Medically reviewed by Dr. Shayon Aram, ND — Last reviewed: September 25, 2026
Dr. Aram is a licensed Naturopathic Medical Doctor at Regenerate Health Medical Center in Santa Barbara, working with patients on gut health, hormones, metabolism, and chronic disease, with a particular focus on men's health and midlife wellness. He is a member of the California Naturopathic Doctors Association and the Oncology Association of Naturopathic Physicians, and provides adjunctive oncology care alongside conventional cancer treatment.
Weight-loss drugs are changing fast.
Semaglutide made GLP-1 medications mainstream. Tirzepatide pushed weight loss even further. Now retatrutide is getting attention because early and late-stage trials suggest it may be even more powerful.
And that is exactly why we think patients need to be careful.
At Regenerate Health Medical Center, our doctors are not against medication simply because it is medication. We use drugs when we believe they are appropriate.
But we also don’t believe that maximum appetite suppression, maximum dosing, and maximum weight loss automatically equal better health.
With GLP-1 medications, including the newer drugs coming down the pipeline, our concern is regular-dose use as a long-term weight-loss strategy.
For selected patients, we may see a role for carefully supervised microdosing as one piece of a larger metabolic plan.
We do not see the medication itself as the plan.
That Distinction Matters ☝🏼
What Is Retatrutide?
That word, investigational, is worth pausing on. It means retatrutide is still in clinical trials and does not yet have FDA approval for weight loss. It is legally available only to participants enrolled in those trials, not something a doctor can currently prescribe or a patient can obtain through legitimate medical channels. We think that distinction deserves more attention than it usually gets in the excitement around new trial results.
It works on three metabolic hormone pathways at once: GLP-1, GIP, and glucagon. You don’t need to memorize those names. What matters is the effect.
Retatrutide can strongly influence appetite, fullness, blood sugar regulation, digestion, and how the body uses energy.
To put that in context: tirzepatide (the drug behind Mounjaro and Zepbound) works on two of those same pathways, GLP-1 and GIP. Retatrutide adds a third, glucagon, which is part of why early trial data shows larger average weight loss than tirzepatide has produced in its own trials. But tirzepatide is FDA-approved with years of real-world prescribing behind it. Retatrutide is not, and that difference matters more to us than the extra percentage points on a chart.
The results have gotten people’s attention for good reason.
In a major 2026 trial, people receiving the highest studied dose lost an average of more than one-quarter of their starting body weight over 80 weeks.
That is a tremendous amount of weight.
But when we look at a result like that, our first question isn’t simply, “How do we get our patients those numbers?”
We ask:
What happened to the rest of the body while that weight was coming off?
That is where the conversation gets more interesting.
Powerful Weight Loss Comes With a Trade-Off
These medications work partly because they can dramatically reduce hunger.
For someone who has struggled with constant cravings, overeating, insulin resistance, or an inability to lose weight despite significant effort, that can feel incredible.
There are real potential benefits.
Patients may lose visceral fat, improve blood sugar, reduce waist circumference, and improve other markers associated with metabolic disease. Retatrutide research is also looking at obesity-related problems such as sleep apnea and osteoarthritis.
We aren’t dismissing those benefits ☝🏼
Our concern is what happens when appetite suppression becomes so strong that a person simply isn’t eating enough to adequately support muscle, nutrition, hormones, recovery, and long-term health.
Weight loss and health are not interchangeable.
You can lose weight and still become metabolically weaker ⚠️
One of Our Biggest Concerns Is Muscle Loss
When the scale drops quickly, the weight coming off isn’t all body fat.
Some is muscle.
For our doctors, that is a major concern, particularly in patients entering their 40s, 50s, and 60s when preserving lean muscle becomes increasingly important.
Muscle helps you regulate blood sugar. It supports your metabolism. It protects your bones and joints. It helps you remain physically capable as you age.
And muscle is difficult to replace once you’ve lost a significant amount of it.
This is why we do not celebrate a 40-pound weight loss without asking what those 40 pounds were made of.
A patient who loses substantial fat while maintaining or gaining muscle is moving in a very different direction than someone who becomes dramatically lighter but also weaker.
The number on the scale may look great in both cases.
The health outcome isn’t the same.
This is why we do not celebrate a 40-pound weight loss without asking what those 40 pounds were made of.
A patient who loses substantial fat while maintaining or gaining muscle is moving in a very different direction than someone who becomes dramatically lighter but also weaker.
