Tirzepatide vs Semaglutide for Weight Loss: First Real-World Head-to-Head Comparison | Research

The takeaway

Tirzepatide produced greater weight loss than semaglutide in a real-world cohort of adults with overweight or obesity, with comparable gastrointestinal side effects.

Tirzepatide wins on weight loss
In the first large real-world comparison, tirzepatide produced greater weight loss than semaglutide with comparable side effects

What the researchers found

Tirzepatide produced greater on-treatment weight loss than semaglutide in adults with overweight or obesity in a real-world clinical setting, with comparable gastrointestinal side effect rates.

Why it matters

Patients and doctors have been waiting for head-to-head data comparing these two drugs. This real-world study provides the first large-scale direct comparison.

The numbers in context

Adults with overweight or obesity identified from EHR data between May 2022 and September 2023. Both drugs were prescribed with type 2 diabetes labeling.

How the study worked

Retrospective cohort study using electronic health records from a clinical setting, comparing adults receiving tirzepatide vs. semaglutide (both labeled for type 2 diabetes).

Who was studied

Adults with overweight or obesity receiving tirzepatide or semaglutide in a clinical setting

What this study cannot tell us

This is an observational study, not a randomized trial. Patients were not randomly assigned, so underlying differences between groups may affect results. Both drugs were prescribed for T2D, not specifically for weight loss.

How to read the evidence

Rated strong: large real-world cohort with electronic health record data, though observational design means patients weren't randomly assigned.

When this study was published

Published in 2024 using data from May 2022–September 2023. Most current real-world comparison available.

The bigger picture

Patients and doctors have been waiting for direct comparison data. Until randomized head-to-head trials are complete, this observational data provides the best available evidence for choosing between the two leading weight loss drugs.

Questions still open

How much greater is tirzepatide's weight loss advantage?
Would the difference change at obesity-specific doses (higher than T2D doses)?

Common questions

Is tirzepatide better than semaglutide for weight loss?

This first real-world comparison found tirzepatide produced more weight loss with similar side effects, though both are prescribed at diabetes doses here.

Do tirzepatide and semaglutide have different side effects?

Gastrointestinal side effects (nausea, diarrhea, vomiting) were comparable between the two drugs in this study.

Read the original research

Semaglutide vs Tirzepatide for Weight Loss in Adults With Overweight or Obesity.

JAMA internal medicine, 184(9), 1056-1064

View on PubMed ↗Publisher’s paper ↗

Citation

Rodriguez, Patricia J; Goodwin Cartwright, Brianna M; Gratzl, Samuel; Brar, Rajdeep; Baker, Charlotte; Gluckman, Ty J; Stucky, Nicholas L. (2024). Semaglutide vs Tirzepatide for Weight Loss in Adults With Overweight or Obesity.. JAMA internal medicine, 184(9), 1056-1064. https://doi.org/10.1001/jamainternmed.2024.2525