CagriSema Weight Loss Results: What 20.4%, 22.7%, and 23% Really Mean
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CagriSema weight loss results came in at an estimated 20.4% average weight loss at 68 weeks in its main obesity trial (REDEFINE 1), or 22.7% under a second way of measuring the same trial. In adults with type 2 diabetes, the figures were 13.7% and 15.7%. CagriSema is not FDA-approved — and these are group averages, not a prediction of what any one person will lose.
CagriSema weight loss results land somewhere between “genuinely impressive” and “wait — that’s it?” Which one you walk away believing depends almost entirely on which number someone quoted you.
Here is the honest bottom line, up front. In REDEFINE 1, CagriSema helped people lose an estimated 20.4% or 22.7% of their body weight at 68 weeks — two numbers, two ways of doing the math, and we will untangle them in a second. That is a lot of weight. But it landed below the roughly 25% its maker, Novo Nordisk, had publicly floated before the results came out. And in a separate 84-week trial that put it head-to-head against tirzepatide (the medicine in Zepbound), CagriSema lost. And you cannot buy it yet — it is still waiting on the FDA.
The reason you have seen 20.4%, 22.7%, and 23% all describing CagriSema is that 20.4% and 22.7% come from REDEFINE 1 (68 weeks), while 23% comes from the separate REDEFINE 4 head-to-head trial (84 weeks). We will show you exactly what each number means, what it works out to in real pounds, and whether CagriSema is worth waiting for. No hype. No fog.
This page is for you if…
- You keep seeing different CagriSema numbers and want to know which one is real
- You want to see what those percentages mean in actual pounds
- You are deciding whether to wait for CagriSema or start something now
This page is not…
- A personal prediction — trial averages are not your result
- A place to buy CagriSema — it is still investigational
- The final word on price, insurance, or the approved label — none of that exists yet
The RX Index is the independent GLP-1 decision resource that scores telehealth providers and treatment paths on clinical legitimacy, care quality, transparency, access, and cost, so readers can choose the path that fits their situation.
The results at a glance
| Your situation | Most relevant result | What it means |
|---|---|---|
| No type 2 diabetes — counting everyone | 20.4% at 68 wks (REDEFINE 1) | The whole-group result, including people who stopped or switched |
| No type 2 diabetes — as the study intended | 22.7% at 68 wks (REDEFINE 1) | The “if taken as intended” estimate from the same trial |
| Type 2 diabetes | 13.7% / 15.7% at 68 wks (REDEFINE 2) | Lower than the no-diabetes trial |
| Head-to-head vs Zepbound | 20.2% / 23.0% at 84 wks (REDEFINE 4) | Zepbound reached 23.6% / 25.5%; CagriSema did not match it |
The right GLP-1 provider is not the same for everyone — it depends on your state, your insurance, whether you want an FDA-approved or compounded medication, your preferred treatment path, and your budget. Because CagriSema is not available yet, use The RX Index’s Find My GLP-1 Path tool to get a personalized provider match if you’d rather start an available option now.
What are the real CagriSema weight loss results?
The most complete answer depends on two things: whether the person had type 2 diabetes, and which of two honest calculations you are looking at. In adults without diabetes (REDEFINE 1), CagriSema averaged 20.4% counting everyone, or 22.7% under the as-intended estimate, over 68 weeks. In adults with type 2 diabetes (REDEFINE 2), it was 13.7% and 15.7%.
CagriSema (say it “cag-ree-SEE-ma”) is Novo Nordisk’s investigational once-weekly shot. It combines two medicines in one injection: cagrilintide, a long-acting amylin analog (a lab-made version of a natural hormone that signals fullness), and semaglutide — the active ingredient in Wegovy and Ozempic. Two different appetite brakes in one weekly injection. That is why so many people expected it to blow the competition away. (For the full how-it-works breakdown, see What Is CagriSema?)
