Tirzepatide achieves greater weight loss than semaglutide in real-world Bangladeshi obesity study | Research

The takeaway

In 100 Bangladeshi adults with obesity, tirzepatide produced greater weight loss than semaglutide (8.53 vs 6.85 kg, p=0.033), with lifestyle interventions further enhancing tirzepatide outcomes, though GI adverse events were more common.

8.53 vs 6.85 kg weight loss
Tirzepatide outperformed semaglutide in real-world Bangladeshi obesity patients, with lifestyle modifications further enhancing the difference

What the researchers found

Tirzepatide: -8.53 kg vs semaglutide: -6.85 kg (p=0.033). 89% achieved ≥5% weight loss; 33% achieved ≥10%. Tirzepatide had higher rates in both thresholds. Lifestyle interventions most enhanced tirzepatide. GI adverse events more frequent with tirzepatide.

Why it matters

Real-world evidence from South Asian populations is critical since most GLP-1 trial data comes from Western populations. This study confirms tirzepatide's superiority in a demographic with distinct metabolic profiles and obesity patterns.

How the study worked

Retrospective observational study of 100 adults from three tertiary centers in Bangladesh (58 tirzepatide, 42 semaglutide) with ≥3 months treatment. Demographics, weight, adverse events collected via structured questionnaire.

What this study cannot tell us

Retrospective, non-randomized. Small sample (n=100). Baseline BMI was significantly different between groups. Young, predominantly female cohort may not be representative. Short follow-up for some patients.

How to read the evidence

Retrospective observational study from Bangladesh. Provides valuable real-world evidence but limited by non-randomized design and baseline differences.

When this study was published

Published in 2025; first real-world comparison of these drugs from Bangladesh.

The bigger picture

As GLP-1 drugs expand globally, real-world data from diverse populations—including South Asia where metabolic disease burden is high—is essential for informed prescribing decisions.

Questions still open

Would the tirzepatide advantage persist with BMI-matched groups?
Are there ethnic/genetic factors that influence GLP-1 drug response in South Asian populations?
What drives the young female demographics in this obesity treatment cohort?

Common questions

Which is better for weight loss: tirzepatide or semaglutide?

In this Bangladeshi real-world study, tirzepatide produced significantly more weight loss (8.53 kg vs 6.85 kg). However, it also had more GI side effects. Both drugs were effective, with 89% of all patients losing at least 5% of their body weight.

Does diet and exercise matter when taking these drugs?

Yes. This study found lifestyle interventions significantly enhanced weight loss, particularly with tirzepatide. Combining medication with dietary changes and physical activity produces better results than medication alone.

Read the original research

Efficacy and Safety of Tirzepatide and Semaglutide for Obesity Management: A Real-World Comparison.

Cureus, 17(12), e98858

View on PubMed ↗Publisher’s paper ↗

Citation

Shil, Kishore Kumar; Hira, Ananda D; Bakchi, Sudipta; Paul, Susanta K; Hossain, Mahmud; Ghosh, Debasish K. (2025). Efficacy and Safety of Tirzepatide and Semaglutide for Obesity Management: A Real-World Comparison.. Cureus, 17(12), e98858. https://doi.org/10.7759/cureus.98858