GLP-1s Explained: What Each One Does in 2026

Last updated: August 19, 2026. Originally published October 24, 2025. This update adds the two GLP-1 pills approved in 2026, the newer approved uses beyond weight and blood sugar, and the current rules on compounded options.

This article is general education, not medical advice. Talk with a licensed clinician about which option, if any, fits your situation.

GLP-1 medications copy a gut hormone that manages blood sugar and appetite, and the category grew substantially in 2026. Two weight-management pills joined the injectable options, the Wegovy pill containing oral semaglutide and Foundayo containing orforglipron (AJMC). Approved uses now reach past weight and diabetes into heart risk, sleep apnea, and liver disease (Wegovy Prescribing Information). Compounded versions still exist, on narrower legal ground than during the shortage.

Who This Helps

If you're trying to figure out what these medicines actually do before starting one, this is for you. Same if you've lost track of which name is which, or if you read up on GLP-1s a year ago and suspect things have moved since. They have.

What Is a GLP-1, and What Does It Do?

GLP-1 stands for glucagon-like peptide-1, a hormone your intestines release after you eat. It signals the pancreas to release insulin when blood sugar is high, slows how fast food leaves your stomach, and tells your brain you have had enough.

The medications are GLP-1 receptor agonists, which means they activate the same receptor that hormone acts on. They reinforce systems your body already runs rather than overriding them, and that's why people describe appetite as feeling different rather than gone.

One update matters for how you read labels now. The current Wegovy label describes who the medicine is for in clinical categories rather than BMI numbers, covering adults with obesity and adults with overweight who have at least one weight-related condition (Wegovy Prescribing Information). The familiar figures of 30, or 27 with a condition, come from the clinical trials rather than the indication itself.

What Are the Different Types?

By 2026 the category splits three ways, and the differences affect dosing, side effects, and cost.

Single-target peptides: semaglutide and liraglutide act on the GLP-1 receptor alone. These are injectable peptides, apart from oral semaglutide.
Dual-target peptides: tirzepatide acts on both the GLP-1 and GIP receptors, which is why it is described as a dual agonist rather than a plain GLP-1.
Small-molecule pills: orforglipron activates the GLP-1 receptor but is built from simpler chemistry than a peptide, which is what allows a daily tablet with no food or water restrictions (Eli Lilly).

If you want a deeper comparison between the two most-discussed molecules, our piece on tirzepatide versus semaglutide covers it, and GLP-1s versus peptides explains why not every peptide is a GLP-1.

Which Medications Are Approved, and for What?

People mix these names up constantly, and honestly it's not their fault, because two different brands can contain the exact same molecule. Here they are in the same format so the differences are easier to hold onto.

Wegovy (semaglutide, weekly injection): approved for weight management, to reduce major cardiovascular events in adults with established heart disease and obesity or overweight, and for a form of fatty liver disease called MASH with moderate to advanced fibrosis (Wegovy Prescribing Information).
Wegovy pill (oral semaglutide, daily tablet): the first oral GLP-1 approved for weight management, with weight loss in its main trial close to the injection (AJMC).
Foundayo (orforglipron, daily tablet): the first small-molecule GLP-1 pill, and the only one that can be taken any time of day without food or water restrictions (Eli Lilly).
Ozempic (semaglutide, weekly injection): approved for type 2 diabetes, and prescribed off-label for weight by some clinicians.
Mounjaro (tirzepatide, weekly injection): approved for type 2 diabetes, acting on both GLP-1 and GIP receptors.
Zepbound (tirzepatide, weekly injection): approved for weight management and, since December 2024, for moderate to severe obstructive sleep apnea in adults with obesity (Eli Lilly).
Rybelsus (oral semaglutide, daily tablet): approved for type 2 diabetes, and the oral semaglutide product that predates the weight-management pill (PR Newswire).
Saxenda (liraglutide, daily injection): an earlier GLP-1 approved for weight management, and the first to have a generic version, launched in August 2025 (Teva).

What this means for you: the molecule matters more than the brand. Wegovy and Ozempic are both semaglutide with different approved uses, and Zepbound and Mounjaro are both tirzepatide. Which one your insurance covers often depends on which approved use your diagnosis matches.

How Much Do They Differ in Results?

The one head-to-head trial between the two leading injections found tirzepatide produced greater average weight loss than semaglutide, about 20.2% versus 13.7% at 72 weeks (New England Journal of Medicine). The pills land lower on average than the strongest injection, and individual response varies widely, so an average is a starting point only.

What Else Are They Approved to Do?

This is the biggest change since the original version of this article. These are no longer only weight and blood sugar drugs. Approved uses now include reducing the risk of heart attack, stroke, and cardiovascular death in adults with established heart disease plus obesity or overweight (FDA), treating moderate to severe obstructive sleep apnea in adults with obesity (Eli Lilly), and treating MASH with moderate to advanced liver scarring (Wegovy Prescribing Information).

The MASH approval came through the accelerated pathway based on improvement in the disease and fibrosis, which means continued approval may depend on a confirmatory trial (Wegovy Prescribing Information). That is a normal condition of accelerated approval and worth knowing when you read about it.

What About Compounded GLP-1 Options in 2026?

Compounded GLP-1 products still exist, though the legal footing shifted under everyone's feet. During the national shortage the FDA allowed wider compounding. That shortage ended and the agency's temporary flexibility expired, so compounding now rests on a documented, patient-specific reason rather than on supply (FDA).