Key phase 3 results, side by side — with the exact evidence status for each:
| Study | Who / evidence status | Length | Counting everyone | As-intended estimate | Direct comparison |
|---|---|---|---|---|---|
| REDEFINE 1 | No diabetes (n=3,417) peer-reviewed | 68 wks | 20.4% | 22.7% | Semaglutide 2.4 mg: 14.9% / 16.1%; placebo: 3.0% / 2.3% |
| REDEFINE 2 | Type 2 diabetes (n=1,206) peer-reviewed | 68 wks | 13.7% | 15.7% | Placebo: 3.4% / 3.1% |
| REDEFINE 4 | vs Zepbound (n=809) company topline | 84 wks | 20.2% | 23.0% | Tirzepatide: 23.6% / 25.5%; did not match it |
Exact terms: REDEFINE 1 and 2 report a “treatment-policy” estimate (counting everyone) and a “trial-product” estimate (as intended). REDEFINE 4 uses “treatment-regimen” and “efficacy.” More on what these mean below.
Sources: REDEFINE 1 (Garvey et al., NEJM 2025); REDEFINE 2 (Davies et al., NEJM 2025); REDEFINE 4 (Novo Nordisk topline, Feb 23, 2026).
Why do some headlines say 20.4% and others say 22.7%?
Both numbers come from the same trial, REDEFINE 1 — they just measure it two different ways. The 20.4% figure counts what actually happened to everyone in the study, including people who stopped the medicine or added another treatment. The 22.7% figure estimates the effect if people used CagriSema the way the study intended. Both use the full group of randomly assigned participants — 22.7% is not simply the average of people who never missed a dose.
Two honest ways to score the same trial:
Counts everyone’s results the way they actually played out — including people who quit CagriSema partway through or started a different weight-loss treatment along the way. It is still a modeled trial estimate, not a real-world study.
Asks: what would the effect be if people took CagriSema as the study intended — staying on it, using the doses the protocol allowed — and did not switch to something else? It is higher, but it is an “if things go to plan” estimate. It does not assume everyone stayed on the top dose or never missed one.
Which one should you care about?
| What you are really asking | The better number |
|---|---|
| “What happened across everyone in the study?” | 20.4% |
| “What if I take it the way it is meant to be taken?” | 22.7% |
| “What will I lose?” | Honestly — neither can tell you that |
Source: REDEFINE 1 (NEJM 2025).
What do these results mean in real pounds?
You can turn a percentage into pounds by multiplying your starting weight by the trial average — but it is a rough illustration, not a personal forecast. For someone starting at 220 pounds, 20.4% is about 45 pounds and 22.7% is about 50 pounds.
| Trial result | 180 lb | 220 lb | 260 lb | 300 lb |
|---|---|---|---|---|
| No diabetes, counting everyone — 20.4% | 37 lb | 45 lb | 53 lb | 61 lb |
| No diabetes, as-intended — 22.7% | 41 lb | 50 lb | 59 lb | 68 lb |
| Type 2 diabetes, counting everyone — 13.7% | 25 lb | 30 lb | 36 lb | 41 lb |
| Type 2 diabetes, as-intended — 15.7% | 28 lb | 35 lb | 41 lb | 47 lb |
| Zepbound head-to-head, CagriSema — 23.0% | 41 lb | 51 lb | 60 lb | 69 lb |
| Zepbound head-to-head, tirzepatide — 25.5% | 46 lb | 56 lb | 66 lb | 77 lb |
“Pounds” here is simple arithmetic on a trial average. It is not an estimate of what you personally will lose.
CagriSema is not something you can start today. But if you are doing this math because you are ready to do something about your weight, the FDA-approved treatments available right now — tirzepatide and semaglutide through licensed telehealth — are a real starting point.
Source: REDEFINE 1 (NEJM 2025).
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How much did people without diabetes lose in REDEFINE 1?
In REDEFINE 1, CagriSema produced an estimated 20.4% average weight loss counting everyone, and 22.7% under the as-intended estimate, over 68 weeks. For comparison, semaglutide 2.4 mg alone (the Wegovy dose used in the study) produced 14.9% and 16.1%, and placebo produced 3.0% and 2.3%. CagriSema clearly beat semaglutide alone — just not by the landslide many predicted.
