Efficacy and Safety of Tirzepatide in the Treatment of Obesity in Adults: A Comprehensive Review
DOI:
https://doi.org/10.12775/QS.2025.41.60368Keywords
Tirzepatide, obesity treatment, pharmacotherapy, GLP-1 and GIP analogs, cardiovascular risk, lifestyle interventions, SURMOUNT, SURPASSAbstract
Obesity is one of the most serious health challenges of the modern world, associated with an increasing incidence and serious health consequences, including cardiovascular diseases and type II diabetes. Pharmacotherapy of obesity is developing rapidly, and tirzepatide, an agonist of GIP and GLP-1 receptors, is emerging as a promising solution. In the SURMOUNT and SURPASS clinical trials, tirzepatide was shown to effectively reduce body weight and improve metabolic parameters in diabetic and non-diabetic patients, surpassing other available therapies, such as semaglutide in terms of efficacy. Tirzepatide not only promotes weight loss but also helps maintain the effects achieved and reduces cardiovascular risk, making it an important tool in the treatment of obesity. Its clinical benefits are further enhanced by the introduction of intensive lifestyle interventions before starting therapy. In summary, tirzepatide is an innovative approach to the treatment of obesity, offering promising long-term effects while maintaining a favorable safety profile.
References
1. Obesity and overweight [Internet]. [cited 2025 Apr 13]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
2. Conway B, Rene A. Obesity as a disease: no lightweight matter. Obes Rev. 2004;5(3):145–51. doi:10.1111/j.1467-789X.2004.00144.x
3. The top 10 causes of death [Internet]. [cited 2025 Apr 14]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
4. de Leeuw AJM, Oude Luttikhuis MAM, Wellen AC, Müller C, Calkhoven CF. Obesity and its impact on COVID-19. J Mol Med Berl Ger. 2021;99(7):899–915. doi:10.1007/s00109-021-02072-4
5. Higuera-Hernández MF, Reyes-Cuapio E, Gutiérrez-Mendoza M, Rocha NB, Veras AB, Budde H, et al. Fighting obesity: Non-pharmacological interventions. Clin Nutr ESPEN. 2018 Jun 1;25:50–5. doi:10.1016/j.clnesp.2018.04.005
6. Ostrowska L., Bogdański P., Mamcarz A. Otyłość i jej powikłania. 1st ed. Warszawa: PZWL; 2021. 1054 p.
7. Wadden TA, Chao AM, Machineni S, Kushner R, Ard J, Srivastava G, et al. Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-3 phase 3 trial. Nat Med. 2023 Nov;29(11):2909–18. doi:10.1038/s41591-023-02597-w
8. Obesity Canada [Internet]. [cited 2025 Apr 14]. Adult clinical practice guideline. Available from: https://obesitycanada.ca/healthcare-professionals/adult-clinical-practice-guideline/
9. PTLO - Polskie Towarzystwo Leczenia Otyłości [Internet]. [cited 2025 Apr 14]. Available from: https://ptlo.org.pl/aktualnosci/258-zalecenia_kliniczne_dotyczace_postepowania_u_chorych_na_otylosc_2024_stanowisko_polskiego_towarzystwa_leczenia_otylosci
10. Žižka O, Haluzík M, Jude EB. Pharmacological Treatment of Obesity in Older Adults. Drugs Aging. 2024;41(11):881–96. doi:10.1007/s40266-024-01150-9
11. Heck AM, Yanovski JA, Calis KA. Orlistat, a New Lipase Inhibitor for the Management of Obesity. Pharmacotherapy. 2000 Mar;20(3):270–9. doi: 10.1592/phco.20.4.270.34882.
