Lilly announced new topline results from a phase three study for its next generation obesity and diabetes medicine yesterday. The drug, retatrutide, is a triple receptor agonist and it scored a dual win in this study. The primary aim of this study was to treat type 2 diabetes and show a good effect in lowering HbA1c – a key measure of glucose control. It met this aim with a reduction of A1c of 1.7 to 2.0%, depending on the dose. This is comparable to what is seen with tirzepatide.

The secondary aim – weight reduction – was a big win. In this 40-week study, these patients with diabetes lost up to 16.8% of their starting weight. Now this is not comparative study. Nonetheless, it’s worth noting that this amount of weight loss is greater than was seen in a similar study of tirzepatide in persons with type 2 diabetes. Weight reduction is notoriously hard for persons who have diabetes.

A High Water Mark for Weight Loss?

So these are excellent results. In fact, the weight loss numbers are among the highest ever in a population of patients with type 2 diabetes. Lilly executive vice president Kenneth Custer pointed out the significance of this:

“For many people with type 2 diabetes, it is a struggle to achieve both A1C control and weight loss, since obesity has historically been harder to treat for those with type 2 diabetes. With triple agonist retatrutide, we set out to make a molecule that could help patients achieve substantial A1C reduction and weight loss.”

In the TRIUMPH-4 study of retatrutide in persons with obesity but not diabetes, the topline weight loss number was 28.7% at the highest dose. In fact, some patients in retatrutide trials have expressed concern or even withdrawn from taking the drug because they felt they were losing too much weight.

Indeed, it may be that retatrutide will establish a high water mark for the weight loss outcomes a new obesity medicine can deliver.

Ready to Shift Focus to Health Gains?

This might be the best news emerging from clinical trial results with retatrutide. Perhaps knowing the top of the range for weight loss will set people free to shift their focus. The much needed shift is from weight loss to health gains. Retatrutide might make people stop and think that more weight loss is not always better.

In fact, the whole point of treating obesity as a chronic disease is long-term gains in health. Not short-term weight loss. Perhaps retatrutide can help us make this shift in focus that we need so much.

Click here for the announcement of topline results from Lilly, here, here, and here for further perspective.

Triple Portrait of Marthe, painting by Maurice Denis / WikiArt