A comprehensive review of next-generation anti-obesity drugs in development, including GLP-1 analogs like semaglutide, amylin mimetics, dual/triple gut hormone agonists, and peptide-based vaccines targeting ghrelin.
20+ pipeline drugs across multiple peptide targetsThe review catalogs over 20 anti-obesity drugs in development targeting diverse neurohormonal pathways — from single gut hormone analogs to triple agonists and anti-obesity vaccines — reflecting the complexity of obesity biology.
What the researchers found
The review identifies several categories of peptide-based anti-obesity drugs in development:
- **GLP-1 analogs**: Semaglutide (injectable and oral forms) leading the field
- **Amylin mimetics**: Davalintide and dual amylin/calcitonin receptor agonists (DACRAs)
- **Dual agonists**: GLP-1/glucagon receptor agonists (oxyntomodulin analogs)
- **Triple agonists**: Tri-agonist 1706 targeting GLP-1, GIP, and glucagon receptors simultaneously
- **Other peptide targets**: Peptide YY, setmelanotide (melanocortin receptor), neuropeptide Y antagonists (velneperit), leptin analogs (pramlintide-metreleptin combination)
- **Anti-obesity vaccines**: Targeting ghrelin and somatostatin
The pipeline reflects growing understanding that obesity involves multiple neurohormonal pathways, and that targeting several simultaneously may produce superior weight loss.
Why it matters
This review captures a pivotal moment in obesity pharmacology — many of the drugs discussed (particularly semaglutide) went on to transform the field. Understanding the breadth of peptide-based approaches in development provides context for the current obesity drug landscape and highlights next-generation therapies that may further improve on current options.
How the study worked
This is a narrative review surveying the anti-obesity drug development pipeline as of 2018. The authors reviewed clinical trial data, preclinical studies, and mechanistic research on drugs at various stages of development, organized by their mechanism of action and molecular targets.
What this study cannot tell us
As a 2018 review, several of the drugs discussed have since either succeeded (semaglutide) or failed (beloranib was halted due to safety concerns) in development. The review could not predict which candidates would ultimately reach market approval. Some approaches discussed (anti-obesity vaccines, some dual agonists) remain in early development or have been deprioritized. The review also doesn't address long-term safety data that has since emerged for some of these agents.
How to read the evidence
This is a narrative review surveying drugs at various stages of development — from preclinical to Phase III trials. The evidence quality varies widely across the drugs discussed, from well-powered clinical trials (semaglutide) to early-stage preclinical concepts (anti-obesity vaccines).
When this study was published
Published in 2018, this review is now several years old and some predictions have been validated while others haven't materialized. Semaglutide became a massive success, dual agonists like tirzepatide also reached market, but some other candidates (beloranib, certain vaccines) stalled. The review remains valuable as a comprehensive snapshot of the obesity drug development landscape at a transformative moment.
The bigger picture
Written in 2018, this review proved remarkably prescient about the direction of obesity pharmacotherapy. Semaglutide, discussed here as a promising pipeline drug, became one of the most transformative medications in medicine. The dual and triple agonist approach (GLP-1 + GIP and/or glucagon) has also advanced significantly, with tirzepatide (a dual GLP-1/GIP agonist) achieving FDA approval. The review serves as a snapshot of the obesity drug revolution in its early stages.
Questions still open
- Which of the triple agonist and next-generation combination peptide drugs will follow semaglutide to FDA approval?
- Can anti-obesity vaccines targeting ghrelin achieve meaningful and sustained weight loss in humans?
- Will oral peptide formulations eventually replace injectable GLP-1 drugs for obesity treatment?
Common questions
What types of peptide drugs are being developed for obesity?
Did the drugs in this 2018 review actually work out?
Read the original research
Future Pharmacotherapy for Obesity: New Anti-obesity Drugs on the Horizon.
Current obesity reports, 7(2), 147-161
Citation
Srivastava, Gitanjali; Apovian, Caroline. (2018). Future Pharmacotherapy for Obesity: New Anti-obesity Drugs on the Horizon.. Current obesity reports, 7(2), 147-161. https://doi.org/10.1007/s13679-018-0300-4