12. Sherman MM, Ungureanu S, Rey JA. Naltrexone/Bupropion ER (Contrave). Pharm Ther. 2016 Mar;41(3):164–72.
13. Billes SK, Greenway FL. Combination therapy with naltrexone and bupropion for obesity. Expert Opin Pharmacother. 2011 Aug;12(11):1813–26. doi:10.1517/14656566.2011.591382
14. Monami M, Dicembrini I, Marchionni N, Rotella CM, Mannucci E. Effects of Glucagon-Like Peptide-1 Receptor Agonists on Body Weight: A Meta-Analysis. Exp Diabetes Res. 2012;2012:672658. doi:10.1155/2012/672658
15. van Can J, Sloth B, Jensen CB, Flint A, Blaak EE, Saris WHM. Effects of the once-daily GLP-1 analog liraglutide on gastric emptying, glycemic parameters, appetite and energy metabolism in obese, non-diabetic adults. Int J Obes 2005. 2014 Jun;38(6):784–93. doi:10.1038/ijo.2013.162
16. Blundell J, Finlayson G, Axelsen M, Flint A, Gibbons C, Kvist T, et al. Effects of once‐weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight in subjects with obesity. Diabetes Obes Metab. 2017 Sep;19(9):1242–51. doi:10.1111/dom.12932
17. Wilding JPH, Batterham RL, Calanna S, Davies M, Gaal LFV, Lingvay I, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 17;384(11):989–1002. doi:10.1056/NEJMoa2032183
18. Žižka O, Haluzík M, Jude EB. Pharmacological Treatment of Obesity in Older Adults. Drugs Aging. 2024;41(11):881–96. doi:10.1007/s40266-024-01150-9
19. Zhao F, Zhou Q, Cong Z, Hang K, Zou X, Zhang C, et al. Structural insights into multiplexed pharmacological actions of tirzepatide and peptide 20 at the GIP, GLP-1 or glucagon receptors. Nat Commun. 2022 Feb 25;13(1):1057. doi:10.1038/s41467-022-28683-0
20. Wang L. Designing a Dual GLP-1R/GIPR Agonist from Tirzepatide: Comparing Residues Between Tirzepatide, GLP-1, and GIP. Drug Des Devel Ther. 2022 May 25;16:1547–59. doi:10.2147/DDDT.S358989
21. Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, et al. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022 Jul 21;387(3):205–16. doi:10.1056/NEJMoa2206038
22. Frias JP, Nauck MA, Van J, Kutner ME, Cui X, Benson C, et al. Efficacy and safety of LY3298176, a novel dual GIP and GLP-1 receptor agonist, in patients with type 2 diabetes: a randomised, placebo-controlled and active comparator-controlled phase 2 trial. The Lancet. 2018 Nov;392(10160):2180–93. doi:10.1016/S0140-6736(18)32260-8
23. Pelle MC, Provenzano M, Zaffina I, Pujia R, Giofrè F, Lucà S, et al. Role of a Dual Glucose-Dependent Insulinotropic Peptide (GIP)/Glucagon-like Peptide-1 Receptor Agonist (Twincretin) in Glycemic Control: From Pathophysiology to Treatment. Life. 2021 Dec 25;12(1):29. doi:10.3390/life12010029
24. Forzano I, Varzideh F, Avvisato R, Jankauskas SS, Mone P, Santulli G. Tirzepatide: A Systematic Update. Int J Mol Sci. 2022 Nov 23;23(23):14631. doi:10.3390/ijms232314631
25. Coskun T, Sloop KW, Loghin C, Alsina-Fernandez J, Urva S, Bokvist KB, et al. LY3298176, a novel dual GIP and GLP-1 receptor agonist for the treatment of type 2 diabetes mellitus: From discovery to clinical proof of concept. Mol Metab. 2018 Dec;18:3–14. doi:10.1016/j.molmet.2018.09.009
26. Nauck MA, Quast DR, Wefers J, Pfeiffer AFH. The evolving story of incretins ( GIP and GLP ‐1) in metabolic and cardiovascular disease: A pathophysiological update. Diabetes Obes Metab. 2021 Sep;23(S3):5–29. doi:10.1111/dom.14496
27. Garvey WT, Frias JP, Jastreboff AM, Le Roux CW, Sattar N, Aizenberg D, et al. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. The Lancet. 2023 Aug;402(10402):613–26. doi:10.1016/S0140-6736(23)01200-X
28. Wadden TA, Chao AM, Machineni S, Kushner R, Ard J, Srivastava G, et al. Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-3 phase 3 trial. Nat Med. 2023 Nov;29(11):2909–18. doi:10.1038/s41591-023-02597-w
