A systematic review and meta-analysis of the efficacy and safety of pharmacological treatments for obesity in adults.

McGowan B, Ciudin A, Baker JL, Busetto L, Dicker D, Frühbeck G, Goossens GH, Monami M, Sbraccia P, Martinez-Tellez B, Woodward E, Yumuk V

Nature medicine2 Oct 2025Cited by 66 (Europe PMC)

PMID41039116PMCIDPMC12532627DOI10.1038/s41591-025-03978-zPepBankPUB-41039116

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Summary

The text of this summary is not shown here, because the article license does not allow reuse. Read it at the source (opens in a new tab)

Text rights: CC BY-NC-ND. Results still quote short attributed sentences.

Results from this study13

12 results from studies that gave the peptide. 12 results from people.

01HumanSystematic reviewEfficacy outcome
In adults with obesity, semaglutide produced significantly greater total body weight loss than placebo, with more than 10% loss, in a network meta-analysis.
In plain wordsIn adults with obesity, semaglutide led to more weight loss than placebo, over 10% of body weight, in a pooled analysis of trials.
Peptide
Semaglutide
Outcome
DecreaseTotal body weight loss (TBWL%) versus placebo
Study
n: not reported in source
Comparator
Placebo
Analysis
Primary
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated
Measurements
Total body weight loss
> 10%
semaglutide versus placebo
Source sentences
Summary
All OMMs showed a significantly greater TBWL% versus placebo (P < 0.0001), more than 10% for semaglutide and tirzepatide.
2 context sentences(design, population, supporting numbers)
Summary · context
Here a Medline and Embase search was performed up to 31 January 2025 for randomized controlled trials comparing OMMs versus placebo/active comparators in adults.
Summary · context
Fifty-six clinical trials were identified-orlistat (22), semaglutide (14), liraglutide (11), tirzepatide (6), naltrexone/bupropion (5) and phentermine/topiramate (2)-enrolling 60,307 patients (32,598 OMM and 27,709 placebo).
Report a problemFND-4103911602
02HumanSystematic reviewEfficacy outcome
In adults with obesity, tirzepatide produced significantly greater total body weight loss than placebo, with more than 10% loss, in a network meta-analysis.
In plain wordsIn adults with obesity, tirzepatide led to more weight loss than placebo, over 10% of body weight, in a pooled analysis of trials.
Peptide
Tirzepatide
Outcome
DecreaseTotal body weight loss (TBWL%) versus placebo
Study
n: not reported in source
Comparator
Placebo
Analysis
Primary
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated
Measurements
Total body weight loss
> 10%
tirzepatide versus placebo
Source sentences
Summary
All OMMs showed a significantly greater TBWL% versus placebo (P < 0.0001), more than 10% for semaglutide and tirzepatide.
2 context sentences(design, population, supporting numbers)
Summary · context
Here a Medline and Embase search was performed up to 31 January 2025 for randomized controlled trials comparing OMMs versus placebo/active comparators in adults.
Summary · context
Fifty-six clinical trials were identified-orlistat (22), semaglutide (14), liraglutide (11), tirzepatide (6), naltrexone/bupropion (5) and phentermine/topiramate (2)-enrolling 60,307 patients (32,598 OMM and 27,709 placebo).
Report a problemFND-4103911603
03HumanSystematic reviewEfficacy outcome
In adults with obesity, semaglutide showed restoration of normoglycemia in a network meta-analysis.
In plain wordsIn adults with obesity, semaglutide was linked to blood sugar returning to normal in a pooled analysis of trials.
Peptide
Semaglutide
Outcome
IncreaseRestoration of normoglycemia
Study
n: not reported in source
Outcome group
Glycemic control · Metabolic and weight
Studied dose
Dose not stated
Source sentences
Summary
Both tirzepatide and semaglutide showed normoglycemia restoration, remission of type 2 diabetes and reduction in hospitalization due to heart failure.
2 context sentences(design, population, supporting numbers)
Summary · context
Here a Medline and Embase search was performed up to 31 January 2025 for randomized controlled trials comparing OMMs versus placebo/active comparators in adults.
Summary · context
Fifty-six clinical trials were identified-orlistat (22), semaglutide (14), liraglutide (11), tirzepatide (6), naltrexone/bupropion (5) and phentermine/topiramate (2)-enrolling 60,307 patients (32,598 OMM and 27,709 placebo).
Report a problemFND-4103911604
04HumanSystematic reviewEfficacy outcome
In adults with obesity, tirzepatide showed restoration of normoglycemia in a network meta-analysis.
In plain wordsIn adults with obesity, tirzepatide was linked to blood sugar returning to normal in a pooled analysis of trials.
Peptide
Tirzepatide
Outcome
IncreaseRestoration of normoglycemia
Study
n: not reported in source
Outcome group
Glycemic control · Metabolic and weight
