In a real-world cohort escalated to at least 10 mg tirzepatide or 1.7 mg semaglutide, tirzepatide produced greater mean percent body weight reduction from baseline over 12 months in adults with obesity or overweight and related complications.

Patients on tirzepatide were more likely to reach weight-loss targets of 10%, 15%, 20%, and 25% at 12 months compared with those on semaglutide within the same escalated-dose group.

The study was funded by Eli Lilly and Company, with Lilly employees or affiliates among the co-authors, as disclosed.

Limitations include potential generalizability issues from selection criteria, possible unobserved differences in cardiovascular risk profiles, drug supply constraints during the study period, and doses inferred from dispensing records rather than confirmed intake.

The findings were presented in a poster at the Obesity Medicine Association annual conference in San Diego, April 10–12, 2026.

Authors suggest the results may help clinicians and patients set expectations and guide obesity medication choice to meet individual needs.

benefits persisted among both adherent and non-adherent patients across dose groups.

The study utilized the Truveta electronic health records database for US adults with obesity or overweight and at least one obesity-related complication but without diabetes, applying propensity score weighting and adjustments for baseline demographics and comorbidities.

Real-world results aligned with SURMOUNT-5 head-to-head trial findings at maximum tolerated doses (tirzepatide 10–15 mg vs semaglutide 1.7–2.4 mg).