SharpyRetatrutide vs Ozempic: Head-to-Head Trial Results (2026)
In TRANSCEND-T2D-2, the first head-to-head Phase 3 trial of retatrutide against Ozempic, adults with type 2 diabetes lost 19.5% (9 mg) and 20.9% (12 mg) of their body weight on retatrutide versus 9.4% on Ozempic 2 mg at 80 weeks, and A1C fell 2.2 points versus 1.8, Eli Lilly said on October 28, 2026. Retatrutide caused somewhat more stopping for side effects (4.8% and 7.9% vs 2.7%), and it is still not approved anywhere, so it cannot be legally bought. Whatever you take, losing that much weight makes protein and strength work matter more, which is what Sharpy helps you track.
How does retatrutide compare with Ozempic now that the two have finally gone head to head? In Eli Lilly's TRANSCEND-T2D-2 trial, retatrutide produced more than twice the weight loss of Ozempic 2 mg and a bigger drop in blood sugar. People with type 2 diabetes lost 19.5% to 20.9% of their body weight on retatrutide versus 9.4% on Ozempic over 80 weeks. Lilly announced the topline results on October 28, 2026. Retatrutide is still not approved, so for now this is a look at what may be coming, not a choice you can make at the pharmacy.
What was the retatrutide vs Ozempic trial?
TRANSCEND-T2D-2 (NCT06260722) is a Phase 3 trial run by Eli Lilly. It enrolled 1,298 adults with type 2 diabetes whose blood sugar was not under control on metformin, with or without an SGLT2 inhibitor such as Jardiance or Farxiga. Their starting A1C was between 7.0% and 10.5%.
People were randomly put into three groups: retatrutide 9 mg, retatrutide 12 mg or Ozempic 2 mg, all once a week. Ozempic 2 mg is the highest dose the FDA has approved. Retatrutide started at 2 mg and went up every four weeks until people reached their target dose. The trial was open label, which means people knew which drug they were on.
It is the first Phase 3 trial to compare retatrutide with another drug in its class. A second head-to-head, TRIUMPH-5 against tirzepatide (Zepbound and Mounjaro), has not reported yet. Our retatrutide clinical trials guide lists every study.
Retatrutide vs Ozempic weight loss and A1C results
Here are the main numbers Lilly released. They come from the "efficacy estimand," which estimates the result if everyone had stayed on their drug for the full 80 weeks.
| Result at 80 weeks | Retatrutide 9 mg | Retatrutide 12 mg | Ozempic 2 mg |
|---|---|---|---|
| A1C change (start 8.3%) | -2.2 points | -2.2 points | -1.8 points |
| Weight change (start 225.8 lb) | -19.5% (-44.3 lb) | -20.9% (-47.4 lb) | -9.4% (-20.9 lb) |
| Stopped due to side effects | 4.8% | 7.9% | 2.7% |
In plain English: someone starting at about 226 pounds lost around 21 pounds on Ozempic and around 44 to 47 pounds on retatrutide. Both drugs brought blood sugar down a lot. Retatrutide brought it down a little more.
Lilly also said retatrutide improved non-HDL cholesterol, triglycerides and systolic blood pressure more than Ozempic did. It did not give those numbers yet.
People with type 2 diabetes usually lose less weight on these drugs than people without diabetes. For comparison, in TRIUMPH-1, adults with obesity but no diabetes lost 28.3% on retatrutide 12 mg at 80 weeks. In TRIUMPH-2, people with obesity and type 2 diabetes lost 20.8%, close to what TRANSCEND-T2D-2 found.
Retatrutide vs Ozempic side effects
The most common side effects were stomach problems for both drugs. The rates were closer than many people expect.
| Side effect | Retatrutide 9 mg | Retatrutide 12 mg | Ozempic 2 mg |
|---|---|---|---|
| Diarrhea | 28.3% | 32.7% | 26.4% |
| Nausea | 21.2% | 23.8% | 21.3% |
| Constipation | 14.2% | 13.1% | 19.8% |
| Vomiting | 10.2% | 15.0% | 13.2% |
| Indigestion (dyspepsia) | 10.4% | 8.5% | 11.6% |
| Dysesthesia (odd skin feeling) | 4.8% | 6.5% | 2.7% |
Lilly said most of these were mild to moderate and usually went away during treatment. Two things stand out:
- More people quit retatrutide 12 mg. 7.9% stopped because of side effects, almost three times the 2.7% on Ozempic.
- Dysesthesia showed up again. This is a change in skin feeling, like tingling, burning or extra sensitivity. It has appeared in earlier retatrutide trials too and is something regulators will look at closely.
Ozempic has been on the market since 2017, so its rarer risks, such as pancreatitis and gallbladder problems, are well described on its label. Retatrutide's long-term safety is still being studied.