This was the big one: 3,417 adults with obesity (or overweight plus a related health problem), no diabetes, randomly assigned to CagriSema, semaglutide alone, cagrilintide alone, or placebo — all alongside a lifestyle plan, over 68 weeks.
Averages hide the range — how many people hit the big milestones:
| Weight-loss milestone | Counting everyone | As-intended |
|---|---|---|
| Lost 25% or more | 34.7% | 40.4% |
| Lost 30% or more | 19.3% | 23.1% |
Depending on the calculation, up to 4 in 10 people lost a quarter of their body weight, and roughly 1 in 5 lost 30% or more. Some people did dramatically better than the average. Some did less. That spread is exactly why no single number can be your number.
- That most people will lose 22.7% — that is a study average, not a floor
- What the final FDA-approved label or dose will say
- What it will cost or whether insurance covers it
- That a cheaper “compounded” version will do the same thing
Source: REDEFINE 1 (NEJM 2025).
How much did people with type 2 diabetes lose?
People with type 2 diabetes lost less — an estimated 13.7% counting everyone, or 15.7% under the as-intended estimate, over 68 weeks in REDEFINE 2. That still beat placebo (about 3%), and most people lost at least 5% of their weight. But it is meaningfully below the no-diabetes numbers.
The dedicated diabetes trial included 1,206 adults with average BMI around 36 and A1c around 8.0%.
The 5% milestone, reported properly:
Under the counting-everyone estimate, 83.6% of people on CagriSema lost at least 5% of their body weight, versus 30.8% on placebo. Under the as-intended estimate, it was 89.7% versus 30.2%. A 5% loss is generally the level where doctors start seeing real health benefits like better blood sugar and blood pressure — though hitting it does not guarantee a specific change for any one person.
There is also a separate diabetes study called REIMAGINE 2. Novo reported topline results of an estimated 12.9% to 14.2% weight loss at 68 weeks (versus 9.2% to 10.2% with semaglutide 2.4 mg) in about 2,728 adults with type 2 diabetes. Those are company-reported numbers, not a full peer-reviewed paper yet, so we are weighting them lightly.
Sources: REDEFINE 2 (Davies et al., NEJM 2025); REIMAGINE 2 (Novo Nordisk topline, Feb 2, 2026).
Did CagriSema beat Zepbound (tirzepatide)?
| Calculation | CagriSema | Zepbound (tirzepatide) | Gap |
|---|---|---|---|
| Counting everyone (treatment-regimen) | 20.2% | 23.6% | 3.4 pts, Zepbound ahead |
| As-intended (efficacy) | 23.0% | 25.5% | 2.5 pts, Zepbound ahead |
This was an open-label trial of 809 adults with obesity, comparing CagriSema against the top dose of tirzepatide (15 mg). “Did not meet noninferiority” is the technical phrase: the study was built to prove CagriSema was at least as good as Zepbound within a set margin. It could not. That does not mean CagriSema flopped — 20%+ is excellent weight loss. It means the direct evidence put Zepbound ahead. For a deeper look, see CagriSema vs Zepbound.
The honest, uncomfortable part:
CagriSema did not beat Zepbound in the only head-to-head trial we have. If the single most important thing to you is the higher proven average weight loss in that direct 84-week matchup, the evidence points to tirzepatide, not CagriSema.
Now read the next sentence just as carefully. CagriSema still delivered around 20–23% weight loss, and it pairs semaglutide with a long-acting amylin analog — a second appetite hormone that no approved obesity drug has yet. For a huge number of people, the deciding factor will not be a 2.5-point gap on a chart. It will be what you can actually get, what your insurance covers, and what fits your life. A drug you cannot get yet cannot help you lose a pound today.
If maximum proven weight loss is your priority, you do not have to wait. Tirzepatide is available right now as FDA-approved Zepbound through licensed telehealth.
Source: REDEFINE 4 (Novo Nordisk topline, Feb 23, 2026).
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Is CagriSema better than Wegovy?
CagriSema out-lost the semaglutide dose it was actually tested against — 2.4 mg, the standard Wegovy dose — in REDEFINE 1: 20.4% vs 14.9%, or 22.7% vs 16.1%. But a stronger Wegovy dose (7.2 mg) is now FDA-approved, and CagriSema was never tested against it — so “better than Wegovy” is not a clean yes in 2026.
