GLP-1 / GIP Dual Agonist · Most Studied

Tirzepatide

Mounjaro® (T2D) · Zepbound® (Obesity) · Compounded versions available

Tirzepatide is FDA-approved for type 2 diabetes and obesity and represents the current gold standard in GLP-1 class therapy. Its dual GLP-1 and GIP receptor agonism may produce superior metabolic outcomes compared to GLP-1 monotherapy, including appetite modulation, improved insulin sensitivity, and meaningful body weight reduction. Phase 3 trial data demonstrated significant weight loss outcomes at maximum therapeutic doses.

Mechanism: Activates both GLP-1 and GIP receptors · Reduces appetite · Improves glucose metabolism · Supports adipose tissue energy utilization.

Typical Administration

Subcutaneous injection · Weekly · Titrated from starting dose under clinician supervision

GLP-1 / GIP / Glucagon Triple Agonist · Investigational

Retatrutide

Triple Agonist · Investigational · Phase 3

Retatrutide adds glucagon receptor agonism to the dual GLP-1/GIP mechanism, potentially increasing energy expenditure beyond appetite suppression. Phase 2 trial data demonstrated notable body weight reduction outcomes. Currently in Phase 3 trials. This compound is investigational and has not received FDA approval for any indication. Full informed consent and clinical evaluation are required before consideration.

Proposed mechanism: Triple agonism of GLP-1, GIP, and glucagon receptors · May increase energy expenditure via glucagon co-activation in addition to appetite modulation.

• ⚠ Investigational: not FDA approved. Phase 3 trials ongoing. Prescribed as investigational compound with full informed consent, risk disclosure, and alternative treatment discussion. Availability subject to regulatory status and compounding regulations.

Typical Administration

Subcutaneous injection · Weekly · Clinician-supervised titration protocol required

Visceral Fat · Body Composition

Tesamorelin

GHRH Analogue · Egrifta® · Visceral Adipose Targeting

Tesamorelin is FDA-approved for HIV-associated lipodystrophy and used off-label in metabolic health programs for its visceral adipose tissue reduction effect. It may selectively target the metabolically active visceral fat surrounding organs that contributes to insulin resistance and cardiovascular risk, a distinct mechanism from GLP-1 agonists.

• FDA-approved for HIV-associated lipodystrophy only. Use in metabolic programs constitutes off-label prescribing, disclosed in full at consultation.

Typical Administration

Subcutaneous injection · Daily · Patient self-administered

Visceral Fat · Body Composition

The Metabolic Stack

GLP-1 Agonist + Tesamorelin + Hormone Optimization

For patients seeking comprehensive body composition transformation, combining a GLP-1 agonist (Tirzepatide or Retatrutide) with Tesamorelin for visceral fat, alongside hormone optimization to ensure testosterone, thyroid, and cortisol are not limiting metabolic response. The specific compounds included are determined at consultation based on individual clinical appropriateness and current regulatory availability.