Hormonal
For patients with Class I obesity (BMI 30–34.9 kg/m2), newer obesity management medications (OMM) such as tirzepatide and semaglutide provide total body weight loss (TBWL) efficacy equivalent to major metabolic bariatric surgeries (MBS) like Roux-en-Y gastric bypass (RYGB) and One-Anastomosis Gastric Bypass (OAGB), while offering superior safety and tolerability profiles.
If you have Class I obesity (BMI 30-34.9), you no longer need to choose between surgery and medication as your first step. Newer medications like tirzepatide and semaglutide can help you lose as much weight as major surgeries like gastric bypass, but with fewer risks and side effects. This makes medication a highly effective and safer first-line treatment for this specific group.
In patients affected by mild to moderate obesity, newer OMMs (i.e., tirzepatide and semaglutide) appear to be valid alternatives to EBP and MBS. They could be preliminarily chosen as a first-line option based on similar efficacy and greater safety and tolerability.
Why this rating
Based on a network meta-analysis of randomized controlled trials (RCTs) with high-quality GRADE methodology.
Source
Efficacy and safety of European Medicines Agency ( <scp>EMA</scp> )‐approved pharmacological, endoscopic, and surgical treatments in different classes of obesity: A network meta‐analysis of randomised controlled trials for the development of the <scp>SIO</scp> (Società Italiana Obesità) Italian guidelines for the diagnosis and treatment of overweight and obesity
Rocco Barazzoni et al. · Diabetes Obesity and Metabolism · 2025
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