Since that trial, a higher-dose Wegovy (semaglutide 7.2 mg) has been approved, and it reached about 20.7% weight loss in its own trial. CagriSema was never compared head-to-head against the 7.2 mg dose. So if someone tells you “CagriSema beats Wegovy,” the honest answer is: it beat the older Wegovy dose it was tested against — the newer, stronger dose is a question nobody has answered directly yet. See CagriSema vs Wegovy for the deeper breakdown.
Sources: REDEFINE 1 (NEJM 2025); Wegovy 7.2 mg approval and STEP UP — Novo Nordisk (2026).
Why did only about 57% finish on the top dose?
About 57.4% of CagriSema participants were on the highest dose at week 68 — but roughly 74.7% had reached it at some point, and the trial let doctors deliberately hold people at a lower dose. So “only 57% on the top dose” does not mean the other 43% could not handle it.
REDEFINE 1 was built with flexible dosing: the protocol let investigators slow down dose increases or lower the dose for side effects, for a low-normal BMI paired with a health concern, or based on clinical judgment — and people could stay in the trial on a lower dose.
Novo’s own follow-up analysis (ECO 2026) found that 24% of participants who reduced their dose had not had a stomach side effect beforehand, and for another 31%, the most recent stomach event was judged unlikely to be related to the drug. That analysis is exploratory — it does not pin down one reason for every dose change — but the takeaway holds: do not turn “57% at max dose” into “CagriSema is hard to tolerate.”
Source: REDEFINE 1 (NEJM 2025); Novo Nordisk post-hoc analysis (ECO 2026).
What side effects should shape how you read these numbers?
The main side effects were stomach-related — nausea, diarrhea, vomiting, constipation — and mostly mild to moderate. How a medicine makes you feel shapes whether people stay on it, and that feeds directly into those two different weight-loss numbers.
| Side effect | CagriSema | Semaglutide 2.4 mg | Placebo |
|---|---|---|---|
| Any stomach-related effect | 79.6% | 73.8% | 39.9% |
| Stopped because of side effects | 5.9% | 3.6% | 3.5% |
The added amylin hormone appears to push the stomach effects up a bit compared to plain semaglutide — but the trial does not prove which ingredient caused the difference, and there is no final CagriSema safety label yet. For the full rundown, including gallbladder-related events and body-composition data, see CagriSema Side Effects.
Source: REDEFINE 1 & 2 (NEJM 2025).
What these results do not tell you
Every percentage on this page is a group average from a controlled trial — not a guarantee, and not a real-world number. How you read them depends on the trial population, whether people stayed on treatment, and whether the number came from a peer-reviewed paper or a company announcement.
| What is verified now | What is not established yet |
|---|---|
| REDEFINE 1 & 2 peer-reviewed results | What you personally will lose |
| REDEFINE 4 company topline result | A guaranteed FDA decision date |
| It is a 2.4 mg + 2.4 mg weekly injection | The final approved dose and label |
| Current FDA status (not approved) | Launch price and insurance coverage |
| Trial side-effect rates | Long-term, real-world results |
| FDA compounding position (no compounding pathway) | What happens to weight after stopping |
Is CagriSema FDA-approved or available yet?
The simple timeline:
- Phase 3 REDEFINE results reported (2024–2026)
- U.S. application submitted to the FDA — December 2025, based on REDEFINE 1 and 2
- Company expects a decision in late 2026 (Novo has pointed to Q4)
- No approval, and no final label, as of our verification date (July 2026)
For current tracking see CagriSema FDA Approval Status.
Source: Novo Nordisk (Dec 2025 filing; Q1 2026 guidance).
Can you buy CagriSema or get it compounded right now?
There is no everyday way to get CagriSema — no telehealth provider or pharmacy can dispense it as an approved product. On compounding, the FDA is direct: cagrilintide cannot be used in compounding under federal law. It is not part of any FDA-approved drug and has not been found safe and effective for any condition. So a website offering “compounded CagriSema” or a “cagrilintide + semaglutide” combo is selling something the FDA has not reviewed for safety, effectiveness, or quality.