A pending decision could narrow it further. In April 2026 the FDA proposed excluding semaglutide, tirzepatide, and liraglutide from the list of bulk substances that 503B outsourcing facilities may use, stating that it "did not identify sufficient clinical need for outsourcing facilities to compound these drugs from bulk substances" (FDA). The comment period has closed and no final determination has been issued as of this update, so treat it as pending rather than settled.

Liraglutide sits in a different position from the other two, and it is worth understanding why. Drug shortage status is a separate pathway from the bulks list, and liraglutide supply has been reported as constrained more recently than semaglutide or tirzepatide, which both came off the shortage list earlier. A generic liraglutide is also now available (Teva). Because shortage status changes, check the current entry in the FDA's shortage database rather than relying on any article, including this one (FDA Drug Shortages database).

Two framing points that have not changed. Compounded preparations are not FDA-approved finished drugs, and the FDA has said companies cannot market them as generic or as the same as an approved drug (FDA). At the same time, licensed compounding is a legitimate pathway that a prescriber and patient may choose together, and it is not the same thing as buying from an unlicensed seller.

What this means for you: if a compounded option is on the table, the question to ask is what the documented clinical reason is for your specific case, and which licensed pharmacy is making it. Our explainer on 503A and 503B pharmacies covers who makes what, and what changed in compounding covers the shift away from shortage-era rules.

What Is Coming Next?

Several candidates are in late-stage testing and none of them are available yet. CagriSema pairs semaglutide with an amylin analogue and is under FDA review. Retatrutide targets three receptors and remains investigational. MariTide is an experimental once-monthly injection in Phase 3, and elecoglipron is an experimental daily pill also in Phase 3.

One legal point belongs with that list. The FDA has stated that retatrutide and cagrilintide cannot be used in compounding under federal law and are not components of approved drugs (FDA). Anything sold as compounded retatrutide is outside the licensed system, which our guide to grey-market peptides covers in more detail.

What Should You Expect When Starting?

Most people notice earlier fullness, fewer cravings, and smaller portions within the first few weeks. Stomach-related side effects are the most common problem, including nausea, constipation, diarrhea, and vomiting, and they often ease as the dose is increased slowly.

The labeling also carries a boxed warning about thyroid tumors seen in rodent studies, and these medicines are not for anyone with a personal or family history of medullary thyroid carcinoma or MEN 2, or a prior serious allergic reaction to the drug (Wegovy Prescribing Information). That screening only works if your prescriber has your full history.

Worth planning for from the start: benefits tend to fade if treatment stops, which our article on what happens after you stop a GLP-1 covers with the 2026 trial data. If you have not had the conversation yet, how to ask your doctor about a GLP-1 is a good place to begin, and common GLP-1 misconceptions clear up the myths that circulate most.

How Do You Find a Legitimate Source?

Whether you end up on an approved brand or a compounded preparation, two things carry the weight: a licensed prescriber who has reviewed your history, and a pharmacy licensed in your state. You can compare providers, pricing, and the pharmacies they work with using the GLP Winner provider survey.

Be precise about the word generic, because it gets used loosely. A generic version of liraglutide exists and is FDA approved (Teva). There is no approved generic of semaglutide or tirzepatide in the United States, so anything sold as generic Ozempic, generic Wegovy, or generic Zepbound is not a generic at all. Compounded preparations are also not generics, and the FDA has said companies cannot market them as such.

Steer clear of sellers offering research peptides or products marketed as generic versions of semaglutide or tirzepatide (FDA).

Final Takeaway

GLP-1 medications work with hormones your body already uses to manage hunger and blood sugar. That basic idea hasn't changed, and it's still the clearest way to think about them.

What changed in 2026 is the menu. Two weight-management pills joined the injections, and approved uses now reach into heart risk, sleep apnea, and liver disease.

Compounded options still exist on narrower legal ground, and a pending FDA decision could narrow it again. Ask what the clinical reason is and which licensed pharmacy is involved.

There's no single best one here. The right choice depends on your diagnosis, your coverage, and how your body handles side effects, which makes it a conversation with your clinician rather than a ranking you can look up.

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Frequently Asked Questions

What is the difference between Wegovy and Ozempic?

Both contain semaglutide, and they carry different approved uses. Wegovy is approved for weight management, cardiovascular risk reduction, and a form of fatty liver disease, while Ozempic is approved for type 2 diabetes. Which one you can get often depends on which diagnosis you have.

Is there a GLP-1 pill now?

Yes, two are approved for weight management. The Wegovy pill contains oral semaglutide, and Foundayo contains orforglipron, which is a small-molecule GLP-1 that can be taken any time of day without food or water restrictions.

What is the difference between Zepbound and Mounjaro?

Both contain tirzepatide, which acts on the GLP-1 and GIP receptors. Zepbound is approved for weight management and for moderate to severe obstructive sleep apnea, while Mounjaro is approved for type 2 diabetes.

Are compounded GLP-1s still available in 2026?

Compounding continues, but on narrower footing than during the shortage. It now depends on a documented patient-specific reason rather than supply problems, and a proposal to exclude semaglutide, tirzepatide, and liraglutide from the 503B bulk substances list is pending with no final decision issued.

Which GLP-1 works best for weight loss?

In the one head-to-head trial between the leading injections, tirzepatide produced greater average weight loss than semaglutide. Averages are not predictions, individual response varies considerably, and the best option also depends on side effects, cost, and coverage.

GLP-1s Explained: What Each Medication Actually Does in 2026