The number on the scale may look great in both cases.
The health outcome isn’t the same.
Then There Is the Gut
GLP-1 medications intentionally slow digestion. That’s part of how they create greater fullness.
At regular doses, however, nausea, constipation, diarrhea, vomiting, and other gastrointestinal symptoms are common.
Retatrutide is no exception. In both earlier research and current trials, gastrointestinal side effects have been among the most frequently reported problems.
For a Naturopathic Medical Doctor, that raises another question.
If a patient already has constipation, bloating, reflux, poor digestion, or compromised gut function, do we really want to aggressively suppress gastric motility without addressing why that digestive system is struggling in the first place?
Sometimes medication can still be useful.
But we want to understand the terrain we’re putting that medication into.
That’s a very different conversation from simply prescribing a weight-loss drug because someone’s BMI qualifies.
Retatrutide Side Effects Are More Than Just an Upset Stomach
The most common GLP-1 side effects are digestive: nausea, constipation, diarrhea, vomiting, reflux, abdominal discomfort, and feeling overly full after eating. Retatrutide has shown many of these same problems in clinical trials.
It is easy to brush these off as the price of losing weight. We don’t.
These medications work partly by slowing how quickly food leaves the stomach. For some patients, that means they simply aren’t hungry. For others, digestion can slow enough that eating becomes uncomfortable, reflux worsens, constipation becomes chronic, or they struggle to consume enough food, protein, and nutrients to properly support their body.
In more serious cases, GLP-1 medications have been associated with problems such as gallbladder disease, pancreatitis, and severe slowing of stomach emptying. These complications aren’t what happens to every patient, but they matter when deciding whether the potential benefit of a medication is worth the risk.
And there is another problem that doesn’t get talked about enough:
side effects can create a medication cascade ⚠️
A patient starts a GLP-1 and develops persistent reflux. Instead of reconsidering what the medication is doing to digestion, another medication may be added to suppress stomach acid.
Now the reflux may feel better, but the underlying digestive problem hasn’t necessarily improved.
Long-term acid suppression can interfere with the absorption of nutrients including vitamin B12, magnesium, calcium, and iron, and prolonged use of proton-pump inhibitors has been associated with additional concerns including increased fracture risk in some populations. Suddenly, a patient who started one medication to lose weight may find themselves taking another medication to tolerate the first one.
That is exactly the kind of cycle our doctors try to prevent ‼️
This Is Why We Take a Different Approach
When you put all of this together, our position becomes easier to understand.
We are not comfortable aggressively suppressing a patient’s appetite, watching them lose muscle, managing constipation or reflux with additional medications, and calling the treatment successful because they’ve lost 40 pounds.
That’s not our definition of metabolic health.
When our doctors believe a GLP-1 medication may benefit a patient, we prefer a much more conservative approach. That may include medically supervised microdosing in appropriately selected patients, while simultaneously addressing nutrition, protein intake, strength training, hormones, insulin resistance, gut function, sleep, stress, and the other factors contributing to their weight.
The medication should support the process.
It shouldn’t become the process.
Our Position on GLP-1 Drugs Is More Conservative
This is where we probably differ from many weight-loss clinics.
We strongly caution against routinely using GLP-1 medications at conventional higher doses simply to drive faster weight loss.
More medication isn’t automatically better.
More appetite suppression isn’t automatically better.
And faster weight loss isn’t automatically healthier.
In patients where we believe this class of medication has a role, our preference is a much more conservative approach, including physician-supervised microdosing when clinically appropriate.
Microdosing generally means using substantially less medication than the standard weight-loss approach, with the goal of creating enough metabolic support to help the patient without completely overpowering appetite and digestion.
Our approach is individualized and medically supervised.
The goal isn’t to see how little medication we can get away with simply for the sake of using less.
It’s to ask whether medication is needed at all, and if it is, whether we can use the lowest effective intervention while we work on the reasons the weight problem developed in the first place.
That philosophy is central to how we practice Naturopathic Medicine.
Your Body Already Has a GLP-1 System
Another part of this conversation rarely gets enough attention.
GLP-1 is not a pharmaceutical invention.
Your body produces it naturally.
When you eat, cells in your digestive tract release hormones that communicate with your brain, pancreas, digestive system, and other tissues. GLP-1 is one of those signals.
Certain foods and nutrients can influence your body’s own GLP-1 response.
Protein is one example.
