What does the research show about tirzepatide?

Tirzepatide

In SURMOUNT-1, weekly tirzepatide cut body weight 15.0 to 20.9% over 72 weeks, depending on dose, against 3.1% on placebo. Pooled trials found fewer major cardiovascular events. People switched to placebo regained 14% within a year. Gastrointestinal events were most common, and about a quarter of weight lost was lean mass.

Add to Bio HackChecked 2026-11-13

Status: Prescription drug in the US. FDA-approved as Mounjaro for type 2 diabetes, and as Zepbound for chronic weight management and for moderate to severe obstructive sleep apnea in adults with obesity.
Also called: Mounjaro, Zepbound, GIP/GLP-1 receptor agonist, dual incretin agonist, tirz
Taken for: weight loss, fat loss, appetite, heart health, heart failure, keeping weight off

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help4

StrongShown to lower body weight 15% to 21% at 72 weeks in adults with obesity without diabetes, against 3% on placebo, and more than semaglutide.Very common
ModerateShown to keep weight off in adults who stayed on treatment, while those switched to placebo regained 14%. Only people who finished a lead-in took part.Very common
ModerateShown to cut cardiovascular death or worsening heart failure, 9.9% against 15.3% on placebo, in adults with obesity and heart failure with preserved ejection fraction.
LimitedOne small trial found about 525 fewer calories eaten at a test lunch, and less hunger and craving, at week 3 in adults without diabetes.

Reported risks11

StrongShown to raise nausea, vomiting, diarrhea and constipation about threefold over placebo, mostly mild to moderate and early. Stopping for side effects rose at higher doses.Common
ModerateInjection site reactions occurred in 2% to 7%, more often than with liraglutide or semaglutide, and rose with dose.Common
ModerateAcute pancreatitis occurred in 0.22% of trial participants, with no difference between doses.Uncommon
ModerateLean mass made up about 25% of weight lost in one substudy, the same share as on placebo, and 15% to 60% in others. A 2026 review called it uncertain.How often is not known
ModerateSerious adverse events and deaths were about as common as on placebo. Against semaglutide, serious adverse events were more frequent.How often is not known
ModerateMixed results: any heart rhythm problem was more frequent than on placebo in adults with obesity, while atrial fibrillation did not differ significantly.How often is not known
ModerateShown to raise dizziness by about two thirds in people with type 2 diabetes, more at age 60 and under. Headache did not differ.How often is not known
LimitedThe label warns that tirzepatide causes thyroid C-cell tumors in rats, and that it is unknown whether it causes them in humans.How often is not known
LimitedThe label reports acute kidney injury, some needing dialysis, mostly in people dehydrated from nausea, vomiting or diarrhea, and tells prescribers to monitor kidney function.How often is not known
LimitedThe label warns that tirzepatide lowers birth control pill levels and tells users to switch to or add a non-oral method for 4 weeks after starting and each dose increase.How often is not known
LimitedThe label warns that use with insulin or a sulfonylurea may raise the risk of low blood sugar, including severe low blood sugar.How often is not known

What people take it for, and what was found

Shown to help4

StrongVery common

Weight loss

Shown to lower body weight 15% to 21% at 72 weeks in adults with obesity without diabetes, against 3% on placebo, and more than semaglutide.

The numbers and sources

How common: Very common: more than 1 in 10 people.
Effect: At 72 weeks, body weight changed by -15.0% (95% CI -15.9 to -14.2) on 5 mg, -19.5% (95% CI -20.4 to -18.5) on 10 mg and -20.9% (95% CI -21.8 to -19.9) on 15 mg, against -3.1% on placebo. A loss of 20% or more occurred in 50% on 10 mg, 57% on 15 mg and 3% on placebo [1]. In an open-label head-to-head trial, weight changed by -20.2% (95% CI -21.4 to -19.1) on tirzepatide and -13.7% (95% CI -14.9 to -12.6) on semaglutide, and waist circumference by -18.4 cm and -13.0 cm [2]. Pooled across RCTs in adults without diabetes, weight changed by a mean difference of -16.32% against placebo (95% CI -18.35 to -14.29) [3]. Stratified by diabetes status, the difference was -17.15% without diabetes and -9.54% with it [4]. Across head-to-head studies, tirzepatide lost 4.28 percentage points more than semaglutide (95% CI -5.28 to -3.28) [5].
Population: 2,539 adults with a BMI of 30 or more, or 27 or more with a weight-related complication, without diabetes, mean weight 104.8 kg [1]; 751 adults with obesity without type 2 diabetes [2]; 6 RCTs in adults without diabetes [3]; 4,467 adults without and 2,174 with diabetes in 10 RCTs [4]; 41,381 participants in 10 studies [5].
Sources: [1], [2], [3], [4], [5]
Caveats: Both lead trials were funded by Eli Lilly, the maker [1][2]. The head-to-head trial was open-label [2], and the head-to-head meta-analysis included observational studies [5].

