Tirzepatide and semaglutide in obesity management and their impact on health-related quality of life – a comparative narrative review
DOI:
https://doi.org/10.12775/QS.2026.67.74311Keywords
obesity, semaglutide, tirzepatide, weight loss, incretin therapy, quality of lifeAbstract
Obesity is a chronic, relapsing disease associated with increased morbidity, mortality, and reduced health-related quality of life (HRQoL). Recent advances in incretin-based pharmacotherapy, including semaglutide and tirzepatide, show substantial efficacy in weight management. This study compared the efficacy, weight loss durability, HRQoL impact, and safety profiles of semaglutide and tirzepatide based on pivotal phase 3 trials. We conducted a comparative narrative review. A structured literature search of PubMed and ClinicalTrials.gov identified randomized controlled trials evaluating semaglutide and tirzepatide in adults with overweight or obesity without type 2 diabetes. The analysis focused on phase 3 trials from the STEP (1, 3, 4) and SURMOUNT (1, 3, 4) clinical programs. Outcomes included percentage weight reduction, achievement of clinically significant thresholds, maintenance of weight loss, HRQoL changes, and safety. Both agents resulted in significant weight reduction versus placebo, with greater effects observed for tirzepatide, particularly at higher doses. A higher proportion of participants achieved ≥10%, ≥15%, and ≥20% weight loss with tirzepatide. Improvements in HRQoL were observed with both treatments, specifically in physical functioning domains. Weight regain occurred following treatment discontinuation, while continued therapy was associated with sustained or further weight loss. Gastrointestinal adverse events were the most commonly reported; overall safety profiles were consistent with incretin-based therapies. Semaglutide and tirzepatide are highly effective pharmacological treatments for obesity, with tirzepatide demonstrating superior weight loss efficacy. Sustained treatment is essential for long-term weight management. These therapies represent a significant advancement in treatment, although differences in study design should be considered when interpreting comparative outcomes.
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Copyright (c) 2026 Weronika Kopniak, Sebastian Konopko, Katarzyna Góra, Wiktoria Wasilewska, Blanka Buszta, Inga Kokuszko, Mateusz Markiewicz
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