Fiber is another. Some types of fiber are fermented by your gut bacteria, producing compounds that can influence natural GLP-1 secretion and feelings of fullness. Human research continues to explore exactly which fibers, probiotics and dietary patterns have the strongest effects.
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Your gut microbiome, insulin sensitivity, sleep, muscle mass, activity level, and overall diet also influence the metabolic environment that regulates hunger and weight.
Research has shown there are several natural compounds that support the body’s own GLP-1, and these are things we routinely recommend to our patients.
Will eating more fiber produce the same effect as taking retatrutide?
Of course not.
But that’s missing the point.
The point is that your metabolism already has a regulatory system.
Our job is to figure out how well that system is functioning before assuming the answer is to overpower it with a drug.
Weight Gain Is Usually Telling Us Something
Weight that will not budge despite reasonable nutrition and exercise often deserves a deeper look.
Our doctors may investigate factors such as:
➡ Insulin resistance and blood sugar regulation
➡ Thyroid and other hormone function
➡ Perimenopause, menopause, or andropause
➡ Loss of muscle mass
➡ Gut health and digestion
➡ Chronic stress and sleep
➡ Nutrient deficiencies
➡ Medications that promote weight gain
➡ Diet and protein intake
➡ Movement and strength training
➡ The answer won’t be identical for every patient.
That’s precisely the point.
At RHMC, we don’t want someone dependent on a medication while the reason they gained weight remains untouched.
If we use medication, we want it working alongside the patient, not replacing the work their metabolism actually needs.
The Goal Is a Healthier Body, Not Simply a Smaller One
This is probably the most important distinction we can make.
Weight loss should improve your health.
You should be protecting muscle. Eating enough protein and nutrients. Getting stronger. Improving blood sugar regulation. Supporting hormones. Sleeping better. Addressing digestive problems. Building habits that will still serve you years from now.
The scale is one measurement.
It is not the final verdict on your health.
Retatrutide may eventually become another tool available to physicians. Current research certainly suggests it can produce dramatic weight loss.
But a stronger drug does not change the philosophy of good medicine.
At Regenerate Health Medical Center, we begin by asking why your body is struggling with weight in the first place.
We use the safest and least invasive therapies that make sense. We work to improve your body’s natural metabolic function. And when medication has a role, our doctors believe in using it thoughtfully, conservatively, and as part of a much bigger plan.
Because the goal isn’t simply getting the weight off.
It’s creating a body that is healthier, stronger, and better equipped to keep it off.
If you’re considering a GLP-1 medication, currently taking one, or want to explore natural ways to improve metabolic health first, our Naturopathic Medical Doctors can evaluate the whole picture and help you understand your options.
At RHMC, you’re an active participant in your healthcare decisions and treatments.
Learn more about our Medically Supervised Weight Loss Program or schedule a consultation with our team to build an individualized approach to your metabolic health.
Frequently Asked Questions About Retatrutide
What is retatrutide and how is it different from Ozempic?
Retatrutide is an investigational weight-loss medication that acts on three metabolic hormone pathways at once (GLP-1, GIP, and glucagon), compared to Ozempic (semaglutide), which acts on GLP-1 alone. Because it engages more pathways, early trial data shows larger average weight loss, but it also means a broader range of side effects to consider.
Is retatrutide FDA-approved?
No. Retatrutide is still investigational and has not been approved by the FDA. It remains in clinical trials, and RHMC does not prescribe, provide, or endorse obtaining it outside of appropriate medical channels.
What are the main side effects of retatrutide?
Like other GLP-1 medications, retatrutide is most commonly associated with gastrointestinal side effects such as nausea, constipation, diarrhea, vomiting, and reflux. Clinical trial data has also linked GLP-1 class medications to more serious concerns including gallbladder disease and pancreatitis, and rapid weight loss with these medications can include a meaningful loss of lean muscle mass alongside fat.
How does retatrutide compare to tirzepatide?
Tirzepatide (Mounjaro, Zepbound) acts on two hormone pathways, GLP-1 and GIP. Retatrutide adds a third, glucagon. Early trial data suggests retatrutide may produce greater average weight loss, but it is still investigational, while tirzepatide is FDA-approved and has a longer track record of real-world use.
Can I raise GLP-1 naturally?
Your body produces GLP-1 on its own, and certain foods and habits, including adequate protein, fermentable fiber, and a well-functioning gut microbiome, can support your body's natural GLP-1 response. This won't replicate the effect of a GLP-1 medication, but it's often where our doctors start before considering whether medication has a role at all.