How retatrutide and Ozempic work
| Retatrutide | Ozempic | |
|---|---|---|
| Maker | Eli Lilly | Novo Nordisk |
| Drug | Retatrutide | Semaglutide |
| Hormone receptors it acts on | GLP-1, GIP and glucagon | GLP-1 |
| How it is taken | Once-weekly shot | Once-weekly shot (a daily pill version also exists) |
| Highest dose tested or approved | 12 mg (tested) | 2 mg (approved) |
| FDA status | Not approved, in Phase 3 | Approved for type 2 diabetes |
GLP-1 and GIP help control appetite and blood sugar. Glucagon may raise the energy the body burns. Hitting all three is the idea behind retatrutide's bigger results. Semaglutide is also sold as Wegovy for weight loss, at higher doses up to 7.2 mg; our Wegovy vs Ozempic guide explains how those two differ.
The muscle question nobody has answered yet
Losing 47 pounds is a lot of weight, and not all of it is fat. Lilly has not shared lean mass or body composition data from this trial. Faster, larger weight loss usually raises the stakes for keeping muscle, especially for people over 50.
That is the part you control on any of these drugs. Sharpy gives you one daily protein target and one 20-minute strength workout, then rolls your progress into a single Shape Score so you can see that the weight coming off is mostly fat. If you are new to lifting, start with our beginner strength program.
Can you get retatrutide instead of Ozempic?
No, not legally. Lilly's own release says retatrutide "has not been approved by FDA or any regulatory organization anywhere in the world," and that anyone selling it to consumers is breaking the law. Vials sold online as "research peptides" are not checked for what is inside. Our guide is retatrutide legal? covers the warning letters and lab tests.
Lilly has said it plans to file for FDA approval in early 2027. Detailed TRANSCEND-T2D-2 results will be presented at a medical meeting and in a journal. Until then, if Ozempic is working for you, there is no reason to change anything. If it is not, talk to your prescriber about the approved options today, including tirzepatide. See our full retatrutide guide for everything else we know.
The bottom line
Retatrutide beat Ozempic 2 mg on both weight loss (about 20% vs 9%) and A1C (2.2 vs 1.8 points) in people with type 2 diabetes, with similar stomach side effects but more people stopping the higher dose. It is a strong result, but it is one company-reported trial of a drug that is not approved yet. Whatever drug you end up on, protect your muscle while the weight comes off. Sharpy keeps it to one protein target, one 20-minute workout and one Shape Score a day.
Sources
- Lilly's retatrutide delivered greater A1C reduction and more than double the weight loss of Ozempic's highest approved dose in head-to-head trial, Eli Lilly via PR Newswire, October 28, 2026
- TRANSCEND-T2D-2, ClinicalTrials.gov NCT06260722
- Ozempic (semaglutide) prescribing information, FDA
- TRIUMPH-1 and TRIUMPH-2 results, Pharmaceutical Executive, July 23, 2026
Questions people ask
Is retatrutide better than Ozempic?
For weight loss and blood sugar in this one trial, yes. In TRANSCEND-T2D-2, people with type 2 diabetes lost about twice as much weight on retatrutide (19.5% to 20.9%) as on Ozempic 2 mg (9.4%) over 80 weeks, and A1C dropped 2.2 points versus 1.8. These are company topline numbers that have not yet been published in a journal. "Better" also depends on side effects, cost and approval, and retatrutide is not approved yet.
Is retatrutide safer than Ozempic?
The trial does not show that. Stomach side effects were in a similar range, but more people stopped retatrutide because of side effects: 4.8% on 9 mg and 7.9% on 12 mg versus 2.7% on Ozempic. Dysesthesia, an odd skin feeling such as tingling or sensitivity, was more common on retatrutide (4.8% and 6.5% vs 2.7%). Ozempic also has years of real-world safety data that a new drug does not have yet.
What is the difference between retatrutide and Ozempic?
Ozempic is semaglutide, which acts on one hormone receptor, GLP-1. Retatrutide, made by Eli Lilly, acts on three: GLP-1, GIP and glucagon, which is why it is called a "triple G" or triple agonist. Ozempic is FDA approved for type 2 diabetes. Retatrutide is still being tested.
Is retatrutide like Ozempic?
They are alike in key ways. Both are once-weekly shots, both act on the GLP-1 receptor, and both mostly cause stomach side effects such as nausea, diarrhea and constipation. The big difference is that retatrutide also hits the GIP and glucagon receptors, and in trials it has produced more weight loss.
Can I switch from Ozempic to retatrutide?
Not legally today. Retatrutide is not approved by the FDA or any other regulator, and Lilly says anyone selling it to consumers is breaking the law. The only legal way to take it now is in a clinical trial. Do not stop or change your Ozempic dose without your prescriber.
When will retatrutide be available?
Lilly has said it plans to submit retatrutide to the FDA in early 2027. FDA reviews usually take many months, so a realistic launch is unlikely before late 2027 at the earliest. No price has been announced.
Does retatrutide cause more muscle loss than Ozempic?
Lilly has not released body composition data from TRANSCEND-T2D-2, so no one can say yet. In general, bigger and faster weight loss means more chance of losing some muscle along with fat, which is why eating enough protein and doing strength training matter on any of these drugs.