What is the best GLP-1 for weight loss?

The leaderboard by average trial weight loss: | Medication | Average loss | Status | | --- | --- | --- | | Retatrutide | ≈24% (phase 2) | Investigational — not available | | Tirzepatide (Zepbound) | ≈21% (SURMOUNT-1) | Approved | | Semaglutide 2.4 mg (Wegovy) | ≈15% (STEP 1) | Approved | | Oral semaglutide 25 mg | ≈15% (OASIS 4) | Under review | | Liraglutide (Saxenda) | ≈8% (SCALE) | Approved, generic | But the leaderboard answers a narrower question than people think. The drug that wins your case is decided by: - Response: averages hide huge spread. Plenty of individuals lose 25% on semaglutide or 10% on tirzepatide. An adequate trial of one drug (3–4 months at meaningful doses) tells you more than any table. - Tolerability: the best drug you quit by week 6 is worse than the second-best you take for two years. - Comorbidities: existing heart disease argues for semaglutide (SELECT-proven); sleep apnea gives Zepbound an on-label lane. - Money: coverage and cash price differences of $200+/month compound over a multi-year therapy — see the cost guide. - Form: needle-averse? The calculus shifts toward oral and sublingual options. The good news embedded in all of this: you are choosing among multiple excellent options, switching is routine, and the pipeline keeps improving.