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What Is Mazdutide (Xinermei)? The First GLP-1/Glucagon Drug Approved in China

Part of Weight Loss Drug Profiles: Every GLP-1 and GLP3 Agonist.

What Is Mazdutide (Xinermei)? The First GLP-1/Glucagon Drug Approved in China

Mazdutide is a dual GLP-1 and glucagon receptor agonist developed by Innovent Biologics, based on a molecule originally discovered by Eli Lilly. It is a once-weekly subcutaneous injection that activates two hormone receptors simultaneously: GLP-1 to suppress appetite and glucagon to increase energy expenditure and promote liver fat oxidation.
Mazdutide is approved in China under the brand name Xinermei — for obesity (June 2025) and type 2 diabetes (September 2025). It is not approved by the FDA or any other Western regulatory agency. There is no confirmed FDA approval or US launch date.
What makes mazdutide distinctive in the current obesity drug landscape is its glucagon component. Unlike semaglutide (GLP-1 only) or tirzepatide (GLP-1 + GIP), mazdutide pairs GLP-1 with glucagon — a receptor that directly drives liver fat breakdown and thermogenesis. It shares this glucagon element with retatrutide, Eli Lilly's investigational triple agonist, though retatrutide adds a third receptor (GIP) on top.

How Mazdutide Works

Mazdutide is a single-molecule dual agonist that activates two distinct receptor pathways. Each receptor contributes a different mechanism to weight loss and metabolic improvement.

GLP-1 Receptor: Appetite Suppression

The GLP-1 (glucagon-like peptide-1) receptor is the same target used by semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro/Zepbound). When activated, it:

  • Reduces appetite by acting on brain regions that control hunger and satiety
  • Slows gastric emptying, prolonging the feeling of fullness after eating
  • Improves insulin secretion in a glucose-dependent manner, lowering blood sugar
  • Suppresses glucagon release from the pancreas after meals

This is the well-established mechanism behind the entire GLP-1 drug class. Mazdutide's GLP-1 activity provides the core appetite-suppressing effect.

Glucagon Receptor: Energy Expenditure and Liver Fat Oxidation

The glucagon receptor is what distinguishes mazdutide from GLP-1-only drugs. Glucagon is a catabolic hormone that acts primarily on the liver. When the glucagon receptor is activated, it:

  • Promotes hepatic fat oxidation — the liver directly breaks down stored fat at an accelerated rate
  • Increases energy expenditure through thermogenesis
  • Stimulates lipolysis — the breakdown of fat in adipose tissue
  • Activates gluconeogenesis — the liver produces glucose from non-carbohydrate sources

Glucagon receptor activity is part of the rationale for studying liver effects. It does not, by itself, prove greater liver benefit than a GLP-1-only drug or quantify how much this pathway contributes in humans.

What Mazdutide Does Not Target: GIP

Notably, mazdutide does not activate the GIP (glucose-dependent insulinotropic polypeptide) receptor. Tirzepatide targets GIP and GLP-1; retatrutide also targets glucagon. GIP complements GLP-1 by enhancing insulin secretion and may have additional effects on fat metabolism.

The absence of GIP agonism means mazdutide takes a different strategic approach: appetite suppression (GLP-1) plus metabolic activation (glucagon), rather than the enhanced incretin signaling (GLP-1 + GIP) used by tirzepatide or the three-pronged approach (GLP-1 + GIP + glucagon) used by retatrutide.

Clinical Trial Data

GLORY-1 (Phase 3 — Obesity)

The GLORY-1 trial was a Phase 3, randomized, double-blind, placebo-controlled study published in the New England Journal of Medicine. It enrolled 610 Chinese adults with obesity (BMI 28 or above) or overweight (BMI 24 or above) with at least one weight-related comorbidity. The following 48-week results use the treatment-policy analysis, which accounts for discontinuation and new obesity treatment:
DoseWeight Loss at 48 Weeks
Mazdutide 4 mg-11.00%
Mazdutide 6 mg-14.01%
Placebo+0.30%
Adverse events led to discontinuation in 1.5% with 4 mg, 0.5% with 6 mg and 1.0% with placebo. These figures do not establish the best tolerability across different trials. GLORY-1 publication.
The newer GLORY-2 trial tested 9 mg for 60 weeks in Chinese adults with BMI at least 30, with or without type 2 diabetes. Average weight loss was 16.65% versus 1.50% with placebo in the treatment-policy analysis. A separate Innovent sponsor report reported 18.55% versus 3.02%; these should not be substituted for the primary treatment-policy result. Innovent’s 20.08% headline refers to the subgroup without diabetes, not the whole trial.

