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What are Semaglutide, Tirzepatide, and Retatrutide?

Semaglutide

Class: GLP-1 receptor agonist

WHAT IT DOES:

  • Mimics the GLP-1 hormone
  • Reduces appetite
  • Slows stomach emptying
  • Improves blood sugar control

WEIGHT LOSS:

  • ~10-15% body weight (on average)

PROS:

  • Proven, widely used
  • Strong appetite suppression
  • Good safety profile over time

CONS:

  • Plateau can happen
  • Gl side effects (nausea, constipation)
  • Doesn't directly increase metabolism

IDEAL PATIENT PROFILE:

  • BMI 27-34 (overweight to mild obesity)
  • First time using GLP-1 medications
  • Wants steady, predictable weight loss
  • Concerned about side effects / more cautious

ALSO GREAT FOR:

  • Women with PCOS
  • Patients with mild insulin resistance
  • People who mainly struggle with portion control / cravings
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Tirzepatide

Class: Dual agonist (GLP-1 + GIP)

WHAT IT DOES:

  • Everything semaglutide does plus:
  • GIP effect -> better insulin sensitivity
  • May reduce fat storage more efficiently

WEIGHT LOSS:

  • ~15-22% body weight

PROS:

  • More powerful than semaglutide
  • Less plateau for many people
  • Better metabolic improvements

CONS:

  • Similar Gl side effects
  • Still relatively new compared to semaglutide
  • Higher cost typically

IDEAL PATIENT PROFILE:

  • BMI 30-40+
  • Has insulin resistance, prediabetes, or type 2 diabetes
  • Has tried semaglutide with plateau or poor results
  • Wants faster, more noticeable transformation
  • Okay paying premium for better results

ALSO GREAT FOR:

  • Patients with visceral fat / belly fat
  • "Yo-yo dieters"
  • Men (often respond extremely well)
  • Patients combining with TRT or peptides
NOT IDEAL IF:
  • Very sensitive to Gl side effects (start lower if so)
  • "Yo-yo dieters"
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Retatrutide

Class: Triple agonist (GLP-1 + GIP + Glucagon)

WHAT IT DOES:

  • Appetite suppression (GLP-1)
  • Insulin & fat metabolism (GIP)
  • Increases energy expenditure / metabolism (glucagon) « this is the game changer

WEIGHT LOSS:

  • ~20-30% body weight (in trials)

PROS:

  • Most powerful of the three
  • Targets both appetite AND metabolism
  • Potential "next-gen" weight loss treatment

CONS:

  • Similar Gl side effects
  • Still relatively new compared to semaglutide
  • Higher cost typically

IDEAL PATIENT PROFILE:

  • BMI 35-50+ (moderate -> severe obesity)
  • Needs aggressive fat loss (20%+)
  • Has metabolic slowdown / low energy expenditure
  • Plateaued on semaglutide or tirzepatide
  • Okay paying premium for better results

ALSO GREAT FOR:

  • Patients with stubborn fat despite dieting
  • Those who say: "I barely eat and can't lose weight"
CONSIDERATIONS:
  • More complex physiology (glucagon = energy burn, but needs monitoring)
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Calculate your BMI.

BMI uses your height and weight to estimate if you're in a healthy range.

Height
ft
in
Weight
lbs
Your BMI
--
Underweight < 18.5
Normal 18.5 – 24.9
Overweight 25 – 29.9
Obese ≥ 30

Compared all three at a glance

Feature Semaglutide Tirzepatide Retatrutide
Hormones targeted GLP-1 GLP-1 + GIP GLP-1 + GIP + Glucagon
Appetite suppression Strong Stronger Strong
Fat loss efficiency Moderate High Very high
Metabolism boost ✕ Slight ✔ Significant
Avg weight loss 10–15% 15–22% 20–30% (trial)
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