Semaglutide and Tirzepatide to Treat Obesity
Abstract
In this issue of the Journal , Aronne et al. 1 report the results of a trial comparing tirzepatide and semaglutide, two drugs currently approved to treat obesity that consistently lead to reductions in body weight of more than 10% from baseline; the results of this trial will give guidance to physicians treating obesity. This comparison trial is notable because head-to-head comparisons of weight-loss medications in a single trial are scarce. In addition, in contrast to clinical trials that tested only the highest dose, this trial used two maximum tolerated dose options for each drug, which reflects how these medications are often . . .
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In longer-term studies of other weight-loss interventions, weight regain restored fat mass but did not restore the fat-free mass that had been lost.
“Studies of other weight loss interventions with longer follow-up have shown that, when weight is regained over time, fat mass is regained but not lost fat-free mass [5].”
From Reply to GM Tinsley et al.; DB Ibsen et al.; and EJ Dhurandhar et al. (2025) · cites this paper as [5]
For people on GLP-1 therapy, especially women, fractures may become more common.
“Sarcopenic obesity poses increased risk of a range of adverse outcomes, including a potential increase in fractures among those using GLP-1 therapy (particularly among women) [5] and all-cause mortality [7], yet may not be as readily apparent in those with obesity compared to normal-weight individuals.”
From Reply to GM Tinsley et al.; DB Ibsen et al.; and EJ Dhurandhar et al. (2025) · cites this paper as [5]
Sarcopenic obesity is linked to a higher risk of several adverse outcomes.
“Sarcopenic obesity poses increased risk of a range of adverse outcomes, including a potential increase in fractures among those using GLP-1 therapy (particularly among women) [5] and all-cause mortality [7], yet may not be as readily apparent in those with obesity compared to normal-weight individuals.”
From Reply to GM Tinsley et al.; DB Ibsen et al.; and EJ Dhurandhar et al. (2025) · cites this paper as [5]
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References 4 · Cited by 7
- Authors
- Greenway, F. L.
- Affiliations
- Pennington Biomedical Research Center (US)
- Corresponding author
- Greenway, Frank L.
- ORCID
- Greenway, Frank L.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2025-07-03
- Volume
- 393
- Issue
- 1
- Pages
- 84-85
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W4411935261
- Cited by
- 7
- References
- 4
- Citations by year
- 2026: 3 · 2025: 4
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- semaglutide, tirzepatide, obesity treatment, anti-obesity drugs, head-to-head comparison, maximum tolerated dose, weight loss, GLP-1 receptor agonists, GIP/GLP-1 receptor agonist
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