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These approaches have led to significant weight loss with the dual GLP-1/glucagon receptor agonist survodutide (-13.5% with the 6-mg dose at 76 weeks in a phase 3 SYNCHRONIZE-1 trial) [16] , the dual GLP-1 receptor agonist and GIP antagonist Maridebart cafraglutide (known as MariTide) (-12.3% to -16.2% across different doses at 52 weeks in a phase 2 trial) [17] or the triple GLP-1/GIP/glucagon receptor agonist retatrutide (-24.2% with the 12-mg dose at 48 weeks in a phase 2 trial) [18]

They pushed patients toward unregulated gray-market sources: research use only vendors with no pharmaceutical oversight, no quality control, and no guarantee of purity or correct dosing