Studied dose
Dose not stated
Source sentences
Summary
Both tirzepatide and semaglutide showed normoglycemia restoration, remission of type 2 diabetes and reduction in hospitalization due to heart failure.
2 context sentences(design, population, supporting numbers)
Summary · context
Here a Medline and Embase search was performed up to 31 January 2025 for randomized controlled trials comparing OMMs versus placebo/active comparators in adults.
Summary · context
Fifty-six clinical trials were identified-orlistat (22), semaglutide (14), liraglutide (11), tirzepatide (6), naltrexone/bupropion (5) and phentermine/topiramate (2)-enrolling 60,307 patients (32,598 OMM and 27,709 placebo).
Report a problemFND-4103911605
05HumanSystematic reviewEfficacy outcome
In adults with obesity, semaglutide showed remission of type 2 diabetes in a network meta-analysis.
In plain wordsIn adults with obesity, semaglutide was linked to remission of type 2 diabetes in a pooled analysis of trials.
Peptide
Semaglutide
Outcome
IncreaseRemission of type 2 diabetes
Study
n: not reported in source
Outcome group
Glycemic control · Metabolic and weight
Studied dose
Dose not stated
Source sentences
Summary
Both tirzepatide and semaglutide showed normoglycemia restoration, remission of type 2 diabetes and reduction in hospitalization due to heart failure.
2 context sentences(design, population, supporting numbers)
Summary · context
Here a Medline and Embase search was performed up to 31 January 2025 for randomized controlled trials comparing OMMs versus placebo/active comparators in adults.
Summary · context
Fifty-six clinical trials were identified-orlistat (22), semaglutide (14), liraglutide (11), tirzepatide (6), naltrexone/bupropion (5) and phentermine/topiramate (2)-enrolling 60,307 patients (32,598 OMM and 27,709 placebo).
Report a problemFND-4103911606
06HumanSystematic reviewEfficacy outcome
In adults with obesity, tirzepatide showed remission of type 2 diabetes in a network meta-analysis.
In plain wordsIn adults with obesity, tirzepatide was linked to remission of type 2 diabetes in a pooled analysis of trials.
Peptide
Tirzepatide
Outcome
IncreaseRemission of type 2 diabetes
Study
n: not reported in source
Outcome group
Glycemic control · Metabolic and weight
Studied dose
Dose not stated
Source sentences
Summary
Both tirzepatide and semaglutide showed normoglycemia restoration, remission of type 2 diabetes and reduction in hospitalization due to heart failure.
2 context sentences(design, population, supporting numbers)
Summary · context
Here a Medline and Embase search was performed up to 31 January 2025 for randomized controlled trials comparing OMMs versus placebo/active comparators in adults.
Summary · context
Fifty-six clinical trials were identified-orlistat (22), semaglutide (14), liraglutide (11), tirzepatide (6), naltrexone/bupropion (5) and phentermine/topiramate (2)-enrolling 60,307 patients (32,598 OMM and 27,709 placebo).
Report a problemFND-4103911607
07HumanSystematic reviewEfficacy outcome
In adults with obesity, semaglutide reduced hospitalization due to heart failure in a network meta-analysis.
In plain wordsIn adults with obesity, semaglutide was linked to fewer hospital stays for heart failure in a pooled analysis of trials.
Peptide
Semaglutide
Outcome
DecreaseHospitalization due to heart failure
Study
n: not reported in source
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated
Source sentences
Summary
Both tirzepatide and semaglutide showed normoglycemia restoration, remission of type 2 diabetes and reduction in hospitalization due to heart failure.
2 context sentences(design, population, supporting numbers)
Summary · context
Here a Medline and Embase search was performed up to 31 January 2025 for randomized controlled trials comparing OMMs versus placebo/active comparators in adults.
Summary · context
Fifty-six clinical trials were identified-orlistat (22), semaglutide (14), liraglutide (11), tirzepatide (6), naltrexone/bupropion (5) and phentermine/topiramate (2)-enrolling 60,307 patients (32,598 OMM and 27,709 placebo).
Report a problemFND-4103911608
08HumanSystematic reviewEfficacy outcome
In adults with obesity, tirzepatide reduced hospitalization due to heart failure in a network meta-analysis.
In plain wordsIn adults with obesity, tirzepatide was linked to fewer hospital stays for heart failure in a pooled analysis of trials.
Peptide
Tirzepatide
Outcome
DecreaseHospitalization due to heart failure
Study
n: not reported in source
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated
Source sentences
Summary
Both tirzepatide and semaglutide showed normoglycemia restoration, remission of type 2 diabetes and reduction in hospitalization due to heart failure.
2 context sentences(design, population, supporting numbers)
Summary · context
