Mazdutide vs Semaglutide: New Data Needs a Closer Look

Original posted at obesity.news/ on Oct 27, 2025

If you’ve been following On The Pen, you already know the name Mazdutide. It’s the GLP-1 and glucagon dual agonist from Innovent Biologics, licensed from Eli Lilly, that was recently approved in China for both type 2 diabetes and obesity.

This week, Innovent dropped topline data from DREAMS-3, the first head-to-head Phase 3 comparison between Mazdutide and Semaglutide in adults with type 2 diabetes and obesity.

Headlines across LinkedIn and media headlines framed it the same way: Mazdutide outperformed semaglutide in both glucose control and weight loss.

While this sounds impressive, it really deserves a lot more context.

The Numbers That Matter

At 32 weeks, adults receiving Mazdutide 6 mg achieved the dual target of HbA1c below 7% and at least 10% body weight reduction at a rate of 48%, compared to just 21% on semaglutide.

Average weight loss was 10.3% versus 6.0%. HbA1c reduction was 2.03 versus 1.84.

No new safety concerns were noted. The most common side effects were the typical mild to moderate GI symptoms seen across the incretin class.

While these are strong results, here’s the context that matters.

Dose Matters

The semaglutide arm in this study used just 1 mg, which is the highest Ozempic dose currently approved in China for diabetes. In the United States, Ozempic is approved up to 2 mg for diabetes, and Wegovy up to 2.4 mg for obesity.

That means the comparison in DREAMS-3 wasn’t wrong, but it wasn’t equal either. It compared the strongest version of Mazdutide available to the strongest version of semaglutide allowed in

China, which is a full step below what’s used in the U.S.

In other words, Mazdutide outperformed 1 mg semaglutide, but not necessarily what we’d expect from 2 mg Ozempic or 2.4 mg Wegovy.

Who Was Studied

The entire trial was conducted in China, enrolling 349 adults with early stage type 2 diabetes and obesity. That matters.

Chinese participants, on average, have different patterns of insulin resistance, visceral fat, and hepatic metabolism than Western populations. These biological and lifestyle differences can influence how incretin drugs behave.

So while the data are fascinating, they don’t automatically translate to Western patients.

Why It Still Matters

Mazdutide is more than another name in the GLP-1 conversation. By targeting both GLP-1 and glucagon receptors, it doesn’t just suppress appetite, it increases energy expenditure and improves fat metabolism, including liver fat reduction.

That’s the direction the field is heading. Multi-pathway incretins like Mazdutide and the triple-G, Retatrutide will likely define the next wave of obesity medicine, moving beyond appetite control toward true metabolic reprogramming.

So while this study was smaller, regional, and based on a lower semaglutide comparator, it still tells us something big. The science behind combination agonists is real, and it represents the near future of obesity medicine.

Mazdutide’s message isn’t that it “beat Ozempic.” It’s that the evolution of incretin therapy is accelerating, and each new molecule brings us closer to the next leap forward.

Stay tuned to OnThePen.com for updates on Mazdutide, Retatrutide, and the broader incretin race. Sharing this story helps more people understand the nuance behind these breakthroughs and why they matter to the patients living this reality every day.

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