide resulted in an average weight loss of 17-20% over 68 weeks.

The drug is administered once a week. The dosage is increased gradually to reduce the likelihood of adverse reactions from the gastrointestinal tract.

Tirzepatide: double hormonal effect

Tirzepatide acts directly on the GLP-1 and GIP receptors. Additional activation of GIP enhances the metabolic response and may affect the distribution of adipose tissue.

According to clinical studies, weight loss with the use of tirzepatide reached approximately 22% over the same period.

Therefore, a decision in favor of tirzepatide or semaglutide always requires an individual discussion with a doctor. Under comparable conditions, tirzepatide demonstrates more pronounced weight loss, however, tolerance and concomitant diseases are always considered individually.

The use of tirzepatide also involves weekly injections with gradual titration of the dose.

The triple mechanism of action of retatrutide

Retatrutide* differs in that it activates three receptors: GLP-1, GIP and glucagon.

It is the effect on glucagon receptors that accelerates metabolic processes and increases energy consumption. In large-scale clinical trials, the average weight loss was up to 28.7% in 68 weeks.

Retatrutide peptide is considered the most promising representative of this group. However, it is important to remember that retatrutide has not yet been approved by the FDA, and its possible market launch is expected no earlier than mid-2026.

Side effects of medications

Despite the differences in the mechanism of action, the profile of side effects of all three drugs is similar.

Most often it is nausea, decreased appetite, loosening of stools or constipation in the first weeks of therapy. Pancreatitis or gallbladder problems are less common. Additional activation of the glucagon receptor when using retatrutide may be accompanied by a slight increase in heart rate.

The drugs are not used simultaneously. Only one drug is prescribed with an individual dose selection.

What to choose

There is no definitive answer.

Semaglutide has a longer clinical history and has been well studied.

Tirzepatide demonstrates a more pronounced decrease in body weight due to a dual mechanism.

Retatrutide shows the most impressive figures in research, but remains in the waiting stage for regulatory approval.

The choice always depends on the patient's metabolic status, diabetes, cardiovascular risk factors, baseline body mass index, and individual tolerance to therapy. These drugs work through hormonal mechanisms, so their appointment requires an assessment of tests, medical history and concomitant conditions.

Injectable weight loss products are not a universal solution. It is a hormonal correction tool that should be used under medical supervision and within the framework of a well-thought-out strategy.

At the clinic, you can get a doctor's advice on choosing a drug based on your performance and goals. We carry out a preliminary diagnosis, assess the risks and select the optimal treatment regimen. The patient receives a recommendation on the choice of the drug and support throughout the treatment stage, including dosage control, tolerance monitoring, and protocol adjustments if necessary.