The pipeline is active. Retatrutide (Eli Lilly) is a triple agonist (GLP-1/GIP/glucagon) that showed up to 24% body weight loss in trials. Survodutide (Boehringer Ingelheim) is a dual GLP-1/glucagon agonist. CagriSema (Novo Nordisk) combines semaglutide with cagrilintide (an amylin analog) for potentially greater weight loss than either alone. Orforglipron is a non-peptide oral GLP-1 agonist. Several of these could reach market in the coming years, potentially offering better efficacy, fewer side effects, or oral dosing. Retatrutide is already appearing on the gray market.