The Zhitong Finance App learned that some media quoted information revealed by people familiar with the matter as reporting that after another patient applied and began receiving this medication, American healthcare industry leader Lilly (LLY.US) will allow more patients to apply for a special channel to use its experimental diet drug retatrutide.
According to information, Retatrutide, a new-generation diet drug created exclusively by Eli Lilly, is currently in phase III clinical trials and is one of the most anticipated drugs in Eli Lilly's R&D pipeline. The drug has a triple mechanism of action and is a combined agonist of glucagon-like peptide-1 (GLP-1), glucose-dependent insulin-stimulating polypeptide (GIP), and glucagon receptors. Eli Lilly's blockbuster weight loss drug Zepbound (i.e. tirpotide) is a GLP-1 and GIP combined receptor agonist.
An Eli Lilly spokesperson told STAT News that a small number of patients who meet specific criteria and are unable to participate in clinical trials can make separate special applications, adding that the company is reviewing applications submitted by doctors.
Eli Lilly broadens special access and plans to file with the FDA in the first quarter of 2027. It is advancing the global diet pills market of about 100 billion US dollars. Retatrutide hit a higher weight loss limit using the triple agonist mechanism of GIP, GLP-1, and glucagon. The maximum dose in the phase 3 trial reduced the average weight loss by 28.3% over 80 weeks. Zepbound's sales and demand are already very strong: US sales reached US$4.1 billion in the first quarter of 2026, up 79% year on year. Strong demand also drove Eli Lilly to raise its 2026 full-year revenue guide to US$82 billion to US$85 billion. Lilly plans to use Retatrutide to build a “second-generation growth curve” based on Zepbound's already huge commercial success.
Eli Lilly expands special access to Retatrutide. The first explanation is that patients with severe obesity have strong unmet demand for drugs with higher efficacy, but this is still an extended medication plan for a small number of patients who are unable to participate in clinical trials and are not effective enough at the current maximum dose. This does not mean early approval or formal commercialization.
Next generation weight loss pills
Retatrutide is seen as a core candidate for Eli Lilly's “next generation weight loss drug” created after tiverpotide. Zepbound (Zepbound) has been approved for marketing. It is a weekly GIP+GLP-1 dual agonist. It mainly reduces weight loss by reducing appetite and caloric intake, delaying gastric emptying, and improving insulin sensitivity.
Retatrutide added glucagon receptors to this, making it a “triple agonist” that simultaneously activates GIP, GLP-1, and glucagon receptors in one molecule. The new glucagon pathway can theoretically further promote energy consumption and fat metabolism, so Retatrutide not only enhances “eating less,” but also tries to increase “energy consumption,” which is the underlying mechanism that distinguishes it from terpopeptides.
In terms of efficacy, Retatrutide has shown a higher weight loss limit at the current trial stage: in the TRIUMPH-1 phase III trial, the average weight loss in the 12 mg group was 28.3% in 80 weeks. Among them, 45.3% of patients lost at least 30% of weight, and the curative effect began to approach the weight loss range; some patients with severe obesity reached an average weight loss of 30.3% after extending it to 104 weeks. In contrast, in the Surmount-1 trial on which Zepbound was approved, the maximum dose of 15 mg lost an average of about 48 pounds in 72 weeks, corresponding to a weight loss of about 20% or more. It should be emphasized that Eli Lilly is still conducting a phase III clinical study directly comparing the two, but the final verification results have not yet been announced.
Zepbound is an active mainstay that has been approved and evidence of efficacy and safety is mature; Retatrutide is a next-generation drug candidate that has not been approved by any regulatory agency. Eli Lilly plans to apply for US approval in the first quarter of 2027 after completing the complete application materials. Common adverse effects of Retatrutide are still mainly gastrointestinal symptoms such as nausea, diarrhea, and constipation. Paresthesia was also observed in some phase III trials, and the rate of discontinuation of the drug due to adverse effects in the higher dose group also needs to be continuously assessed. Therefore, it is more likely to target patients with severe obesity, inadequate weight loss with existing dual-target drugs, or complex metabolic complications rather than simply and immediately replacing alpopeptides.
The 100 billion dollar diet drug market enters the finals of efficacy, production capacity and affordability
As far as the global diet drug market is concerned, diet drug leaders such as Eli Lilly and Novo Nordisk are focusing on “next-generation diet pills”, which means that the competition is being upgraded from “whether GLP-1 is effective” to a comprehensive competition of multi-target efficacy, oral convenience, complication benefits, and long-term compliance.
If retatrutide is successfully approved, Eli Lilly will form a stratified product matrix for Zepbound to cover mainstream patients, expand initial treatment groups with oral medications, and retatrutide compete for patients with high BMI and difficult to treat, thereby extending the growth cycle of metabolic diseases and reducing the risk of dependence on tirpopeptides alone. Eli Lilly's fundamentals are a major benefit in the medium to long term, but its high valuation already includes strong expectations of success. Ultimately, stock price elasticity still depends on long-term safety, gastrointestinal tolerance, insurance coverage, pricing, diet drug product line capacity expansion, and product performance of competitors such as Novo Nordisk; expanding special access itself is closer to demand expectations and verification signals, rather than a real profit catalyst.
The mainstream institutional forecast range for the global pure diet pills market around 2030 is about US$95 billion to US$105 billion. If diabetes, cardiovascular and other metabolic indications are included, the broad market limit could be close to US$200 billion.
Goldman Sachs recently predicted that the global anti-obesity drug market will reach about US$95 billion by 2030; Morgan Stanley's benchmark scenario is US$105 billion, and the optimistic scenario is US$144 billion. If we start with sales of about US$6 billion in 2023, the benchmark scenario implies a compound growth rate of about 50.5% from 2023; J.P. Morgan predicts that the global pancreatic market, which includes diabetes and obesity indications, will reach 200 billion US dollars by 2030, with a wider range of estimates and statistics.