Key takeaways:
- Peptides are short chains of amino acids that act on specific receptors. They are not interchangeable, and the evidence behind them ranges from FDA approval to a failed clinical trial, depending on which peptide you are discussing.
- GLP-1 medications are the only peptides in common wellness use that are FDA-approved for weight management. Clinical trials cited in the FDA’s approval of tirzepatide found patients on the highest approved dose lost an average of 18% of body weight over 72 weeks compared to placebo.
- Weight loss and fat loss are not the same result. A DEXA scan separates fat mass from lean mass, which is the only way to confirm that a weight management plan is working the way it should.
- Sermorelin and ipamorelin act on two different receptors to amplify the body’s own growth hormone release, rather than replacing it. Sermorelin was FDA-approved as Geref in 1997 and was later discontinued for commercial reasons, not for safety or effectiveness.
- In July 2026, an FDA advisory committee voted to recommend six peptides for the list of substances pharmacies may compound, including BPC-157, MOTS-c, and Semax. Those votes are advisory and have not yet been finalized.
Peptide therapy covers a wide range of compounds that share one feature and little else. Semaglutide and BPC-157 are both peptides. One is an FDA-approved medication for weight loss supported by large trials. The other is supported mostly by animal studies for reducing inflammation and promoting healing and has not yet been FDA-approved in the United States. Treating them as a single category is how patients end up with unrealistic expectations.
At Alchemy Beauty in Austin, our Body and Wellness programs are built on objective measurement and medical oversight. This guide explains what the peptides we work with actually do, where the evidence is strong, where it is thin, and how the FDA currently treats them.
What is peptide therapy?
Peptide therapy uses short chains of amino acids to act on specific receptors in the body. Proteins are long amino acid chains. Peptides are short ones, generally under 50 amino acids, and that smaller size lets them bind to particular receptors and trigger a targeted response rather than a broad one.
Peptide medicine is not new. Insulin is a peptide hormone and has been used clinically for a century. What changed recently is the number of peptides being studied for metabolic health, recovery, and cognition, and the speed at which those compounds reached consumer wellness clinics ahead of the research.
Two commonly offered wellness compounds are worth defining precisely, because the category label is often applied loosely. NAD+, or nicotinamide adenine dinucleotide, is a coenzyme built from two nucleotides. It is not a peptide and contains no amino acid chain. Glutathione is a tripeptide made of glutamic acid, cysteine, and glycine, so it does meet the definition, though it functions as an antioxidant rather than a signaling peptide. Both are frequently grouped under peptide therapy in marketing. We separate them here because what a compound is determines how it behaves.
The metabolic peptides: GLP-1 medications, AOD-9604, and MOTS-c
GLP-1 medications mimic a naturally occurring hormone released by the gut after eating that helps regulate appetite, blood sugar, and digestion by signaling the brain to increase feelings of fullness, reducing hunger and food cravings, and slowing how quickly food leaves the stomach. Tirzepatide works on both the GLP-1 and GIP receptors, two complementary hormone pathways involved in appetite regulation, insulin release, and blood sugar control.
The FDA has approved specific GLP-1 and dual-agonist medications for chronic weight management in adults with obesity, or adults with overweight plus at least one weight-related condition such as high blood pressure or type 2 diabetes. In its announcement approving Tirzepatide for chronic weight management, the agency cited two 72-week trials. Patients on the highest approved dose lost an average of 18% of body weight in one trial and 12% in a trial of adults with type 2 diabetes, both against placebo. The FDA noted that roughly 70% of American adults are obese or overweight, and that losing 5% to 10% of body weight through diet and exercise is associated with reduced cardiovascular risk.
These are prescription medications with some documented risks. The FDA’s approval materials include warnings related to pancreatitis, gallbladder problems, and low blood sugar, among others, all of which require a prescribing provider to monitor.
AOD-9604 is a fragment of human growth hormone, corresponding to its fat-mobilizing region, that was developed to promote lipolysis (the breakdown of stored fat) without the growth-promoting and metabolic effects associated with full human growth hormone. It is sometimes used as an adjunct to nutrition, exercise, and other weight-management therapies with the goal of supporting fat reduction, including reduction of abdominal and visceral fat; however, this specific benefit has not been established in adequately powered human clinical trials. Early studies showed some promising weight-loss signals, but development for obesity was discontinued in 2007 after a 24-week Phase 2b trial involving 536 enrolled participants failed to demonstrate statistically significant weight loss compared with placebo. The compound never advanced to Phase 3, and detailed results from the pivotal trial were not published in the peer-reviewed medical literature. Therefore, AOD-9604 should not be presented as a proven standalone weight-loss medication or a proven treatment for visceral adiposity, but rather as an investigational adjunct whose proposed fat-metabolism effects remain supported more strongly by preclinical data than by clinical outcomes.