29. Rubino D, Abrahamsson N, Davies M, Hesse D, Greenway FL, Jensen C, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021 Apr 13;325(14):1414. doi:10.1001/jama.2021.3224
30. James WPT, Astrup A, Finer N, Hilsted J, Kopelman P, Rössner S, et al. Effect of sibutramine on weight maintenance after weight loss: a randomised trial. The Lancet. 2000 Dec;356(9248):2119–25. doi:10.1016/S0140-6736(00)03491-7
31. Aronne LJ, Sattar N, Horn DB, Bays HE, Wharton S, Lin WY, et al. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial. JAMA. 2024 Jan 2;331(1):38. doi:10.1001/jama.2023.24945
32. Azuri J, Hammerman A, Aboalhasan E, Sluckis B, Arbel R. Tirzepatide versus semaglutide for weight loss in patients with type 2 diabetes mellitus: A value for money analysis. Diabetes Obes Metab. 2023 Apr;25(4):961–4. doi:10.1111/dom.14940
33. Rosenstock J, Wysham C, Frías JP, Kaneko S, Lee CJ, Fernández Landó L, et al. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. The Lancet. 2021 Jul;398(10295):143–55. doi:10.1016/S0140-6736(21)01324-6
34. Frías JP, Davies MJ, Rosenstock J, Pérez Manghi FC, Fernández Landó L, Bergman BK, et al. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. N Engl J Med. 2021 Aug 5;385(6):503–15. doi:10.1056/NEJMoa2107519
35. Michałowska J, Bogdański P. Rola hormonów i leków inkretynowych w terapii otyłości i wybranych zaburzeń metabolicznych. Forum Zaburzeń Metab. 2021;12(2):61–9.
36. Fontanella RA, Ghosh P, Pesapane A, Taktaz F, Puocci A, Franzese M, et al. Tirzepatide prevents neurodegeneration through multiple molecular pathways. J Transl Med. 2024 Jan 29;22(1):114. doi:10.1186/s12967-024-04927-z
37. Hankosky ER, Wang H, Neff LM, Kan H, Wang F, Ahmad NN, et al. Tirzepatide reduces the predicted risk of atherosclerotic cardiovascular disease and improves cardiometabolic risk factors in adults with obesity or overweight: SURMOUNT‐1 post hoc analysis. Diabetes Obes Metab. 2024 Jan;26(1):319–28. doi:10.1111/dom.15318
38. Wilson JM, Lin Y, Luo MJ, Considine G, Cox AL, Bowsman LM, et al. The dual glucose‐dependent insulinotropic polypeptide and glucagon‐like peptide‐1 receptor agonist tirzepatide improves cardiovascular risk biomarkers in patients with type 2 diabetes: A p OST HOC analysis. Diabetes Obes Metab. 2022 Jan;24(1):148–53. doi:10.1111/dom.14553
39. Ludvik B, Giorgino F, Jódar E, Frias JP, Fernández Landó L, Brown K, et al. Once-weekly tirzepatide versus once-daily insulin degludec as add-on to metformin with or without SGLT2 inhibitors in patients with type 2 diabetes (SURPASS-3): a randomised, open-label, parallel-group, phase 3 trial. The Lancet. 2021 Aug;398(10300):583–98. doi:10.1016/S0140-6736(21)01443-4
40. Del Prato S, Kahn SE, Pavo I, Weerakkody GJ, Yang Z, Doupis J, et al. Tirzepatide versus insulin glargine in type 2 diabetes and increased cardiovascular risk (SURPASS-4): a randomised, open-label, parallel-group, multicentre, phase 3 trial. The Lancet. 2021 Nov;398(10313):1811–24. doi:10.1016/S0140-6736(21)02188-7
41. Dahl D, Onishi Y, Norwood P, Huh R, Bray R, Patel H, et al. Effect of Subcutaneous Tirzepatide vs Placebo Added to Titrated Insulin Glargine on Glycemic Control in Patients With Type 2 Diabetes. JAMA. 2022 Feb 8;327(6):534–45. doi:10.1001/jama.2022.0078
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Karolina Skonieczna, Olimpia Wiciun, Kacper Ordon, Magdalena Badziąg, Paulina Szulc, Laura Kurczoba, Martyna Kłossowska, Olga Kądziołka

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 108
Number of citations: 0