Survodutide acts on two receptors, glucagon and GLP-1, which is a different pairing from tirzepatide's combination of GIP and GLP-1. Adding glucagon appears to increase energy expenditure alongside appetite reduction. It originated at the Danish company Zealand Pharma and was licensed to Boehringer Ingelheim. Beyond obesity it is being pursued seriously for fatty liver disease with scarring, where it holds fast track and breakthrough therapy designations from the FDA, and the liver trials are large. Its main obesity trial enrolled seven hundred and twenty six people and reported about sixteen and a half percent weight loss over seventy six weeks against three percent on placebo, published in mid 2026. It is not approved anywhere.