DREAMS-3 (Phase 3 — Type 2 Diabetes)

The DREAMS-3 trial is notable because it included a head-to-head comparison against semaglutide. This open-label trial enrolled 329 Chinese adults with type 2 diabetes and obesity. It compared mazdutide 6 mg with semaglutide 1 mg over 32 weeks. The table uses the efficacy estimand from Innovent’s report.
OutcomeMazdutide 6 mgSemaglutide 1 mg
Primary composite (HbA1c under 7% + 10%+ weight loss)48%21%
HbA1c reduction-2.03%-1.84%
Weight loss-10.3%-6.00%

Mazdutide outperformed semaglutide 1 mg on both glycemic control and weight loss. Note that this trial used semaglutide 1 mg, not the maximum approved dose for diabetes (2 mg for Ozempic), so the comparison has limitations.

US Phase 2 Results

A US Phase 2 study published in August 2026 enrolled 179 adults without diabetes and studied doses up to 16 mg over 48 weeks. At the primary 32-week endpoint, the 16 mg group had 18.1% mean weight reduction under the efficacy estimand, versus 0.9% with placebo. Adverse events, mainly gastrointestinal disorders, led to treatment discontinuation in 20% of the 16 mg group. These results come from a different dose range and population than the Chinese studies.

MASLD Substudy (Phase 2 — Liver Fat)

Earlier studies explored changes in liver fat. More recently, the GLORY-2 report described a 71.9% relative liver-fat reduction at 60 weeks with 9 mg in a subgroup without diabetes and with baseline liver fat of at least 10%, compared with a 5.1% increase on placebo.

That is an imaging result in a selected subgroup. It is not proof of MASH resolution, fibrosis reversal or superiority over another drug’s liver outcomes.

Side Effects

Mazdutide's side effect profile is broadly consistent with other GLP-1-class drugs: gastrointestinal symptoms are the most common adverse events, concentrated during the dose escalation period.

The most frequently reported side effects include:

  • Nausea (the most common, typically mild and transient)
  • Diarrhea
  • Decreased appetite
  • Vomiting (less common than nausea)

What the Tolerability Data Shows

“Best in class” is not established. Low discontinuation in GLORY-1 cannot be generalized across medicines, doses and populations.

In the direct DREAMS-3 comparison, nausea occurred in 30.5% with mazdutide 6 mg versus 12.6% with semaglutide 1 mg; vomiting occurred in 23.6% versus 8.6%. In GLORY-2, adverse-event discontinuation was 2.9% on 9 mg versus 0% on placebo. These findings are more useful than a blanket claim of better tolerability.

How Mazdutide Compares to Other Weight Loss Drugs

The strongest direct comparison summarized here is DREAMS-3: mazdutide 6 mg versus semaglutide 1 mg in Chinese adults with diabetes and obesity. It does not establish superiority to Wegovy’s obesity doses, tirzepatide or retatrutide.

Receptor targets differ, but separate weight-loss and liver-fat percentages cannot establish an overall ranking. Approval also depends on jurisdiction: mazdutide’s Chinese approval does not provide US authorization.

Mazdutide vs Retatrutide

Mazdutide targets GLP-1 and glucagon; retatrutide also targets GIP. Mazdutide is approved in China, whereas retatrutide remains investigational.

The trials summarized here do not directly compare the two drugs. Their weight-loss and liver-fat findings differ in population, dose, duration and analysis. See Retatrutide vs Mazdutide.

Current Status and Availability

Approved in China

Mazdutide is approved in China under the brand name Xinermei, manufactured by Innovent Biologics:
  • June 2025: Approved by China's National Medical Products Administration (NMPA) for chronic weight management in adults with obesity or overweight with comorbidities
  • September 2025: Approved in China for type 2 diabetes

Not Available in the US or Europe

Mazdutide is not approved by the FDA, the European Medicines Agency, or any regulatory body outside China. The sources reviewed here do not establish a confirmed FDA approval or US launch timeline.

