Hormonal
For patients with Class II obesity (BMI 35-39.9 kg/m2), tirzepatide is significantly superior to other medications and endoscopic procedures, but its weight loss efficacy is inferior to major surgeries like Roux-en-Y gastric bypass (RYGB) and One-Anastomosis Gastric Bypass (OAGB).
If you have Class II obesity (BMI 35-39.9), surgery (like gastric bypass) will likely help you lose more weight than medication. However, if you are not ready for or cannot undergo surgery, newer medications like tirzepatide are still significantly more effective than other non-surgical options, though they will not achieve the same level of weight loss as surgery.
In trials on class II of obesity, tirzepatide was significantly superior to all the other comparisons and inferior to both OAGB and RYGB.
Why this rating
Network meta-analysis of RCTs.
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
DOI 10.1111/dom.70204
More from this paper
- 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.Strong
- For patients with Class III obesity (BMI >39.9 kg/m2), metabolic bariatric surgery (MBS) is significantly more effective than any currently approved medication, with BilioPancreatic Diversion (BPD) showing the highest estimated weight loss.Strong
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