Here a Medline and Embase search was performed up to 31 January 2025 for randomized controlled trials comparing OMMs versus placebo/active comparators in adults.
Summary · context
Fifty-six clinical trials were identified-orlistat (22), semaglutide (14), liraglutide (11), tirzepatide (6), naltrexone/bupropion (5) and phentermine/topiramate (2)-enrolling 60,307 patients (32,598 OMM and 27,709 placebo).
Report a problemFND-4103911609
09HumanSystematic reviewEfficacy outcome
In adults with obesity, semaglutide was effective in reducing major adverse cardiovascular events in a network meta-analysis.
In plain wordsIn adults with obesity, semaglutide was linked to fewer major heart and blood vessel events in a pooled analysis of trials.
Peptide
Semaglutide
Outcome
DecreaseMajor adverse cardiovascular events (MACE)
Study
n: not reported in source
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated
Source sentences
Summary
Semaglutide was effective in reducing major adverse cardiovascular events
2 context sentences(design, population, supporting numbers)
Summary · context
Here a Medline and Embase search was performed up to 31 January 2025 for randomized controlled trials comparing OMMs versus placebo/active comparators in adults.
Summary · context
Fifty-six clinical trials were identified-orlistat (22), semaglutide (14), liraglutide (11), tirzepatide (6), naltrexone/bupropion (5) and phentermine/topiramate (2)-enrolling 60,307 patients (32,598 OMM and 27,709 placebo).
Report a problemFND-4103911610
10HumanSystematic reviewEfficacy outcome
In adults with obesity, semaglutide was effective in reducing pain in knee osteoarthritis in a network meta-analysis.
In plain wordsIn adults with obesity, semaglutide was linked to less knee osteoarthritis pain in a pooled analysis of trials.
Peptide
Semaglutide
Outcome
DecreasePain in knee osteoarthritis
Study
n: not reported in source
Outcome group
Pain · Musculoskeletal
Studied dose
Dose not stated
Source sentences
Summary
Semaglutide was effective in reducing major adverse cardiovascular events and reducing pain in knee osteoarthritis.
2 context sentences(design, population, supporting numbers)
Summary · context
Here a Medline and Embase search was performed up to 31 January 2025 for randomized controlled trials comparing OMMs versus placebo/active comparators in adults.
Summary · context
Fifty-six clinical trials were identified-orlistat (22), semaglutide (14), liraglutide (11), tirzepatide (6), naltrexone/bupropion (5) and phentermine/topiramate (2)-enrolling 60,307 patients (32,598 OMM and 27,709 placebo).
Report a problemFND-4103911611
11HumanSystematic reviewEfficacy outcome
In adults with obesity, tirzepatide was effective in remission of obstructive sleep apnea syndrome in a network meta-analysis.
In plain wordsIn adults with obesity, tirzepatide was linked to remission of sleep apnea in a pooled analysis of trials.
Peptide
Tirzepatide
Outcome
IncreaseRemission of obstructive sleep apnea syndrome
Study
n: not reported in source
Outcome group
Sleep · Sleep
Studied dose
Dose not stated
Source sentences
Summary
Tirzepatide was effective in remission of obstructive sleep apnea syndrome
2 context sentences(design, population, supporting numbers)
Summary · context
Here a Medline and Embase search was performed up to 31 January 2025 for randomized controlled trials comparing OMMs versus placebo/active comparators in adults.
Summary · context
Fifty-six clinical trials were identified-orlistat (22), semaglutide (14), liraglutide (11), tirzepatide (6), naltrexone/bupropion (5) and phentermine/topiramate (2)-enrolling 60,307 patients (32,598 OMM and 27,709 placebo).
Report a problemFND-4103911612
12HumanSystematic reviewEfficacy outcome
In adults with obesity, tirzepatide was effective in remission of metabolic dysfunction-associated steatohepatitis in a network meta-analysis.
In plain wordsIn adults with obesity, tirzepatide was linked to remission of fatty liver inflammation (MASH) in a pooled analysis of trials.
Peptide
Tirzepatide
Outcome
IncreaseRemission of metabolic dysfunction-associated steatohepatitis (MASH)
Study
n: not reported in source
Outcome group
Liver fat and liver function · Liver
Studied dose
Dose not stated
Source sentences
Summary
Tirzepatide was effective in remission of obstructive sleep apnea syndrome and metabolic dysfunction-associated steatohepatitis.
2 context sentences(design, population, supporting numbers)
Summary · context
Here a Medline and Embase search was performed up to 31 January 2025 for randomized controlled trials comparing OMMs versus placebo/active comparators in adults.
Summary · context
Fifty-six clinical trials were identified-orlistat (22), semaglutide (14), liraglutide (11), tirzepatide (6), naltrexone/bupropion (5) and phentermine/topiramate (2)-enrolling 60,307 patients (32,598 OMM and 27,709 placebo).
Report a problemFND-4103911613