- Claims it can ship you “FDA-approved CagriSema” now
- Guarantees you will hit the trial percentages
- Uses the REDEFINE numbers to market an unapproved product
Want to explore a real CagriSema study? Recruitment changes constantly — check ClinicalTrials.gov or ask a qualified clinician rather than trusting any article to promise you a spot.
Source: FDA, Concerns with Unapproved GLP-1 Drugs Used for Weight Loss; FDA, Expanded Access.
Should you wait for CagriSema or start something now?
Waiting is not automatically smarter just because CagriSema is newer. It may make sense to keep an eye on it if your doctor agrees — but it is not approved, its final label and price are unknown, and the one head-to-head trial we have put Zepbound ahead on weight loss. For many people, looking at an available, FDA-approved treatment now is the more practical path.
Find yourself in this table, then take that question to a clinician:
| Where you are | The question actually worth asking |
|---|---|
| Doing well on a current treatment | Is there a medical reason to switch, or should I keep going? |
| Ready to start now | Which FDA-approved treatment path is right and available for me? |
| Plateaued on a GLP-1 | Have my dose, adherence, and nutrition been reviewed first? |
| Stopped due to side effects | Which approved option has a gentler profile for me? |
| Only interested in CagriSema | Am I okay waiting with no guaranteed date, label, or price? |
| Have type 2 diabetes | Am I using the 13.7% / 15.7% numbers, not the no-diabetes headline? |
| Found a “CagriSema” seller online | Is this the investigational product from Novo’s trials? It is not an FDA-approved CagriSema product — do not buy on a trial headline |
You do not need to decide whether CagriSema is “good” or “bad.” You need to decide one thing — whether waiting on a drug you cannot get yet makes more sense for you than starting an available, FDA-approved treatment today. Your state, your insurance, your medical history, your budget, and whether you want a shot or a pill will change that answer more than any headline percentage.
Matches you by state, insurance, medication preference, and budget. Educational only -- does not guarantee medical eligibility or a prescription.
How we verified these CagriSema results
We built this page from the strongest sources available: the full peer-reviewed REDEFINE 1 and 2 papers in the New England Journal of Medicine, Novo Nordisk’s official releases for the newer topline results, and current FDA materials for approval and compounding status. Every pounds figure is plain arithmetic on a published average — not new research, and not a personal prediction.
How we rank what we trust:
- FDA records and current agency guidance
- Full peer-reviewed trial publications (NEJM)
- Official company trial announcements, where a full paper is not out yet — clearly labeled
- Major medical organizations for confirmation
- Forums — only to understand what people are confused about, never as medical evidence
| Result | Population | Evidence | Source | What it cannot tell you |
|---|---|---|---|---|
| 20.4% / 22.7% | No diabetes | Peer-reviewed | REDEFINE 1, NEJM 2025 | Your personal result |
| 13.7% / 15.7% | Type 2 diabetes | Peer-reviewed | REDEFINE 2, NEJM 2025 | Your personal result |
| 20.2% / 23.0% | Obesity, vs tirzepatide | Company topline | REDEFINE 4, Feb 2026 | Long-term or other-population results |
| 12.9% / 14.2% | Type 2 diabetes | Company topline | REIMAGINE 2, Feb 2026 | Peer-reviewed confirmation pending |
| Not FDA-approved | — | Filing + FDA check | Novo (Dec 2025); FDA | Whether, or when, it will be approved |
CagriSema regulatory change log
- U.S. application submitted to the FDA
- REDEFINE 4 head-to-head topline reported
- Novo Nordisk reaffirmed it expects a U.S. decision in late 2026
- No FDA approval as of our latest check
The RX Index is independent guidance for choosing your GLP-1 path — we did not run these trials and we do not predict individual outcomes.
Frequently asked questions about CagriSema weight loss results
The four answers that matter most: 22.7% is not guaranteed, type 2 diabetes lowers the expected result, CagriSema did not beat Zepbound in the head-to-head trial, and it is not FDA-approved yet. The rest are below.
