# Survodutide: What SYNCHRONIZE-1 Found, and Why It Reads Weaker Than Phase 2 SYNCHRONIZE-1 randomized 725 adults to survodutide 3.6 mg, 6.0 mg or placebo. Weight fell 12.2% and 13.0% against 5.4%, with gastrointestinal events at 80.9% and 89.7%. Publisher: This GLP Editorial Team Canonical: https://thisglp.com/research/survodutide-synchronize-1 Updated: 2026-09-17 Published: 2026-09-17 [← Research](https://thisglp.com/research) Evidence # Survodutide: What SYNCHRONIZE-1 Found, and Why It Reads Weaker Than Phase 2 Weight fell 13.0% at the top dose over 76 weeks, against 14.9% in the earlier phase 2 trial. The drug did not get worse — the two trials measured different things. [This GLP Editorial Team](https://thisglp.com/about)September 20267 min read Weight change — but not the same measurement · phase 2, 4.8 mg · −14.9% · phase 3, 6.0 mg · −13% · phase 3, 3.6 mg · −12.2% · Placebo moved too: −2.8% then −5.4%. · Compare the gaps, never the bars. **Research, not medical advice.** This GLP is independent and educational. Nothing here is a substitute for individualized care from a licensed clinician, and reading it creates no doctor–patient relationship. Talk to your own provider before starting, stopping, or changing any medication, peptide, or therapy. See our [methodology](https://thisglp.com/methodology) and [terms](https://thisglp.com/terms). ## Key takeaways - Survodutide pairs GLP-1 with glucagon — a different second mechanism from the GIP in tirzepatide or the amylin in CagriSema. - In phase 3, weight fell 12.2% on 3.6 mg and 13.0% on 6.0 mg over 76 weeks, against 5.4% on placebo. - The phase 2 trial had reached 14.9% at 4.8 mg over 46 weeks, so the phase 3 figure looks lower at a higher dose. - The two trials measured different things: phase 3 used an estimand that counts discontinuation against the drug, and its placebo arm lost nearly twice as much. Survodutide is the glucagon entry in a field that has mostly paired GLP-1 with something else. Its phase 3 result arrived looking slightly weaker than the phase 2 result that made people interested in it. That comparison is the thing worth getting right, because the obvious reading of it is wrong. The mechanism it competes against is set out in [the head-to-head that was finally run](https://thisglp.com/research/is-cagrisema-better-than-semaglutide). ## What the phase 3 trial found SYNCHRONIZE-1 randomized 725 adults with obesity and without diabetes to survodutide at 3.6 mg, 6.0 mg or placebo, and followed them for 76 weeks [\[1\]](https://thisglp.com/research/survodutide-synchronize-1#ref-1). Weight fell 12.2% on the lower dose and 13.0% on the higher one, against 5.4% on placebo. At least 5% of body weight was lost by 72.6%, 71.9% and 46.3% of each group respectively. Read the two active arms against each other and the dose step bought 0.8 percentage points. Over that same step, gastrointestinal events rose from 80.9% of participants to 89.7%. Nearly nine in ten people on the higher dose reported one, for less than a point of extra result. ## Why it looks weaker than phase 2 The same drug, measured two different ways. | | Phase 2 | Phase 3 (SYNCHRONIZE-1) | | --- | --- | --- | | Participants | 386 | 725 | | Duration | 46 weeks | 76 weeks | | Top dose tested | 4.8 mg → −14.9% | 6.0 mg → −13.0% | | Placebo arm | −2.8% | −5.4% | | Gap to placebo at top dose | about 12 points | about 7.6 points | | Analysis | Planned treatment, COVID discontinuations censored | Treatment-regimen estimand | The same drug, measured two different ways. Phase 2 dose-finding trial and SYNCHRONIZE-1 The phase 2 trial found a clean dose-response, with weight falling 6.2%, 12.5%, 13.2% and 14.9% across 0.6, 2.4, 3.6 and 4.8 mg against 2.8% on placebo [\[2\]](https://thisglp.com/research/survodutide-synchronize-1#ref-2). Set beside 13.0% at 6.0 mg in phase 3, that looks like a drug losing ground as it moved into a larger trial, and it almost certainly is not. The two trials asked different questions Phase 3 reports a treatment-regimen estimand, which deliberately counts early discontinuation, prohibited medication use and a prolonged escalation period against the drug rather than excluding them. Phase 2 reported the dose people were assigned, with COVID-related discontinuations censored out. The first is a harder test than the second, and neither paper decomposes how much of the difference that accounts for — so the honest statement is that the measurements differ, not that the effect shrank. The same distinction is why this site quotes gaps