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Evidence-based GLP-1 & peptide discussion since 2023
ForumsRetatrutide & Triple AgonistsRetatrutide resting energy expenditure — looking for input Page 2

Retatrutide resting energy expenditure — looking for input

tyler_CSCS Sun, Dec 29, 2024 at 4:01 PM 14 replies 1,666 viewsPage 2 of 3
wei_SG
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Singapore, SG
Dec 29, 2024 at 6:51 PM#6

Sorry if this is a dumb question but how is this different from tirzepatide? I thought Mounjaro was already the "best" option. Now there's something even better? How long until insurance would cover this?

40 11WendyG_ATL, SaraMom3, Dr.MetabolicMD and 37 others
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Dr.EndoIndy
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Oct 2024
Indianapolis, IN
Dec 29, 2024 at 7:08 PM#7

Not a dumb question at all. The key difference is the third receptor:

  • Semaglutide = GLP-1 agonist (one receptor)
  • Tirzepatide = GLP-1 + GIP agonist (two receptors)
  • Retatrutide = GLP-1 + GIP + glucagon agonist (three receptors)

The glucagon component is theorized to increase energy expenditure (thermogenesis) and promote hepatic fat oxidation. So you're not just reducing appetite — you're also potentially burning more calories at rest. That's the mechanistic hypothesis for the superior efficacy.

As for insurance: Lilly hasn't filed yet. Optimistic timeline is FDA approval late 2026, commercial launch early 2027. Insurance coverage usually lags 6-12 months after that, depending on the payor.

Last edited: Dec 29, 2024 at 10:08 PM
39 16LeilaHI, marcus_mpls, DeniseRN_TPA and 36 others
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NeuroNate
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Chicago, IL
Dec 29, 2024 at 7:25 PM#8

One thing that isn't getting enough attention: the TRIUMPH-4 trial is studying retatrutide specifically for MASH (metabolic-associated steatohepatitis). The Phase 2 liver fat data was remarkable — something like 80%+ of participants achieved ≥70% liver fat reduction. If that holds up in Phase 3, retatrutide could be approved for both obesity AND liver disease, which would be a first for any incretin.

This is the drug I'm most excited about in the pipeline, full stop.

Last edited: Dec 30, 2024 at 1:25 AM
12 18sarah_TO, wendy_avl, jason_paloalto and 9 others
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