MOTS-c is a naturally occurring 16-amino-acid mitochondrial-derived peptide that is encoded by mitochondrial DNA. Research has focused on its role in metabolic regulation, mitochondrial function, skeletal muscle metabolism, and cellular adaptation to metabolic stress. MOTS-c activates pathways involving AMPK, an important cellular energy sensor also influenced by exercise and medications such as metformin. In preclinical studies, MOTS-c has been associated with improved insulin sensitivity and glucose utilization, increased fatty-acid oxidation, improved metabolic flexibility, protection against diet-induced obesity, enhanced skeletal-muscle function and exercise capacity, improved mitochondrial efficiency, and reductions in oxidative stress. These findings have generated interest in MOTS-c as a potential adjunct for metabolic health, body-composition support, exercise performance and recovery, healthy aging, and mitochondrial function. Human research has demonstrated that endogenous MOTS-c responds to exercise, further supporting a possible role in the body’s adaptation to physical and metabolic stress. In July 2026, MOTS-c was reviewed by the FDA’s Pharmacy Compounding Advisory Committee for possible inclusion on the 503A Bulks List, reflecting continued interest in its potential therapeutic applications while its clinical evidence and safety profile remain under evaluation.
Growth Factor Peptides: Sermorelin, Ipamorelin, and BPC-157
Sermorelin and Ipamorelin increase growth hormone without introducing growth hormone from outside the body, and they do it through two separate receptors.
Sermorelin reproduces the first 29 amino acids of human growth hormone-releasing hormone and binds the pituitary GHRH receptor. It has the strongest regulatory history of any peptide in this group. The FDA approved it in 1997 under the brand name Geref for pediatric growth hormone deficiency.
Ipamorelin is a pentapeptide and was described in 1998 as the first selective growth hormone secretagogue, meaning it raised growth hormone without the increases in cortisol and prolactin seen with earlier compounds in its class. It acts on the ghrelin receptor, GHSR-1a, not the GHRH receptor.
Because the two peptides bind different receptors, combining them produces more growth hormone release than either one alone. That is the reason the pairing is common. A second point is more clinically interesting: secretagogues stimulate the body’s own pulsatile release pattern and remain subject to somatostatin, the hormone that shuts growth hormone secretion off. Injected growth hormone bypasses that feedback and can produce sustained levels above the normal range. Working through the pituitary keeps the body’s own regulation intact, which is a meaningful difference in how the two approaches behave.
BPC-157 is a sequence derived from a protein found in gastric juice. It has been studied for tendon, ligament, inflammation and gastrointestinal healing, and the results in rodent models have been consistent enough to sustain a large body of follow-up work. BPC-157 was among the six peptides the FDA’s advisory committee recommended in July 2026. F
The Cellular Energy Compounds: NAD+ and glutathione
NAD+ is a coenzyme involved in mitochondrial energy production and in the activity of sirtuins, a family of enzymes associated with cellular repair. NAD+ levels decline with age, which is the premise behind supplementing it.
The evidence for intravenous NAD+ specifically is early. There is no FDA-approved injectable form. Published human data comes from small studies with short follow-up, and dosing protocols vary widely between clinics. A 2026 review in Frontiers in Aging concluded that direct evidence showing intravenous administration outperforms oral supplementation is currently lacking. Patients considering NAD+ should weigh that against the cost and time an infusion requires.
Glutathione is the body’s principal endogenous antioxidant and is involved in neutralizing reactive oxygen species and in liver detoxification pathways. We offer it for antioxidant support. We want to be specific about one thing it should not be used for: a 2025 systematic review concluded that the intravenous route is not appropriate for skin lightening, on grounds of both efficacy and side effects, and the randomized human evidence for glutathione and pigmentation involves topical and oral forms rather than infusion. Any clinic marketing IV glutathione as a skin brightening treatment is ahead of the evidence.
The Cognitive and Stress Peptides: Semax and Selank
Semax is a synthetic analog of a fragment of adrenocorticotropic hormone, corresponding to amino acids 4 through 10, modified to resist rapid breakdown. Research has examined its effects on attention, memory, and neuroprotection after ischemic events. Semax was one of the six peptides recommended by the FDA advisory committee in July 2026.
Selank is an analog of tuftsin, an immunomodulatory peptide fragment, and has been studied primarily for anxiety. Notably, Selank was not among the peptides that advisory committee recommended, which leaves it in a less certain regulatory position than Semax.
How are these peptides combined?
