Somapacitan vs Tesamorelin
A once-a-week growth hormone shot that replaces daily shots. Controlled trials show it works as well as daily doses. It is a shot that cuts belly fat in people with HIV. It cut deep belly fat about 15% in six months, but the fat returned after stopping, and outside HIV there is one trial of 60 people.
Somapacitan has the stronger evidence, grade A (strong human evidence) against grade B for Tesamorelin. Both are FDA approved.
Evidence
AStrong human evidence
BSome human evidence
Human studies cited
Animal or cell studies cited
Why the grade
The adult approval rested on REAL 1, a randomized, double-blind, placebo-controlled and active-controlled trial of 301 adults with growth hormone deficiency, and the pediatric approvals on randomized trials against daily somatropin, the most recent being the REAL8 basket trial across three indications. The question these trials answer is whether weekly somapacitan matches daily growth hormone, and they show it does.
Two phase 3 randomized trials in HIV-associated abdominal fat, pooled at 806 patients, support the approved indication, which would be A for that use. The use tesamorelin is best known for outside clinics, trimming visceral fat in people without HIV, rests on one 60-person randomized trial in obese adults with reduced growth hormone and one 61-person trial in HIV-related fatty liver, so the popular use grades B.
FDA
FDA approved
Somapacitan is FDA-approved as Sogroya (Novo Nordisk), a once-weekly injection, for adults with growth hormone deficiency (August 2020), children aged 2.5 and older with growth hormone deficiency (2023), and, since February 27, 2026, children aged 2.5 and older with idiopathic short stature, short stature after being born small for gestational age, or growth failure from Noonan syndrome.
FDA approved
Tesamorelin is approved by the FDA as Egrifta (2010), Egrifta SV, and Egrifta WR (2025) to reduce excess abdominal fat in adults with HIV and lipodystrophy. It is not approved for weight loss, fat loss in people without HIV, or anti-aging.
Sold for
Somapacitan is the once-a-week growth hormone that replaces daily injections for children and adults who lack the hormone.
Tesamorelin is marketed by longevity and body-composition clinics as a growth-hormone-releasing injection that melts belly fat without the risks of growth hormone itself.
Studies say
Randomized trials show weekly somapacitan reduces body fat in adults with growth hormone deficiency as well as daily growth hormone does and produces equivalent growth in children, which supports an A for its approved uses.
In people with HIV it reliably cuts visceral fat by about 15 percent over six months, but the fat returns when the drug stops and the evidence in people without HIV is a single small trial, which is the logic of the B grade.
Class
Long-acting GH analog
GHRH analog
Route
Injection
Injection