Most compounds this site examines have a mechanism and no file. Tesamorelin is the reverse case: a full regulatory dossier, a phase 3 programme, two independent meta-analyses published this year — and a label sentence that undercuts nearly everything written about it in the fitness market.
This is research journalism. It reports what the sources state, including the amounts used in trials and on labels where those are on the record, each figure carrying its source and date — and it never tells anyone what to take.
What it is
Tesamorelin is human growth-hormone-releasing factor with a modification. FDA's own description is precise: the 44-amino-acid sequence of human GRF, with a hexenoyl moiety — a six-carbon chain carrying a double bond — attached to the tyrosine at the N-terminal end. That attachment is the whole invention, because unmodified GRF is destroyed in circulation within minutes.
It therefore works one step further back than the compounds it shares a shelf with. Ipamorelin and the ghrelin-receptor agonists push the pituitary through a different receptor; tesamorelin uses the body's own releasing-hormone pathway, which is the same route sermorelin and CJC-1295 take. The class distinction is set out on our secretagogue page.
The approval, and the sentence inside it
EGRIFTA SV holds BLA 022505, sponsored by Theratechnologies. The indication reads: "for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy."
Then come the limitations of use, and one of them is the most quotable line on this page:
"EGRIFTA SV is not indicated for weight loss management as it has a weight neutral effect."
A regulator wrote that about a growth-hormone-axis drug, on the drug's own label, after reviewing its trials. Two other limitations sit beside it: long-term cardiovascular safety has not been established, and prescribers are told to reconsider continuing treatment in patients whose visceral fat has not fallen.
The most precise body-composition number in this market
Two meta-analyses of the randomised trials appeared independently in 2026 — one in Obesity Research & Clinical Practice pooling five trials (PMID 41545261), one in the Journal of the International Association of Providers of AIDS Care pooling four trials in 909 patients (PMID 42538058).
They agree to the second decimal place.
| Pooled outcome | Effect versus placebo |
|---|---|
| Lean body mass | +1.42 kg (95% CI 1.13 to 1.71), I² = 0% |
| Visceral adipose tissue | −27.71 cm² (95% CI −38.37 to −17.06) |
| Trunk fat | −1.18 kg |
| Limb fat | −0.22 kg |
| Waist circumference | −1.61 cm |
| Hepatic fat percentage | −4.28% |
| Subcutaneous adipose tissue, BMI | no significant change |
Zero heterogeneity across separate randomised trials is rare and it is the strongest feature of this dataset. It means the trials were not disagreeing with each other; the effect is consistent and it is small.
The distribution matters as much as the total. Trunk fat fell more than five times as far as limb fat, and subcutaneous fat did not move at all. This is a drug that redistributes fat from the abdominal compartment, which is precisely the clinical problem it was approved to treat — and precisely why the scale does not move.
The class ceiling, and the number that keeps reappearing
Set the pooled figure beside the two other compounds on this axis with real human data:
| Compound | Evidence | Lean or fat-free mass change | Strength or function |
|---|---|---|---|
| MK-677 (ibutamoren) | one 12-month RCT, 65 adults aged 60–81 | about +1.1 kg fat-free mass | no significant gain |
| Capromorelin | one RCT, 395 participants, terminated early | about +1.4 kg lean mass | prespecified effect not met |
| Tesamorelin | five RCTs, pooled, I² = 0% | +1.42 kg lean mass | not measured |
Three different molecules. Three receptor routes — a ghrelin-receptor agonist, a second ghrelin-receptor agonist and a releasing-factor analogue. Three populations: healthy older adults, older adults with functional limitation, and HIV patients with lipodystrophy. Three grades of evidence, from a single terminated trial to a zero-heterogeneity pooled estimate.
One number, between 1.1 and 1.42 kg.
That convergence is the finding. It is not derivable from any single paper and no vendor page states it, because it is the least commercially useful fact about the class: raising growth hormone by any route so far tested, in any population so far studied, produces roughly a kilogram and a half of lean tissue, and in the two trials that looked for a strength or function benefit, none appeared.
The caveat belongs in the same paragraph. These populations were not trained adults, the measurement methods differ, and lean body mass on a DXA scan includes water and glycogen as well as contractile protein. What the table cannot be read as is a prediction for a lifter. What it can be read as is a ceiling: no compound on this axis has yet produced more.
What is not known yet, and who is testing it
The gap on this page is functional outcome, and it is now being filled. NCT06554717 is recruiting 100 participants to test tesamorelin as an adjunct to exercise for improving physical function in people with HIV, with frailty and impaired physical function among its listed conditions.
That trial matters beyond its own population, because it is the first registration on this axis to combine the drug with training and measure what the person can do afterwards. Across all 24 tesamorelin registrations, none studies trained healthy adults — the programme runs through HIV lipodystrophy, non-alcoholic fatty liver disease and metabolic endpoints.
For a tested athlete the position is unambiguous: a growth-hormone-releasing factor is prohibited at all times, approval or no approval. The per-compound detail sits on our drug-testing page, and the wider question of what any of this does for muscle is the subject of the evidence ledger.