The Eli Lilly Connection

The mazdutide molecule was originally discovered by Eli Lilly and licensed to Innovent Biologics for development in the China market. Eli Lilly separately developed retatrutide as its own next-generation obesity drug for global markets. The two drugs share a corporate lineage but are structurally distinct compounds with different receptor profiles.

Frequently Asked Questions

What is mazdutide?

Mazdutide is a dual GLP-1 and glucagon receptor agonist developed by Innovent Biologics (originally discovered by Eli Lilly). It is a once-weekly injectable drug that suppresses appetite through GLP-1 and increases energy expenditure and liver fat oxidation through glucagon receptor activation. It is approved in China under the brand name Xinermei.

Is mazdutide FDA approved?

No. Mazdutide is approved only in China (for obesity and type 2 diabetes). It is not approved by the FDA or any European regulatory agency. There is no confirmed FDA approval or US launch date.

How much weight can you lose on mazdutide?

GLORY-1 reported 11.00% and 14.01% average loss with 4 and 6 mg at 48 weeks, versus a 0.30% gain on placebo. GLORY-2 reported 16.65% loss with 9 mg at 60 weeks versus 1.50% with placebo in its treatment-policy analysis. These are separate Chinese trial populations.

What is the difference between mazdutide and semaglutide?

Mazdutide targets GLP-1 and glucagon; semaglutide targets GLP-1. DREAMS-3 favored mazdutide 6 mg over semaglutide 1 mg for glucose control and weight loss in adults with diabetes and obesity, but GI symptoms were more frequent. It was not a comparison with Wegovy’s obesity doses.

What is the difference between mazdutide and tirzepatide?

Tirzepatide targets GLP-1 and GIP; mazdutide targets GLP-1 and glucagon. The separate trials summarized here do not establish which provides better weight loss, liver outcomes or tolerability.

What is the difference between mazdutide and retatrutide?

Retatrutide adds GIP activity to the GLP-1 and glucagon targets shared with mazdutide. Separate trials cannot establish superiority. See our comparison.

Where can I get mazdutide?

Mazdutide (brand name Xinermei) is available by prescription in China for obesity and type 2 diabetes. It is not available in the United States, Europe, or other markets outside China. There is no established timeline for availability in Western countries.

Is mazdutide good for fatty liver disease?

Studies show reductions in liver fat, including a selected GLORY-2 subgroup. Imaging changes do not establish MASH resolution or fibrosis reversal, and cannot prove better liver outcomes than another medicine.

Sources

  1. Ji, L., et al. (2025). Mazdutide in Chinese Adults with Overweight or Obesity (GLORY-1). New England Journal of Medicine. NEJM
  2. Innovent. DREAMS-3 results, June 2026.
  3. Gao L, et al. GLORY-2, JAMA, 2026.
  4. Innovent. Diabetes approval, September 19, 2025.
  5. Innovent Biologics. Mazdutide (Xinermei) prescribing information and regulatory filings. Innovent
  6. ClinicalTrials.gov: Mazdutide trials
  7. Jastreboff, A.M., et al. (2023). Triple-Hormone-Receptor Agonist Retatrutide for Obesity — A Phase 2 Trial. New England Journal of Medicine. DOI: 10.1056/NEJMoa2301972
This article is for informational purposes only and does not constitute medical advice. Mazdutide (Xinermei) is approved in China but is not approved by the U.S. Food and Drug Administration (FDA). Always consult a healthcare provider before starting any medication. This site is not affiliated with Innovent Biologics, Eli Lilly, or any pharmaceutical manufacturer.
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Educational information, not medical advice. It reports published research — it doesn’t recommend that you use, obtain, or supply anything.
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Mazdutide is approved in China for weight management and type 2 diabetes; it is not FDA approved.
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Do not make decisions about your health without consulting a qualified healthcare provider. For trial enrolment, see ClinicalTrials.gov. More on how we review.

Sources

Grounded in primary sources
NEJMThe LancetJAMAFDAClinicalTrials.gov

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