After years of thinking about hunger and weight, I understand why a new treatment headline can feel personal. Could this make things easier? Could food take up less space in my head? Could I have more energy for the rest of my life?
Then comes another unfamiliar name to decode.
Amylin is one I think is worth understanding. It gives researchers another route to investigate appetite and metabolic health, including combinations with medicines you may already have heard about.
A review by Panou and colleagues in Diabetes Therapy, published on 28 September 2026, brings together zenagamtide, eloralintide and CagriSema. It discusses existing studies; it did not recruit new patients. Its research search ended in June 2026, so I have also kept later trial reports in view.
The update dated 1 October 2026 adds the 30 September EloraTZP announcement and the ZUPREME-1 publication update. Those findings were not in the earlier review.
These approaches remain under clinical development in the sources discussed here. A result does not establish Australian approval or routine availability. That distinction matters when asking a clinician about options available now.
First, what is amylin?
Amylin is a hormone released by the pancreas alongside insulin. It helps with appetite and blood sugar after eating, including signals of fullness and how quickly the stomach empties. Researchers are developing treatments that act on that pathway.
“After GLP-1” does not mean GLP-1 medicines are being left behind. Several of these approaches combine the pathways.
Here is how I keep the names straight. CagriSema combines cagrilintide, which acts like amylin, with semaglutide, the active ingredient in Ozempic and Wegovy. Zenagamtide, previously called amycretin, brings amylin and GLP-1 activity into one molecule; oral and injected forms are being studied.
Eloralintide acts on amylin receptors without a GLP-1 component when studied alone. EloraTZP combines it with tirzepatide, the GIP/GLP-1 medicine known as Mounjaro and Zepbound. Petrelintide is a long-acting amylin analogue studied on its own in ZUPREME-1.
The names matter because a result for a combination does not establish what one ingredient does alone. Nor are trial formulations interchangeable with products offered online.
Three big numbers, three different stories
The weight-loss figures are striking. But putting them beside each other does not create a fair ranking: the people, time periods and ways of calculating results differ.
| Treatment studied | Reported result | What to keep beside it |
|---|---|---|
| Injected zenagamtide | 24.3% at 36 weeks | One group in a small early Phase 1b/2a obesity trial; 1.1% with placebo. |
| Eloralintide | 20.1% at 48 weeks | Phase 2, without diabetes; estimated continued-treatment results; 0.4% with placebo. |
| CagriSema | 22.7% at 68 weeks | Phase 3 REDEFINE 1, without diabetes; estimated continued-treatment results; 2.3% with placebo. |
For CagriSema, another calculation from the same trial allowed for people stopping or needing additional treatment. It estimated 20.4% versus 3.0%. That is not a contradiction: it asks a different question. I would keep both estimates labelled rather than simply choosing the larger one.
A percentage also means something different depending on starting weight. Twenty per cent of 100 kg is 20 kg; twenty per cent of 80 kg is 16 kg. Those are examples of the calculation, not predictions.
Zenagamtide now also has a published Phase 2 trial in people with type 2 diabetes. The 24.3% figure belongs to the earlier obesity study, not that later trial.
Our research section keeps the details together for zenagamtide, eloralintide and CagriSema.
A larger effect, or something easier to live with?
The late-September reports make that question especially interesting. Lilly reported 23.3% average weight loss with EloraTZP versus 14.8% with tirzepatide alone over 48 weeks in a Phase 2b trial involving people with type 2 diabetes.
But 10.8%–27.0% across the combination groups stopped because of adverse events, compared with 2.9% taking tirzepatide. The weight calculations assume continued treatment. These are still company-reported findings.
That makes the experience of staying on treatment central to the story. A bigger possible effect does not tell us whether the balance suits someone’s priorities.
Petrelintide raises a different question. ZUPREME-1 reported 10.7% weight loss versus 1.7% with placebo at 42 weeks. Its peer-reviewed publication adds detail to earlier reporting. Low vomiting and stomach-and-bowel-related stopping rates are encouraging, but nausea was more common than with placebo.
There was no direct comparison with a GLP-1 medicine, and the EloraTZP and petrelintide trials involved different people and durations. We cannot use them to decide which is best for every woman.
Explore the EloraTZP findings, the petrelintide results and my longer EloraTZP feature.
Why “remission” needs its own explanation
The review reports diabetes remission in around 53% of the higher-dose CagriSema group versus 20% with placebo in REIMAGINE 1. The assessment came after 40 weeks of treatment followed by 12 weeks off treatment.
The criterion was HbA1c, a measure of blood sugar over time, below 6.5% without diabetes medicine. So the timing matters: researchers looked at whether that result persisted through a defined period after stopping.
The participants had previously managed diabetes with diet and exercise. This does not predict the same outcome for everyone with diabetes, or establish permanent remission.
“Cured” would go too far. The international consensus calls for ongoing follow-up because blood glucose can rise again. Any decision about changing prescribed treatment belongs with the treating clinician.
The questions I want women to be able to ask
Will eating feel less mentally demanding? Food noise is a phrase that makes sense to me because of my own experience. But an appetite mechanism or weight reduction alone does not prove relief from persistent thoughts about food. I want studies to ask people directly, alongside questions about eating and quality of life. These reports cannot promise benefits for ADHD or addiction.
Will I feel stronger and more capable? A scan showing body-composition changes is different from someone being able to climb the stairs more easily. The headline figures do not establish muscle preservation or better everyday function for every woman.
Were women like me studied? Women made up 78% of the eloralintide Phase 2 trial, which is useful representation. It still does not give us a menopause-specific answer. I want to know about life stage, age and starting function too.
Could I continue treatment? CagriSema and zenagamtide studies reported nausea and other stomach and bowel symptoms. Eloralintide also had fatigue. The earlier studies were not a direct three-way comparison. EloraTZP compared with tirzepatide; ZUPREME-1 compared with placebo. A different pathway does not itself promise fewer side effects.
Then there are food, cost, access, practical support and what matters to you. Our nourishment guidance offers a separate starting point for discussing eating adequately and strength; it is not proof of an amylin-specific benefit.
What I am watching at EASD
Novo Nordisk’s congress schedule lists 29 September presentations on CagriSema body composition in REIMAGINE 1 and a later analysis of patient-reported physical function with cagrilintide in REDEFINE 1.
I am not drawing numerical conclusions from those programme listings. They tell us the topics, not the size or certainty of a benefit. We need to see the analyses, who was included and what information was missing. Someone reporting better physical function is also different from a measured gain in muscle strength.
The questions I am keeping
Which outcome matters most to me? Were people with my health circumstances included? How many stopped, and why? What do we know about longer-term benefit and harm? What would help me stay nourished and active?
There is room for hope here. More approaches give researchers more possibilities to test. What I want for women is more than another impressive percentage: useful improvements in the parts of life we care about, with benefits and uncertainties we can understand.