Eloralintide
Eloralintide — the selective amylin agonist with ~20% weight loss: the amylin story and what it means for the class

Class: peptide
Synonyms: Eloralintide
LY3841136 (Lilly development code)
Function tags: weight management / obesity
selective amylin-receptor agonism (satiety)
cardiometabolic improvement
combination-ready (with incretins)
Overall evidence grade: A
WADA prohibited: no
Last updated: 2026-07-13

In brief: Eloralintide (Lilly's LY3841136) is a once-weekly, selective amylin-receptor agonist — and it closes the register's amylin story with the class's strongest monotherapy data yet. The amylin lineage has a lovely origin: the hormone was discovered as the mysterious amyloid "junk" clogging diabetics' pancreases for a century, which turned out to be a third islet hormone that signals fullness (co-secreted with insulin). Eloralintide's Phase 2 (Lancet, 2025) delivered up to ~20% mean weight loss over 48 weeks (range 9.5–20.1% vs 0.4% placebo) — incretin-class numbers from a non-incretin mechanism — with generally good tolerability (GI/fatigue AEs dose-dependent; placebo-like at lower doses). That result matters beyond the drug: arriving just after Petrelintide (#69) — whose ~10.7% disappointed the market — eloralintide shows the amylin class can reach the top tier, so efficacy magnitude, not just tolerability, is the real battleground. Lilly went straight to Phase 3 and is testing an eloralintide + tirzepatide combination. The honest read: a standout Phase 2 for a selective amylin agonist — high efficacy, good tolerability — but still investigational, Phase 3 pending, and (as Petrelintide showed) mid-stage promise isn't approval.

## Identity a **synthetic, selective agonist of the amylin receptor**, engineered for **once-weekly subcutaneous** dosing, from **Eli Lilly**. Lilly emphasizes **"molecule specificity"** — eloralintide is designed to hit the amylin receptor **cleanly/selectively** (rather than a broad multi-receptor sweep), the company's bet on precision within this class. ## Mechanism (as proposed) like all amylins, eloralintide engages **amylin receptors (AMY = calcitonin receptor + RAMP)** concentrated in the **hindbrain area postrema / NTS** and hypothalamic circuits, producing **satiety**, **delayed gastric emptying**, and **glucagon suppression** — making people **eat less and feel full sooner.** Its distinguishing design is **selectivity** for the amylin receptor (Lilly's "molecule specificity" thesis), aiming for a **clean** amylin signal. Because this pathway is **entirely separate from GLP-1/GIP incretins**, it can serve as an **alternative** (for people who don't tolerate incretins) **or a complement** (stacked with tirzepatide). As with the whole class, the molecule is engineered to **avoid the amyloid fibrillation** that makes native amylin toxic — the direct legacy of amylin's "discovered-as-toxic-amyloid" origin.

Evidence grades by outcome:
outcome: Weight loss / obesity
grade: B
base: Phase 2, Lancet 2025 (263 pts, 48 wk): up to 20.1% (−21.3 kg) vs 0.4% placebo; dose-dependent; Phase 1 ~11%/12 wk
caveat: Standout Phase 2 — highest amylin-monotherapy weight loss reported — but not yet Phase 3-confirmed; predominantly female cohort (78%)
outcome: Tolerability
grade: A
base: GI + fatigue AEs, dose-dependent; similar to placebo at; slower escalation helped
caveat: Strong — but the highest-efficacy (highest-dose) arms had more AEs; escalation protocol matters
outcome: Cardiometabolic risk factors
grade: B
base: Improvements in waist, BP, lipids, glycemia, inflammation
caveat: Consistent secondary benefits; Phase 2 level
outcome: Combination with tirzepatide
base: Trial ongoing (LY3841136 + tirzepatide)
caveat: No combination efficacy data yet
outcome: Safety
grade: B
base: Phase 2 (263) + Phase 1
caveat: No unexpected signals; investigational — Phase 3/long-term safety pending

Legal status:
region: EU
status: Not FDA-approved (gray-market)
note: investigational; not approved. Phase 2 complete → Phase 3 enrolling (obesity). A well-capitalized Lilly clinical program, not a gray-market compound.

Cosmetic claims:

Note: The amylin that hit incretin-level weight loss — and rewrote the class's market lesson. Eloralintide (Lilly) closes the register's amylin lineage on a high note, and it comes with a genuinely beautiful backstory. Three threads: (1) the amylin origin story — the whole class descends from a mysterious "junk" amyloid found clogging diabetics' pancreases for a century, which turned out to be a third islet hormone; (2) eloralintide is a selective amylin-receptor agonist that delivered up to ~20% weight loss in Phase 2 — matching tirzepatide-class numbers without an incretin mechanism; (3) landing weeks after Petrelintide (#69), it flips that entry's lesson: amylins can reach top-tier efficacy, so magnitude — not just tolerability — is now in play for the class. Straight to Phase 3.
Status note: Phase 3 obesity enrolling; eloralintide + tirzepatide combination and Phase 3 readouts are the catalysts — and the real test of whether ~20% holds at scale

Sources:
Bailey et al. Eloralintide, a selective amylin receptor agonist for the treatment of obesity: a 48-week phase 2… trial. The Lancet, 2025 (NCT06230523; up to 20.1% / −21.3 kg vs 0.4% placebo; tolerability).
Eli Lilly press release (6 Nov 2025): Phase 2 results; 9.5–20.1% weight loss; cardiometabolic improvements; Phase 3 enrollment beginning; "molecule specificity" (Kenneth Custer).
Amylin discovery/history: Cooper GJ et al. PNAS 1987; Westermark P et al. 1986–1987 (IAPP isolation from islet amyloid); "islet hyalinization" 1900 → amyloid identification → third islet hormone; fibrillation/toxicity → engineered non-aggregating analogs.
Combination study: LY3841136 + tirzepatide (ClinicalTrials.gov). (Investigational; not approved as of 2026.)