Eloralintide: what the first trial shows about Lilly's weekly amylin shot
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Eloralintide is a new weekly weight-loss shot that is still being tested. In one mid-sized trial people on the highest dose lost about a fifth of their weight in 48 weeks, with nausea and tiredness as the main downsides. It is not approved, and the big trials run to 2028.
Eloralintide is an experimental once-weekly injection from Eli Lilly that copies amylin, a hormone that signals fullness. It is not a GLP-1 drug and it is not approved in any country. In its 48-week phase 2 trial in 263 adults, people who stayed on the 9 mg dose lost about 20% of their body weight, against 0.4% on placebo. Nausea and fatigue were the most common side effects. Five phase 3 trials are recruiting, and none is due to finish collecting its main data before 2028.
- What it is: a selective amylin receptor agonist, injected under the skin once a week. Lilly's code name for it is LY3841136.
- The trial: 263 adults with obesity, or overweight with a weight-related condition, and no type 2 diabetes. 46 US centres, 48 weeks, double-blind, against placebo. Published in The Lancet.
- Weight at 48 weeks, for people who stayed on treatment: 9% lower on 1 mg, 12% on 3 mg, 18% on 6 mg and 20% on 9 mg. Placebo: 0.4%.
- Side effects on 9 mg: nausea in 33% (placebo 14%) and fatigue in 43% (placebo 12%).
- Still unknown: how it compares with a GLP-1 drug, what happens after stopping, and how it does beyond 48 weeks.
- You cannot be prescribed it. Anything sold online under this name is not the product that was studied.
Graded by CureMed against human clinical evidence, and reviewed by CureMed Labs.
Eloralintide: 20% weight loss in 48 weeks — the appetite shot that is not a GLP-1
Eloralintide in 33 seconds: Eli Lilly's once-weekly shot that copies amylin, not GLP-1. In its 48-week phase 2 trial in 263 adults, people who stayed on the top dose lost about 20% of their weight, against almost nothing on placebo. One in three felt nausea and four in ten felt tired. It is not approved, and the main phase 3 trial runs into 2028.
What eloralintide is
Eloralintide is a once-weekly injection under the skin, developed by Eli Lilly under the code name LY3841136. The published trial describes it as a selective amylin receptor agonist: a drug that switches on the same receptor as the body's own amylin.
That makes it a different kind of drug from semaglutide (Wegovy, Ozempic), which copies GLP-1, and from tirzepatide (Zepbound, Mounjaro), which copies GLP-1 and a second gut hormone, GIP.
The trial at a glance
| What the paper reports | |
|---|---|
| Design | Phase 2, randomised, double-blind, placebo-controlled, seven groups |
| People | 263 adults aged 18 to 75 at 46 research centres in the United States; 78% women; average age 49; average weight 109 kg; average BMI 39 |
| Who could join | A BMI of 30 or more, or 27 or more with at least one weight-related condition; nobody with type 2 diabetes |
| Groups | Placebo (53 people) · 1 mg (28) · 3 mg (24) · 6 mg (28) · 9 mg (54) · 6 mg stepped up to 9 mg (24) · 3 mg stepped up to 9 mg (52) |
| Length | 48 weeks, one injection a week |
| Main measure | Per cent change in body weight after 48 weeks |
| Paid for by | Eli Lilly, which makes the drug; seven of the ten authors are Lilly employees |
Weight loss by dose
Average change in body weight after 48 weeks
| Weekly dose | People | Weight change | 95% confidence interval |
|---|---|---|---|
| Placebo | 53 | −0.4% | −2.2% to +1.4% |
| 1 mg | 28 | −9% | −12.6% to −6.3% |
| 3 mg | 24 | −12% | −14.9% to −9.8% |
| 6 mg | 28 | −18% | −20.7% to −14.5% |
| 9 mg | 54 | −20% | −22.7% to −17.5% |
| 6 mg, then 9 mg | 24 | −20% | −22.7% to −17.0% |
| 3 mg, then 9 mg | 52 | −16% | −18.6% to −14.1% |
The average person in the trial weighed 109 kg (240 lb). Twenty per cent of that is about 22 kg, or 48 lb.
These figures are the trial's efficacy estimand: an estimate of what happens to people who stay on the drug. The abstract does not give the other common measure, which counts everyone who started whether or not they kept taking it. That one is usually somewhat lower.
Side effects by dose
The two most common side effects
| Weekly dose | Nausea | Fatigue |
|---|---|---|
| Placebo | 14% | 12% |
| 1 mg | 11% | 0% |
| 3 mg | 13% | 13% |
| 6 mg | 64% | 29% |
| 9 mg | 33% | 43% |
| 6 mg, then 9 mg | 54% | 46% |
| 3 mg, then 9 mg | 25% | 21% |
Fatigue stands out. With the GLP-1 drugs the most common complaints are in the stomach and gut. Here, more than four in ten people on the highest doses also reported tiredness.
