The full GLP-1 medication family tree (2026 edition)

What you will learn

• The two main branches of the GLP-1 family and what splits them
• Each medication, its approval status, and a dated trial-average figure
• How the new oral options differ from the weekly injections
• What "investigational" means and which drug it applies to
• How a compounded preparation fits, framed honestly and without the generic myth

What does GLP-1 actually do?

GLP-1 is short for glucagon-like peptide-1. Your gut releases it after you eat. It does three quiet things. It tells your brain you are satisfied. It slows how fast your stomach empties. And it helps your body manage blood sugar. The medications in this family are built to mimic that natural signal and make it last longer than your own body can.

The single-target branch stops there. It pulls the one lever, GLP-1, and pulls it well.

The dual-target branch pulls a second lever too. It adds GIP, which stands for glucose-dependent insulinotropic polypeptide. More levers is not automatically right for any one person, but it is the line that divides the tree.

Liraglutide is the elder of the branch. It is a daily injection, approved by the FDA for chronic weight management in adults back in December 2014 under the brand Saxenda® ¹. It paved the way, and it is still prescribed, though the newer weekly options now carry most of the conversation.

Semaglutide is the name most people have heard. As a once-weekly injection, it was FDA-approved for chronic weight management in June 2021 under the brand Wegovy® ². In the STEP 1 trial, semaglutide at its 2.4 mg dose lowered weight by 14.9% on average at 68 weeks ⁴. That is a trial average across a group. Individual results vary.

Oral semaglutide is the newest twig on this branch. In December 2025, Wegovy® tablets were added to the label, so the same single-target medicine now comes as a daily pill, not only a weekly shot ³. The arrival of a pill is one of the biggest 2026 shifts in the whole family.

Tirzepatide was FDA-approved for chronic weight management in November 2023 under the brand Zepbound® ⁵. In the SURMOUNT-5 head-to-head trial, published in the New England Journal of Medicine in May 2025, tirzepatide lowered weight by 20.2% on average over 72 weeks, compared with 13.7% for semaglutide in the same trial ⁶. Read that as a description of two groups, not a forecast for one person. Individual results vary.

A note people miss: you cannot compare the milligram numbers across the two branches. The maintenance figures, 2.4 mg weekly for injected semaglutide and up to 15 mg for tirzepatide ³⁷, are different molecules at their own ranges. A bigger number does not mean a bigger dose in any real sense. Comparing the milligram figures directly is a classic apples-to-oranges trap.

What makes orforglipron different?

Orforglipron, sold as Foundayo™, was approved in April 2026. Lilly describes it as the only GLP-1 pill for weight loss that can be taken any time of day without food or water restrictions ⁸. Wegovy® tablets, by contrast, are taken on an empty stomach in the morning with a small amount of water ³.

In its ATTAIN-1 trial, people on the highest dose of orforglipron saw their weight drop by 12.4% on average, per Lilly ⁸. That is an average across a trial group, not a promise to any individual. Individual results vary.

Why does a pill matter so much? For some people, a daily tablet is simply easier to live with than a weekly injection. For others, the weekly shot is the simpler routine. Neither is automatically right. It is a fit question, and the answer is personal.

Retatrutide is a triple agonist. It mimics GLP-1, GIP, and a third hormone, glucagon. In its phase 3 TRIUMPH-1 trial, announced in May 2026, people on the top dose saw their weight fall by 28.3% on average over 80 weeks, and by up to 30.3% in a subgroup followed to 104 weeks (baseline BMI of 35 or higher), per Lilly ⁹. That figure is striking, and it is also a trial average from a research setting in a drug that is not yet approved. Individual results vary, and an investigational result is not the same as an approved option you can choose today.

So when a friend mentions a drug with a huge number attached, this is usually the one. It is real science in progress. It is not a 2026 prescription.

*All figures are averages from controlled trials, not promises. Different trials enroll different people, so the numbers are not perfectly comparable across rows. Individual results vary. Your clinician interprets what any of this means for you.

Here is the honest framing. A 503A compounded preparation is made by a state-licensed pharmacy for an individual patient based on that person's prescription. It is its own distinct preparation, and compounded drugs are not FDA-approved ¹⁰. It is not a generic, and it is not an equivalent of, or the same as, a branded FDA-approved product. Calling it a generic version of the brand is a myth worth retiring, because the so-called generic framing is simply inaccurate. Anyone who tells you a compounded preparation is identical to the brand is not giving you the full picture.

There is also a moving regulatory backdrop. On April 30, 2026, the FDA proposed excluding semaglutide, tirzepatide, and liraglutide from the 503B bulk-compounding list, saying outsourcing facilities cannot compound from bulk substances when FDA-approved drugs are available unless there is a clear clinical need ¹¹. The FDA had declared the tirzepatide and semaglutide shortages resolved in December 2024 and February 2025 ¹². The comment window on the proposal closed July 30, 2026, after a 30-day extension ¹¹. That proposal addresses large-scale 503B outsourcing facilities, not the 503A patient-specific path built around a prescription written for you.

A good GLP-1 provider tells you the truth on the tree above. It names the medication plainly, states its approval status, and never dresses a compounded preparation up as a generic or an equal of the brand. It frames every efficacy figure as a trial average, pairs it with "individual results vary," and points to a dated source. And it puts the money in writing: the full monthly cost, any recurring charge, and one-click cancellation, all before your card is charged. If a brand cannot do those four things, that tells you something. This is the standard sipra was built around; here is how it works.

Recurring monthly charge until canceled. Cancel anytime in your account. No phone call required. Full cost disclosed before checkout.

1. Place the names you have heard. Single-target branch, dual-target branch, a new oral shoot, or the dashed investigational limb. Sorting them this way cuts through most of the noise.
2. Write down what matters to you. Pill or injection, gentlest start or highest average result, simplest routine or lowest cost. Rank them before any appointment.
3. Bring the list to a licensed clinician and decide together. The medication is one variable. The care around it, and a provider who shows you every cost up front, is the rest. That is the part sipra was built to get right.

The tree shows you what exists. A clinician helps you find your place on it.