The US weight-loss treatment is on the verge of a significant shift, with the development of a new generation of medicines that could leave current options behind in efficacy. The Wegovy pill, approved by the US Food and Drug Administration, is now estimated to be part of the daily regimen of about 400,000 Americans. A second pill is under review at the FDA and is expected to be approved next month and many more are in clinical trials. The next wave could be driven by cost and convenience as much as by new approaches to treatment. One drug, retatrutide, a weekly injectable medicine in development by Eli Lilly, is breaking records for weight loss induced with medicines and leading to average loss of up to 29% of participants’ body weight after 68 weeks, or about 71 pounds in a study of people with knee osteoarthritis. New research also revealed that retatsepatide, which mimics two hormones: GLP-1 and GIP, could offer options for people who don't get enough benefit from currently available therapies but also risk inappropriate use. However, doctors have warned of the risk of inappropriate use due to its high use.