Patients buying from the black market are conducting their own unmonitored experiments
Uma droga experimental da Eli Lilly chamada retatrutida demonstrou, em ensaios clínicos publicados simultaneamente no The Lancet e apresentados à Associação Americana de Diabetes, resultados de perda de peso comparáveis aos da cirurgia bariátrica — até 28,3% do peso corporal. O medicamento age sobre três receptores hormonais ao mesmo tempo, superando gerações anteriores de tratamentos para obesidade e diabetes tipo 2. Ainda sem aprovação regulatória, a retatrutida já circula ilegalmente no Brasil e no Paraguai, colocando pacientes vulneráveis diante de riscos desconhecidos em busca de uma promessa que a ciência ainda não liberou ao mundo.
- Com resultados que rivalizam com a cirurgia bariátrica, a retatrutida reacende a esperança de milhões de pacientes com obesidade severa — e a urgência por acesso imediato.
- Mais de 65% dos participantes dos ensaios saíram da categoria de obesos, e os benefícios se estenderam ao controle do diabetes, à pressão arterial, à apneia do sono e à dor no joelho.
- A lacuna entre os resultados promissores e a aprovação regulatória criou um mercado negro perigoso: versões não verificadas do medicamento já circulam no Brasil e atravessam a fronteira com o Paraguai.
- A Receita Federal brasileira já apreendeu carregamentos com centenas de frascos de medicamentos não autorizados, e os responsáveis enfrentam penalidades civis, criminais e fiscais.
- Pacientes que recorrem ao mercado ilegal estão, na prática, conduzindo experimentos não monitorados em si mesmos, sem supervisão médica e sem garantia alguma sobre o que estão injetando.
A Eli Lilly apresentou neste fim de semana, na 86ª sessão científica da Associação Americana de Diabetes, os resultados do ensaio TRIUMPH-1 com retatrutida — um medicamento experimental para obesidade e diabetes tipo 2. Os dados foram publicados simultaneamente no The Lancet: pacientes que receberam a dose máxima de 12 miligramas por semana perderam, em média, 31,9 quilos ao longo de 80 semanas, o equivalente a 28,3% do peso corporal. Mais de dois terços dos participantes deixaram de ser classificados como obesos.
O que distingue a retatrutida dos medicamentos já disponíveis é sua ação tripla: enquanto o Ozempic age sobre um receptor hormonal e o Mounjaro sobre dois, a retatrutida atua simultaneamente sobre os receptores GLP-1, GIP e glucagon, controlando fome, produção de insulina, regulação do açúcar no sangue e gasto energético. Em um segundo ensaio, o TRANSCEND-T2D-1, conduzido com 537 pacientes diabéticos nos Estados Unidos, México e Índia, 90% mantiveram a hemoglobina glicada abaixo de 7% — e quase metade atingiu níveis considerados normais.
Os benefícios foram além do peso e do açúcar no sangue. Triglicerídeos caíram 41%, a pressão arterial recuou mais de 12 pontos, e pacientes com apneia do sono registraram redução de mais de 60% nos episódios. Aqueles com osteoartrite no joelho relataram alívio de mais de 70% na dor.
Apesar de tudo isso, a retatrutida ainda não tem aprovação regulatória em nenhum país. Essa lacuna abriu espaço para um mercado ilegal preocupante. A Receita Federal brasileira já apreendeu carregamentos com centenas de frascos de medicamentos vendidos como retatrutida — incluindo uma apreensão em fevereiro no aeroporto de São Luís, com material avaliado em cerca de 264 mil reais. Produtos também cruzam a fronteira com o Paraguai de forma contínua. Qualquer versão vendida hoje no Brasil não tem verificação de segurança nem garantia de composição. Quem compra no mercado negro está, essencialmente, experimentando uma substância desconhecida sem nenhuma supervisão médica.
Eli Lilly announced this week that retatrutida, an experimental drug for obesity and type 2 diabetes, can produce weight loss of up to 28.3 percent of a patient's body weight—a result that puts it in the same league as bariatric surgery. The company presented the findings Saturday at the American Diabetes Association's 86th scientific session and published them simultaneously in The Lancet, giving the results the kind of dual validation that gets attention in both the medical world and beyond.
