Hormonal
Tirzepatide and semaglutide are the only obesity management medications (OMMs) achieving greater than 10% total body weight loss (TBWL) at study endpoints, with tirzepatide uniquely associated with a significantly higher proportion of patients achieving ≥25% TBWL.
If you are seeking significant, clinically meaningful weight loss (over 10% of body weight), current evidence strongly supports using tirzepatide or semaglutide over older oral medications. Tirzepatide shows the highest efficacy, with a unique ability to help a larger proportion of patients lose 25% or more of their body weight. Be aware that these are long-term treatments; stopping them typically leads to regaining most of the lost weight, so they should be viewed as ongoing management for obesity, not a short-term fix.
The estimated TBWL% was greater than 10% only for semaglutide and tirzepatide... Only tirzepatide was associated with a greater proportion of patients achieving at least 25% TBWL reduction (odds ratio [95% confidence interval]: 33.8 [18.4–61.9], P < 0.001).
Why this rating
Based on a network meta-analysis of 56 RCTs involving 60,307 patients with 'high' GRADE evaluation for the primary endpoint.
Source
A systematic review and meta-analysis of the efficacy and safety of pharmacological treatments for obesity in adults
Barbara McGowan et al. · Nature Medicine · 2025
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