Rankings / Weight Loss — Incretins & Amylin
Tirzepatide
Weight loss · GLP-1/GIP agonist (dual)
Tier B+
What this is
SURMOUNT-1: ~22.5% weight loss over 72 weeks at 15 mg — highest of any approved weight loss drug. SURMOUNT-5 (head-to-head 2025): tirzepatide -20.2% vs semaglutide -13.7% at 72 weeks. SURPASS-CVOT showed CV non-inferiority to dulaglutide. SURMOUNT-1 176-week extension (Heerspink 2026, Diabetes Obes Metab) confirmed sustained weight loss and renal-function preservation. Awaiting SURMOUNT-MMO for CV outcomes in obesity without diabetes.
Mechanism
Dual GIP/GLP-1 receptor agonist; GIP component enhances weight loss and glycemic effects beyond GLP-1 alone; mechanisms similar to semaglutide but more potent
Dose & route
Zepbound (obesity): titrate to 10-15 mg SC weekly; Mounjaro (T2DM)
Citations
- https://www.nejm.org/doi/full/10.1056/NEJMoa2206038
- https://www.nejm.org/doi/full/10.1056/NEJMoa2416394
- https://doi.org/10.1111/dom.70622
- https://www.nejm.org/doi/full/10.1056/NEJMoa2107519
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This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.