Week 44 | October 26 – November 1, 2026
Story of the Week: Six Peptides Return to US Pharmacies
On Wednesday, October 28, the US Department of Health and Human Services (HHS) announced that pharmacies may once again compound six peptides on prescription. The story was covered by TIME ("The Peptide Rush Has Begun"), NBC and ABC, and the health news site STAT, among others.
Which peptides are covered:
- BPC-157
- TB-500
- MOTS-c
- KPV
- Semax
- Epitalon
How it works: This is not a drug approval. HHS chose an approach known as enforcement discretion: authorities have committed not to take action against pharmacies, federal facilities and physicians that compound these peptides for an individual patient, provided they meet set conditions. According to an analysis by the law firm Foley & Lardner, these include:
- The bulk substance must come from an FDA-registered facility and have a valid certificate of analysis (CoA). The manufacturer must follow current good manufacturing practice (GMP).
- The product may contain only one active ingredient.
- Pharmacies must report serious adverse events to the FDA's MedWatch program.
- The label must state that the product is not for resale.
According to ABC News, prescriptions must be patient-specific, ingredients must be traceable and products must undergo quality testing.
How we got here: In 2023, the FDA placed these peptides among the substances pharmacies were not allowed to compound. In July 2026, an FDA advisory committee recommended allowing them. HHS has now chosen a faster route than formally adding them to the list of permitted substances, which can take years.
What's next: The public can submit comments on the policy until November 13. The FDA may later propose permanently adding the peptides to the list of substances for pharmacy compounding. HHS has said it may revisit the policy if safety issues emerge. Peptides that have not yet been decided on (including GHK-Cu, LL-37 and Melanotan II) are due to be reviewed by the committee by the end of February 2027.
Why it's a big deal: It's the first time US authorities have officially opened a regulated pathway to peptides that are in huge demand but not approved as drugs. According to TIME, the market for them could reach as much as $3.3 billion. It's also worth noting how much weight the policy places on quality: traceable sourcing, a certificate of analysis and GMP manufacturing. Nothing changes directly in Europe, but the US approach often serves as a benchmark for the peptide debate elsewhere.
Read more: We wrote about MOTS-c, one of the six permitted peptides, in our article MOTS-c: The Exercise Peptide Made by Your Mitochondria. Melanotan II, which is still awaiting a decision, is covered in Melanotan II: History, Mechanism and Research Explained.
Retatrutide Goes Head-to-Head With Ozempic: Twice the Weight Loss
The second big story of the week also came on October 28. Eli Lilly released topline results from the phase III trial TRANSCEND-T2D-2, in which retatrutide was compared directly for the first time with Ozempic (semaglutide) from Novo Nordisk, one of the best-known medicines of our time.
Retatrutide is a so-called triple agonist: it mimics three hormones, GIP, GLP-1 and glucagon. Last week, we reported how it eased sleep apnea in clinical trials.
What the trial looked at:
- Adults with type 2 diabetes whose blood sugar wasn't adequately controlled by metformin (some were also taking another diabetes medicine from the SGLT2 inhibitor class).
- Retatrutide was compared with Ozempic at its highest approved dose.
- The trial lasted 80 weeks.
What it showed:
- HbA1c (glycated hemoglobin), a measure of long-term blood sugar, fell by about 2.2 percentage points with retatrutide and by about 1.8 with Ozempic.
- People on retatrutide lost an average of about 20% of their body weight, compared with about 9% on Ozempic. Weight loss was therefore more than double.
Why it matters: Head-to-head comparisons of two drugs are rare in medicine and very valuable, because they show which drug works better under the same conditions. The results suggest that adding a third hormonal signal can deliver a much stronger effect than drugs that mimic just one hormone. These are initial results released by the company. The detailed data have not yet been presented at a medical meeting or published in a peer-reviewed journal, and retatrutide is not yet approved.
Read more: We explain how tirzepatide, retatrutide's "dual" predecessor, works in our article Tirzepatide: How It Works and What the Trials Showed.
Europe: Novo Nordisk Prepares 26 New Obesity Studies
The main news from Europe this week came from Danish company Novo Nordisk, the maker of semaglutide. On October 29, it announced that it will present 26 abstracts on obesity treatment at ObesityWeek 2026 (November 14–17 in Washington, D.C.).
What Novo Nordisk will present:
- Wegovy in practice: data on how semaglutide performs in everyday practice outside clinical trials, in both pill and injection form, including patients treated through telehealth.
- CagriSema: new analyses from the REDEFINE program and results from REDEFINE 9, which studied lower doses. CagriSema combines two peptides, semaglutide and cagrilintide (which mimics the satiety hormone amylin). Last week, we reported that women on it lost an average of a quarter of their body weight.
- Semaglutide in children: research in children aged 6 to 12.
Why it matters: Real-world data show how a drug works in "everyday" patients, not just in carefully selected trial participants. And research into lower doses of CagriSema could help find a treatment approach that more people tolerate well. CagriSema and the use of semaglutide in younger children are still investigational.
Study of the Week: Some People on GLP-1 Drugs Drink Less Alcohol
A topic that was widely shared this week was a study published on October 30 in the leading medical journal JAMA.
What it found:
- Researchers surveyed more than 200 adults who had started GLP-1 medications (such as semaglutide or tirzepatide) and were drinking alcohol at the time.
- About 44% of them said they drank less during the first three months of treatment.
How to read it: This was a questionnaire in which people rated their own drinking, and the study had no comparison group. So it doesn't prove that the drugs directly caused people to drink less. But researchers have an intriguing hypothesis: GLP-1 receptors are also found in brain areas linked to reward. The drugs might therefore dampen not only appetite but also the urge to drink. Similar signals have appeared in a number of other studies, and the topic is now one of the most closely watched in GLP-1 research.
The Week in Brief
- The US has allowed pharmacies, since October 28, to compound six peptides (BPC-157, TB-500, MOTS-c, KPV, Semax and Epitalon) under strict quality conditions, including a certificate of analysis and GMP manufacturing.
- Retatrutide, in a head-to-head comparison with Ozempic, led to more than twice the weight loss in people with type 2 diabetes and lowered blood sugar more.
- Novo Nordisk will present 26 studies at ObesityWeek, including on CagriSema, the Wegovy pill and semaglutide in children.
- A JAMA study found that about 44% of people on GLP-1 drugs drink less alcohol.
We'll be back with the next roundup next week.
Sources
- ABC News – Some wellness peptides will become widely available, HHS says (October 28, 2026): abcnews.com
- TIME – The Peptide Rush Has Begun (October 28, 2026): time.com
- NBC News – RFK Jr. takes shortcut to make some unapproved peptides available for use: nbcnews.com
- STAT – HHS green lights six peptides, despite concerns from FDA scientists (October 29, 2026): statnews.com
- Foley & Lardner – Peptides: HHS Announces Limited Enforcement Discretion for Compounding of Six Peptides (October 30, 2026): foley.com
- Eli Lilly and Company – Lilly's retatrutide delivered greater A1C reduction and more than double the weight loss of Ozempic's highest approved dose in head-to-head trial (October 28, 2026): investor.lilly.com
- ad-hoc-news.de – Novo Nordisk stock adds new ObesityWeek data catalyst (October 29, 2026): ad-hoc-news.de
- Vinetur – Survey Finds GLP-1 Drugs May Curb Drinking for Many Patients (October 30, 2026): vinetur.com