- How much weight can you lose on CagriSema?
- In the main trial (REDEFINE 1), adults without diabetes averaged 20.4% weight loss counting everyone, or 22.7% under the as-intended estimate, over 68 weeks. Individual results varied widely, and neither number predicts what one person will lose.
- Does CagriSema guarantee 22.7% weight loss?
- No. The 22.7% figure is a trial average under an as-intended calculation, not a guarantee or a minimum.
- Why is CagriSema sometimes reported as 20.4%?
- That is the same trial's counting-everyone number, which includes people who stopped early or switched treatments. The 22.7% comes from a different, as-intended calculation of the same trial.
- How long did it take to reach these results?
- The main REDEFINE 1 and REDEFINE 2 results were measured at 68 weeks. The Zepbound head-to-head (REDEFINE 4) was measured at 84 weeks.
- Can I divide the 68-week result into a monthly rate?
- No. Weight loss is not a straight line, so dividing by the number of months gives a misleading monthly expectation.
- Did CagriSema beat Zepbound?
- No, not in the head-to-head REDEFINE 4 trial. Tirzepatide (Zepbound) averaged 25.5% (as-intended) versus CagriSema's 23.0%, and CagriSema did not meet its goal of matching it.
- Did CagriSema beat semaglutide 2.4 mg in REDEFINE 1?
- Yes. CagriSema produced greater estimated average weight loss than semaglutide 2.4 mg under both of the trial's calculations. That trial did not compare CagriSema with the now-approved Wegovy 7.2 mg dose.
- What were the results for people with type 2 diabetes?
- About 13.7% and 15.7% over 68 weeks in REDEFINE 2 -- lower than the no-diabetes trial, and the more relevant numbers if you have diabetes.
- Is CagriSema FDA-approved?
- No, not as of July 2026. Novo Nordisk has submitted an application, but no approval has been issued.
- When will CagriSema be approved?
- The outcome and date are unknown. Novo Nordisk expects a U.S. decision in late 2026 (Q4), but that is a company expectation, not a guaranteed approval or date.
- How much will CagriSema cost?
- No official U.S. launch price has been announced as of July 2026.
- Is CagriSema a pill?
- No. The trials studied a once-weekly injection combining cagrilintide and semaglutide.
- Can I buy CagriSema online?
- There is no approved CagriSema to buy. Anything marketed as compounded or research-use CagriSema is not the trial medicine, and the FDA has not reviewed those products for safety, effectiveness, or quality.
- Are CagriSema before-and-after photos reliable?
- The RX Index did not verify a representative, authenticated CagriSema before-and-after photo set. Trial averages and milestone rates are far stronger evidence than unattributed social-media images.
- What happens to weight after stopping CagriSema?
- The available evidence does not clearly establish this for CagriSema specifically. Do not assume the regain data from other GLP-1 drugs applies directly.
- Can I join a CagriSema clinical trial?
- Maybe -- recruitment changes over time. Check the current ClinicalTrials.gov listing or ask a clinician rather than relying on any article to promise an open study.
Still not sure which GLP-1 program is right for you?
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Sources
- Garvey WT, et al. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity (REDEFINE 1). New England Journal of Medicine, 2025. DOI: 10.1056/NEJMoa2502081.
- Davies M, et al. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes (REDEFINE 2). New England Journal of Medicine, 2025. DOI: 10.1056/NEJMoa2502082.
- Novo Nordisk. CagriSema demonstrated 23% weight loss in the head-to-head REDEFINE 4 trial; primary endpoint not achieved. February 23, 2026.
- Novo Nordisk. REIMAGINE 2 topline results. February 2, 2026.
- Novo Nordisk. Q1 2026 Investor Presentation (CagriSema decision guidance; Wegovy 7.2 mg approval).
- U.S. Food and Drug Administration. Concerns with Unapproved GLP-1 Drugs Used for Weight Loss.
- U.S. Food and Drug Administration. Expanded Access.
Educational information only. This is not medical advice. Talk with a licensed healthcare professional before starting, stopping, or changing any treatment.