rather than arms, as in [the same percentage in different kilograms](https://thisglp.com/research/do-glp1-drugs-work-the-same-in-asian-patients). There is a second reason to compare gaps rather than headline figures. The placebo arm lost 2.8% in phase 2 and 5.4% in phase 3. The distance between drug and no drug therefore fell from about twelve points to about 7.6, before anything else is considered. A page quoting 14.9% and 13.0% side by side is comparing two numbers that were never measured against the same floor. One further limit sits underneath the phase 2 figure. Only 60.4% of its participants completed the 46-week treatment period. That is a lot of people to lose from the trial whose top-dose result everyone remembers. ## What it costs to tolerate Tolerability is where this drug has consistently been expensive. In phase 2, adverse events occurred in 91% of survodutide recipients against 75% on placebo, and gastrointestinal events specifically in 75% against 42%. In phase 3 the gastrointestinal figures reached 80.9% and 89.7% across the two doses. That is the pattern this site has found across the class. The agents taking off the most weight are generally the ones people find hardest to stay on, as set out in [the network meta-analysis of nineteen drugs](https://thisglp.com/research/the-best-losers-are-the-worst-tolerated). Whether the glucagon arm eventually earns its place will depend on outcomes nobody has measured yet rather than on the weight column. No deaths were reported in the phase 3 trial, and it was funded by Boehringer Ingelheim, which the paper states and which is ordinary for a phase 3 program. Survodutide is not approved and is not sold, so no price exists for it anywhere. This site keeps making that point about the whole pipeline in [what is not for sale](https://thisglp.com/research/what-new-weight-loss-drugs-are-coming). It is worth holding on to whenever a seller mentions a drug you cannot buy. ## Frequently asked How much weight did survodutide take off? In the phase 3 trial, 12.2% at 3.6 mg and 13.0% at 6.0 mg over 76 weeks, against 5.4% on placebo in 725 adults with obesity and without diabetes. Why was the phase 2 number higher? Phase 2 reached 14.9% at 4.8 mg, but it reported the assigned dose with COVID discontinuations censored, while phase 3 used an estimand that counts discontinuation against the drug. Its placebo arm also lost nearly twice as much. Is the higher dose worth taking? On these numbers it bought 0.8 percentage points of weight while gastrointestinal events rose from 80.9% to 89.7%, and the share of people losing at least 5% was essentially the same at both doses. Can I buy survodutide? No. It is investigational, not approved anywhere, and not sold by any seller this site tracks. ## Sources 1. \[1\] le Roux CW, Wharton S, Startseva E, Kloer IM, Hussain SA, Unseld A (2026). Survodutide Once Weekly for the Treatment of Adults with Obesity The New England Journal of Medicine. [PMID 42253238](https://pubmed.ncbi.nlm.nih.gov/42253238/) 2. \[2\] le Roux CW, Steen O, Lucas KJ, Startseva E, Unseld A, Hennige AM (2024). Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial The Lancet Diabetes & Endocrinology. [PMID 38330987](https://pubmed.ncbi.nlm.nih.gov/38330987/) ## Where to get it ### Best GLP-1 injections Every injectable seller we can verify, with the price each one publishes and an honest read of what the trials measured. [Compare providers →](https://thisglp.com/best/compounded-semaglutide) ## More in Evidence - [ 150 minutes · Weekly activity goal · 2 days · Muscle strengthening · Adapt · Symptoms and ability ### Exercise on Ozempic: Building Strength Without Ignoring Symptoms ](https://thisglp.com/research/exercise-on-ozempic) - [ STEP 1, semaglutide 2.4 mg vs placebo, % change at 68 weeks · LDL cholesterol · −2.5% vs +1.3% · Total cholesterol · −3.3% vs +0.1% · HDL cholesterol · +5.2% vs +1.4% · Triglycerides · −21.9% vs −7.3% · Wegovy label, Table 13. Adults without diabetes. Ozempic doses are lower. ### Does Ozempic Lower Cholesterol? What the Lipid Results in the Trials Show ](https://thisglp.com/research/does-ozempic-lower-cholesterol) - [ Where the insulin reduction came from, units per day · week 4 · 13.4 total · week 26 · 21.9 · the drug itself · the weight loss · The drug’s own contribution barely moved: 11.1 then 11.4. · Everything added between weeks 4 and 26 came from weight. ### Does Semaglutide Help Type 1 Diabetes? What Two Small Trials Found ](https://thisglp.com/research/semaglutide-in-type-1-diabetes)