Amycretin Alternatives

Semaglutide is a GLP-1 receptor agonist, a peptide engineered to mimic the natural gut hormone GLP-1 but with a roughly week-long half-life so it can be dosed once weekly. It is FDA-approved and sold as Ozempic and Rybelsus for type 2 diabetes and as Wegovy for chronic weight management, with cardiovascular benefit also on the label. This is one of the most rigorously tested peptides in existence, backed by large randomized trials, so the evidence here is in a completely different league from research-only peptides.

Tirzepatide is a single peptide that activates two receptors at once: GIP and GLP-1, the two main incretin hormones your gut releases after eating. It is FDA-approved as Mounjaro for type 2 diabetes and as Zepbound for chronic weight management and obstructive sleep apnea, and it has produced the largest weight-loss numbers of any approved drug to date. Like semaglutide, this is a heavily trialed, fully approved medicine, not a gray-market research compound.

AOD-9604 is a synthetic fragment of human growth hormone: residues 177 to 191 of the hormone with an extra tyrosine added at the front, 16 amino acids in total. The idea was to keep the fat-burning end of growth hormone while leaving out the part that raises IGF-1 or messes with blood sugar. It was developed by Metabolic Pharmaceuticals in Australia and tested as an anti-obesity drug, but it is not approved by the FDA or any major regulator, development stopped after its big Phase IIb trial missed its weight-loss target, and it is banned in sport by WADA.

Retatrutide is the heavy hitter of the new weight-loss drugs: a once-weekly injectable peptide that hits three receptors at once - GIP, GLP-1, and glucagon - earning it the nickname triple-G agonist. In phase 2 it produced about 24 percent weight loss at the top dose, and in the phase 3 TRIUMPH-1 trial Lilly reported 28.3 percent at 12 mg over 80 weeks. It is investigational, made by Eli Lilly, and not FDA approved; Lilly plans to file with the FDA in the first quarter of 2027. Because it is not an approved drug, FDA says it cannot be legally compounded.

HGH Fragment 176-191 is exactly what it sounds like: a short tail-end piece of the human growth hormone molecule, amino acids 176 through 191. The idea was to keep the fat-burning part of growth hormone while ditching the parts that raise blood sugar and IGF-1. The bare fragment has never been tested in a controlled human trial. Its modified cousin, AOD-9604, did go through real obesity trials, and the blunt result is that it was very safe but did not produce meaningful weight loss. It is banned in sport by WADA.

Liraglutide is a once-daily injectable GLP-1 receptor agonist, a synthetic peptide that shares about 97% of its sequence with the natural gut hormone GLP-1 but is engineered with a fatty acid chain so it survives in the body far longer. It is FDA-approved as Victoza for type 2 diabetes (2010) and as Saxenda for chronic weight management (2014), and is one of the most studied drugs in its class. As of 2024 a generic version is also FDA-approved.

Dulaglutide (brand name Trulicity) is a once-weekly injectable GLP-1 receptor agonist made by fusing a modified GLP-1 peptide to a fragment of a human antibody, which is what lets it last a full week between shots. It is FDA-approved for type 2 diabetes and, notably, to reduce cardiovascular risk in adults with diabetes. The once-weekly dosing made it a major convenience step up from earlier daily and twice-daily agents.

Exenatide is the original GLP-1 receptor agonist and it came from an unlikely source: the saliva of the Gila monster, a venomous desert lizard. It is a synthetic 39-amino-acid peptide (a copy of the natural exendin-4) sharing about 50% of its sequence with human GLP-1. It was developed by Amylin and Lilly (later owned by AstraZeneca) and sold as the twice-daily Byetta (FDA-approved 2005) and the once-weekly Bydureon (2012). AstraZeneca discontinued both brands in the US in October 2024 for business reasons, not safety, and a generic twice-daily exenatide from Amneal (approved November 2024) launched in April 2025. It was the first drug to successfully turn the short-lived incretin hormone into a real diabetes therapy.