The peptides are grouped by the system they act on, and a protocol addresses a specific goal rather than combining compounds for their own sake.
The most clinically useful combination addresses a real limitation of GLP-1 therapy. GLP-1 medications reduce total body weight, and some of that reduction comes from lean muscle rather than fat. A patient can hit a target weight and be worse off in body composition than when they started. Growth hormone secretagogues act on a different system than GLP-1 medications, which is why sermorelin and ipamorelin are sometimes used alongside a weight management plan rather than instead of one. The goal shifts from weight loss to recomposition.
That approach only means something if it is measured. Without body composition data, adding peptides to a GLP-1 protocol is an assumption rather than a plan, which is why scanning comes before and during treatment rather than after.
The other combinations are simpler. Repair peptides are used around recovery from injury or surgery. Cellular energy compounds are used for fatigue and general metabolic support. Cognitive peptides address attention and stress. A consultation determines which of these, if any, apply.
Where does the evidence actually stand?
Not every compound in this guide is supported to the same degree, and patients deserve to see that stated plainly rather than buried.
| Evidence tier | Compounds | What supports them |
| FDA-approved for this use | Semaglutide, tirzepatide | Approved for chronic weight management, supported by large randomized trials |
| Previously FDA-approved | Sermorelin | Approved as Geref in 1997, discontinued in 2008 for commercial reasons, and formally determined by the FDA not to have been withdrawn for safety or effectiveness |
| Mechanism established, human data limited | Ipamorelin, BPC-157, MOTS-c, Semax | Receptor activity and mechanism are characterized, but human trials are small or conducted outside standard US reporting practice |
| More limited clinical trials | AOD-9604, IV NAD+, IV glutathione, Selank | Lacks published human evidence supporting the route of administration being used |
How do we measure whether it is working?
A DEXA scan measures fat mass, lean mass, and bone density using low-dose X-ray, which gives a far more specific picture than body weight. According to UC Davis Health’s sports medicine program, the scan uses dual X-ray beams to differentiate bone mineral, lean tissue, and fat, and produces a report breaking down percentage and mass for each.
This is the difference between knowing that a patient lost 20 pounds and knowing what those 20 pounds were made of. Two patients with identical scale results can have opposite outcomes if one lost mostly fat and the other lost a significant amount of muscle. Lab work covers the second half of the picture, establishing a baseline before treatment and tracking how metabolic markers respond.
Our Body Balance Program combines compounded semaglutide or tirzepatide with lab testing, DEXA body composition and nutrition and exercise counseling in a single program. A wellness and peptide consultation with our Physician Assistant reviews health history, symptoms, and goals before any protocol is built. Follow-up visits track measurements and progress so the plan can be adjusted.
No peptide replaces nutrition, training, and sleep. These compounds can support a plan that already has those elements in place. They do not substitute for them, and any provider suggesting otherwise is selling something.
Frequently asked questions
Is peptide therapy FDA-approved? Some peptides are and most are not. Semaglutide and tirzepatide are FDA-approved for chronic weight management. Sermorelin was approved in 1997 and later discontinued for commercial reasons. The remaining peptides discussed here are not approved in the United States for the uses described, and several are pending a decision on whether pharmacies may compound them.
What is the difference between peptide therapy and GLP-1 medication? GLP-1 medications are one category of peptide. Peptide therapy is the broader term covering compounds that act on other systems, including growth hormone release, tissue repair, and cognition. All GLP-1 medications are peptides. Most peptides are not GLP-1 medications.
Is NAD+ a peptide? No. NAD+ is a coenzyme made from two nucleotides and contains no amino acid chain. It is often grouped with peptide therapy in wellness marketing, but it belongs to a different class of molecule and works through a different mechanism.
Can peptides help preserve muscle during weight loss? That is the reasoning behind using growth hormone secretagogues alongside a GLP-1 protocol, since GLP-1 medications reduce lean mass along with fat. The way to know whether it is working for a specific patient is to scan body composition before and during treatment rather than relying on the scale.
Are compounded peptides legal right now? The situation is unresolved. In July 2026, an FDA advisory committee recommended six peptides for the list of substances pharmacies may compound, but that recommendation is not binding and has not been finalized. Any clinic describing the current status as settled is overstating it.
Do I need lab work before starting? Yes. A health history and baseline labs determine whether a given protocol is appropriate and what starting dose makes sense, which is why an initial consultation and labwork come first in our program.
Schedule a consultation
To discuss peptide therapy, GLP-1 medication, or a DEXA body composition scan, book a wellness and peptide consultation with our team. We will review your health history and goals and tell you directly what the evidence supports for the outcome you are after. You can also see our full list of services.