The authors' own summary is that the drug was "generally well tolerated". The abstract does not say how many people stopped because of side effects.
How to read these numbers
- It is one trial of 263 people. The 9 mg result rests on 54 of them.
- It ran for 48 weeks. Nobody yet knows whether the weight stays off for longer, or what happens when the injections stop.
- Most participants were women (78%) and White (78%), with an average BMI of 39. Results in other groups are still to come.
- Nobody with type 2 diabetes took part. A separate phase 3 trial is testing eloralintide in people who have it.
- No trial has compared it with a GLP-1 drug. Figures from separate trials cannot be set side by side: they ran for different lengths and counted people in different ways.
- The company that makes the drug paid for the trial.
When could you get it?
Not soon. Eloralintide is not approved anywhere. Five phase 3 trials, the ENLIGHTEN programme, are recruiting. Phase 3 is the last and largest stage of testing before a company can ask regulators for approval.
The phase 3 trials
| Trial | Who it studies | Planned size | Main data due |
|---|---|---|---|
| ENLIGHTEN-1 (NCT07321886) | Obesity, or overweight, without type 2 diabetes | 1,980 | March 2028 |
| ENLIGHTEN-2 (NCT07282600) | Obesity or overweight with type 2 diabetes | 1,035 | January 2028 |
| ENLIGHTEN-3 (NCT07369011) | Obstructive sleep apnoea with obesity or overweight | 800 | March 2028 |
| ENLIGHTEN-4 (NCT07353931) | Knee osteoarthritis pain with obesity or overweight | 900 | March 2028 |
| ENLIGHTEN-6 (NCT07392190) | Obesity that persists in people already treated with a weekly incretin drug, the family that includes the GLP-1 drugs | 900 | June 2028 |
The first of these is due to finish collecting its main data in January 2028. The results, a filing and a regulator's review all come after that, so a prescription before late 2028 is not realistic and 2029 is more likely. That is our reading of the registry dates, not a date from Lilly.
What to do with this
- If you want treatment now, ask a clinician about the drugs that are approved. Semaglutide and tirzepatide have large trials and years of use behind them.
- Do not buy it online. Nothing sold under this name is the trial product.
- If you would consider joining a trial, the five ENLIGHTEN studies are recruiting, and ClinicalTrials.gov lists their sites.
- Watch for two things: the phase 3 results in 2028, and any trial that sets eloralintide against a GLP-1 drug.
Frequently asked questions
What is eloralintide?
Eloralintide is an experimental once-weekly injection from Eli Lilly, code name LY3841136, that copies amylin, a hormone that signals fullness. It is being tested for weight loss and is not approved in any country.
Is eloralintide a GLP-1?
No. GLP-1 drugs such as semaglutide copy a gut hormone. Eloralintide copies amylin, a different hormone that the pancreas releases with insulin after a meal. Lilly has also tested it together with tirzepatide, and is testing it with another experimental drug, macupatide.
How much weight do people lose on eloralintide?
In the 48-week phase 2 trial, people who stayed on treatment lost on average 9% of their body weight on 1 mg, 12% on 3 mg, 18% on 6 mg and 20% on 9 mg, against 0.4% on placebo. That is one trial of 263 adults.
What are the side effects of eloralintide?
Nausea and fatigue were the most common in the phase 2 trial. On 9 mg, 33% reported nausea (14% on placebo) and 43% reported fatigue (12% on placebo). The authors described the drug as generally well tolerated.
Is eloralintide FDA approved, and when will it be available?
It is not approved. Five phase 3 trials are recruiting, and the earliest is due to finish collecting its main data in January 2028. Results, a filing and a regulator's review come after that, so a prescription before late 2028 is not realistic and 2029 is more likely.
Can I buy eloralintide?
No. It is available only to people taking part in a clinical trial. Products sold online under its name are not the studied product, and no regulator has checked what is in them.
Is eloralintide better than tirzepatide or retatrutide?
Nobody knows. No trial has compared them, and results from separate trials cannot be set side by side because they ran for different lengths and counted people in different ways. CureMed sets out each drug's own trial numbers on a separate page.
Who makes eloralintide?
Eli Lilly and Company, which also makes tirzepatide (Mounjaro, Zepbound) and is developing retatrutide.
Keep reading
- Weight-loss peptides compared: semaglutide, tirzepatide, retatrutide and CagriSema
Semaglutide, tirzepatide, retatrutide and the rest, each on its own trial numbers.
- Retatrutide side effects: every number from the trials, by dose
Lilly's other experimental weight-loss drug, side effect by side effect.
- How we grade evidence
Why one phase 2 trial is promising and not proof.
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