Studies that did not test the peptide alone1

In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking Liraglutide.

13HumanNot a test of Liraglutide aloneSystematic reviewEfficacy outcome
In adults with obesity, all obesity management medications pooled, including liraglutide, produced significantly greater total body weight loss than placebo in a network meta-analysis.
In plain wordsIn adults with obesity, obesity medicines as a group, including liraglutide, led to more weight loss than placebo in a pooled analysis of trials.
Peptide
Liraglutide
Outcome
DecreaseTotal body weight loss (TBWL%) versus placebo
Study
n: not reported in source
Comparator
Placebo
Analysis
Primary
Outcome group
Body weight · Metabolic and weight
Source sentences
Summary
All OMMs showed a significantly greater TBWL% versus placebo (P < 0.0001), more than 10% for semaglutide and tirzepatide.
2 context sentences(design, population, supporting numbers)
Summary · context
Here a Medline and Embase search was performed up to 31 January 2025 for randomized controlled trials comparing OMMs versus placebo/active comparators in adults.
Summary · context
Fifty-six clinical trials were identified-orlistat (22), semaglutide (14), liraglutide (11), tirzepatide (6), naltrexone/bupropion (5) and phentermine/topiramate (2)-enrolling 60,307 patients (32,598 OMM and 27,709 placebo).
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Report a problemFND-4103911601

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Registered trials1

Trials this study reports on, or that list this study as a reference. Registry data from ClinicalTrials.gov.

1 trial · 1 not yet recruiting · source ClinicalTrials.gov (opens in a new tab)

Not yet recruitingPhase not statedNCT07504172

Real-world Effectiveness and Dosing Patterns of Tirzepatide in People With Obesity

Radboud University Medical Centern = 1,700est. 1 Apr 2026 to est. 1 Aug 2026

Overweight , Obesity · Obesity (Disorder)

Trial page ClinicalTrials.govUpdated 31 Mar 2026

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 4Current
12 Oct 2026, 11:11 UTC
Study results updated
Versions 2 to 3
9 Oct 2026, 03:07 UTC
The same notice was added 2 times, first on 9 Oct 2026, 03:06 UTC. The status did not change between them.
Study data updated · source update from Europe PMC
Version 1
9 Oct 2026, 03:04 UTC
First added · source update from Europe PMC