Mazdutide: the GLP-1/glucagon dual agonist approved in China

Most of the incretin drugs that dominate Western headlines were designed and trialed in the United States and Europe. Mazdutide is different. It is a GLP-1 and glucagon dual receptor agonist that Eli Lilly out-licensed to the Chinese company Innovent Biologics, and its pivotal evidence — and its first regulatory approvals — came out of China. If semaglutide hits one incretin receptor and tirzepatide hits two, mazdutide takes a different two-receptor route. Here is what the trials actually show, and exactly where it is and is not approved.

What it is: a two-receptor drug that isn't tirzepatide

Mazdutide (development codes IBI362 and LY3305677) is a once-weekly injectable peptide built on oxyntomodulin, a natural gut hormone that activates both the GLP-1 and the glucagon receptors. That combination is the whole point. The GLP-1 component suppresses appetite and improves glucose handling the way the familiar incretin drugs do; the glucagon component is intended to raise energy expenditure and mobilize liver fat. Innovent developed it in China under an exclusive license from Eli Lilly, and early Phase 1b work in Chinese patients with type 2 diabetes established the dual-agonist profile.^[4] Note the contrast with tirzepatide, whose second receptor is GIP, not glucagon — these are genuinely different mechanisms, not two names for the same idea.

The Phase 2 groundwork

A randomized, double-blind, placebo-controlled Phase 2 obesity trial enrolled 248 Chinese adults with overweight or obesity across doses up to 6 mg. Over 24 weeks, mean weight loss was about 6.7% at 3 mg, 10.4% at 4.5 mg and 11.3% at 6 mg, versus a roughly 1% gain on placebo.^[1] A separate Phase 2 trial in Chinese adults with type 2 diabetes ran mazdutide against both placebo and active-comparator dulaglutide over 20 weeks: HbA1c fell by roughly 1.4 to 1.7 percentage points across mazdutide doses (versus about 1.4 with dulaglutide and essentially no change on placebo), with weight loss up to about 7.1%.^[2] So even before Phase 3, the drug showed the dual-purpose metabolic signature you would expect — weight and glucose moving together.

The headline: the GLORY-1 Phase 3 obesity trial

GLORY-1 is the pivotal study. In this Phase 3, double-blind, placebo-controlled trial, 610 Chinese adults with overweight or obesity were randomized 1:1:1 to mazdutide 4 mg, mazdutide 6 mg or placebo for 48 weeks. At week 48, mean weight change was about −11.0% at 4 mg and −14.0% at 6 mg, versus roughly +0.3% on placebo. Nearly half of the 6 mg group (about 49.5%) lost at least 15% of body weight, compared with 2% on placebo.^[3] The trial also reported beneficial effects across prespecified cardiometabolic measures, and gastrointestinal events were the most common adverse effects — mostly mild to moderate, with low discontinuation rates.^[3] Those magnitudes sit in the range of the leading approved agents but come from a single-country program, so cross-trial comparison with Western trials is suggestive, not definitive.

For context on how the field is stacking up, our coverage of retatrutide's Phase 2 data, the oral contender orforglipron, and the CagriSema REDEFINE results lays out the moving benchmarks. Mazdutide's distinguishing feature is less the headline percentage than the glucagon-driven emphasis on visceral and hepatic fat.

Regulatory status — read this carefully

This is where precision matters. China's National Medical Products Administration (NMPA) approved mazdutide for chronic weight management in June 2025, making it the first dual glucagon/GLP-1 receptor agonist approved anywhere for weight loss.^[5] The NMPA subsequently approved it for glycemic control in adults with type 2 diabetes in September 2025.^[6] A supplementary application for a higher 9 mg dose aimed at moderate-to-severe obesity is under NMPA review, supported by the GLORY-2 program, in which the 9 mg dose reported up to about 20.1% weight loss.^[7] Critically, these approvals are Chinese. Mazdutide is not approved in the United States, and outside China it remains investigational. Anyone implying US availability is wrong.

The honest bottom line

Mazdutide is a real, approved obesity and diabetes drug — in China — with a coherent mechanism and robust randomized Phase 2 and Phase 3 data behind it. The evidence grade is moderate: the trials are well-designed but concentrated in Chinese populations, there are no published long-term cardiovascular outcomes trials yet, and data outside China are limited. The glucagon component is the interesting variable to watch, both for its potential hepatic and energy-expenditure benefits and for the cardiometabolic safety questions that longer studies exist to answer. Treat mazdutide as a promising, regionally approved entrant — not as something available or endorsed for use in the US.