What makes retatrutida different from the weight-loss drugs already on the market—Ozempic and Mounjaro—is how it works at the molecular level. Ozempic targets one hormone receptor; Mounjaro targets two. Retatrutida hits three at once: the GLP-1, GIP, and glucagon receptors, which together control hunger, insulin production, blood sugar regulation, and energy expenditure. In the TRIUMPH-1 trial, patients receiving the maximum 12-milligram weekly dose lost an average of 31.9 kilograms over 80 weeks. That translated to the 28.3 percent figure. More than 65 percent of treated patients dropped out of the obese category entirely, reaching a BMI below 30. Another third achieved a BMI below 25, which is considered normal weight.
The weight loss alone would be remarkable. But the drug showed other effects that matter just as much to people living with these conditions. In a separate trial called TRANSCEND-T2D-1, which tracked 537 patients with type 2 diabetes across medical centers in the United States, Mexico, and India, the drug reduced hemoglobin A1C—the marker doctors use to measure average blood sugar over months—by up to two percentage points. Ninety percent of participants kept their A1C below 7 percent, the target most endocrinologists aim for. Forty-six percent actually reached normal levels.
Beyond weight and blood sugar, the trials documented improvements in the cardiovascular risk factors that often travel alongside obesity. Triglycerides dropped by 41 percent. Non-HDL cholesterol fell by nearly a quarter. Blood pressure declined by more than 12 points. Waist circumference shrank by an average of 24 centimeters. The drug also showed striking effects on conditions that obesity makes worse: patients with sleep apnea saw their episodes drop by more than 60 percent, and those with knee osteoarthritis reported pain reductions of more than 70 percent.
Yet retatrutida remains unapproved. It is still in clinical trials and has not received authorization from regulatory agencies like Brazil's Anvisa to be sold. This gap between promising results and market availability has created a dangerous space. Eli Lilly representatives warned during the presentation that unauthorized versions of the drug are already circulating. The company was not exaggerating. Brazil's federal tax authority has already seized shipments of what was being sold as retatrutida. In February, customs officers intercepted a cargo at São Luís airport containing 240 vials of tirzepatida, 22 pens of Mounjaro, and 12 pens of retatrutida, valued at roughly 264,000 reais. The material was destroyed, and those responsible face civil, criminal, and tax penalties.
The illegal trade is not confined to airports. Significant quantities of counterfeit weight-loss drugs are flowing across the border from Paraguay, where regulatory oversight is looser and the profit margins are enormous. Authorities monitoring the frontier report steady traffic in unauthorized GLP-1 class medications. The risk is not abstract. Any product currently being sold as retatrutida in Brazil has no approval, no safety verification, and no guarantee of what it actually contains. Patients buying from the black market are essentially conducting their own unmonitored experiments, with no medical oversight and no recourse if something goes wrong.
Citações Notáveis
Eli Lilly representatives warned that unauthorized versions of the drug are already circulating— Eli Lilly company statement during American Diabetes Association presentation
Any product currently being sold as retatrutida in Brazil has no approval, no safety verification, and no guarantee of what it actually contains— Brazilian health authorities
A Conversa do Hearth Outra perspectiva sobre a história
Why does it matter that retatrutida hits three receptors instead of two? What's the practical difference for someone taking it?
The more receptors you activate, the more levers you have to pull on the body's hunger and metabolism systems. With three targets instead of two, you're addressing the problem from multiple angles at once. That's why the weight loss is so much more dramatic—you're not just suppressing appetite, you're also changing how the body burns energy and processes sugar.
The weight loss numbers are impressive, but what struck me was the sleep apnea result. Sixty percent reduction in episodes. How does losing weight do that?
Sleep apnea happens because excess tissue in the throat collapses when you sleep. When you lose significant weight, there's less tissue to collapse. But it's not just mechanical—the drug also seems to improve how the body regulates breathing and inflammation. The effect is real enough that people can actually breathe at night again.
The drug isn't approved yet, but it's already being seized at airports. What does that tell you about demand?
It tells you that people are desperate. They see the results, they hear about it, and they're willing to buy something with no safety verification because the alternative—staying obese, staying diabetic—feels worse. That's the dangerous part. The demand is real. The supply is uncontrolled.
Do we know what's actually in those counterfeit versions?
No. That's the point. It could be nothing. It could be something toxic. It could be a lower dose that doesn't work. There's no way to know, and no doctor overseeing what happens to the person taking it. That's why the authorities keep warning people.
When do you think this will actually be approved?
The trials look solid. The data is published in The Lancet. But regulatory agencies move slowly by design—they want to be sure. Months, probably. Maybe longer. In the meantime, the black market will keep growing.