ModerateVery common

Keeping weight off while staying on treatment

Shown to keep weight off in adults who stayed on treatment, while those switched to placebo regained 14%. Only people who finished a lead-in took part.

The numbers and sources

How common: Very common: more than 1 in 10 people.
Effect: After 36 weeks on tirzepatide (mean loss 20.9%), people randomized to continue lost a further 5.5% by week 88, while those switched to placebo regained 14.0%, a difference of -19.4% (95% CI -21.2 to -17.7). On tirzepatide, 89.5% kept at least 80% of their earlier loss, against 16.6% on placebo [6]. In SURMOUNT-MAINTAIN, after 60 weeks of open-label treatment, weight change from baseline at week 112 was -21.9% for those continuing the maximum tolerated dose, -16.6% on a reduced 5 mg dose and -9.9% on placebo (difference against placebo -12.0%, 95% CI -13.8 to -10.1). Rescue tirzepatide, offered to those who regained more than half their loss, was given to 8%, 25% and 67% of the three groups [7].
Population: 670 adults with obesity or overweight without diabetes, 71% women, mean weight 107.3 kg, in a 52-week randomized withdrawal [6]; 378 adults with obesity randomized at week 60, 65% women, mean weight 113.8 kg [7].
Sources: [6], [7]
Caveats: Two trials, both funded by Eli Lilly. Each randomized only people who completed an open-label lead-in [6][7].

Limited

Appetite and food intake

One small trial found about 525 fewer calories eaten at a test lunch, and less hunger and craving, at week 3 in adults without diabetes.

The numbers and sources

Effect: At week 3, tirzepatide cut energy intake at a self-serve lunch by 524.6 kcal more than placebo (95% CI -648.1 to -401.0). Self-reported appetite, food cravings, tendency to overeat and hunger fell against placebo [8].
Population: 114 adults without diabetes, BMI 27 to 50, in a 6-week phase 1 trial [8].
Sources: [8]
Caveats: One small trial that measured a single test meal.

Moderate

Heart failure with preserved ejection fraction

Shown to cut cardiovascular death or worsening heart failure, 9.9% against 15.3% on placebo, in adults with obesity and heart failure with preserved ejection fraction.

The numbers and sources

Effect: Cardiovascular death or worsening heart failure occurred in 9.9% on tirzepatide and 15.3% on placebo (HR 0.62, 95% CI 0.41 to 0.95). Worsening heart failure events were 8.0% and 14.2% (HR 0.54, 95% CI 0.34 to 0.85). Cardiovascular deaths were 8 (2.2%) and 5 (1.4%) (HR 1.58, 95% CI 0.52 to 4.83). The KCCQ health status score rose 6.9 points more on tirzepatide (95% CI 3.3 to 10.6) [9]. Pooled with observational studies, tirzepatide was associated with fewer cardiovascular deaths or worsening heart failure events than standard therapy (HR 0.50, 95% CI 0.42 to 0.60). Heart failure hospitalization and all-cause mortality did not differ, and no outcome differed significantly against semaglutide [10].
Population: 731 adults with heart failure, ejection fraction of 50% or more and BMI of 30 or more, median follow-up 104 weeks [9]; 47,710 patients with this type of heart failure and BMI of 30 or more in 5 studies [10].
Sources: [9], [10]
Caveats: SUMMIT had few deaths, so its death estimate is imprecise, and it was funded by Eli Lilly [9]. The meta-analysis mixed randomized and observational studies [10].

Not shown to help2

Moderate

New heart failure in type 2 diabetes or obesity

Not shown to change the risk of new heart failure in people with type 2 diabetes or obesity.

The numbers and sources

Effect: Against placebo or other glucose-lowering drugs, tirzepatide did not change overall heart failure risk (RR 0.63, 95% CI 0.35 to 1.13), an absolute risk reduction of 0.17% [11]. A second meta-analysis found no association with heart failure hospitalization [12].
Population: 13,378 participants in 11 RCTs [11]; 29,023 participants in 22 RCTs [12].
Sources: [11], [12]
Caveats: All 11 trials in the first review were funded by Eli Lilly, and its certainty was rated moderate [11].

Moderate

Heart attack, stroke and cardiovascular death

Not shown to lower heart attack, stroke or cardiovascular death more than dulaglutide in type 2 diabetes with heart disease. Pooled trials found about 13% fewer events.

The numbers and sources

Effect: Against the GLP-1 drug dulaglutide, a major cardiovascular event occurred in 12.2% on tirzepatide and 13.1% on dulaglutide (HR 0.92, 95.3% CI 0.83 to 1.01). This met the trial's noninferiority margin but not superiority [13]. Across RCTs in type 2 diabetes or overweight and obesity, tirzepatide was associated with fewer major cardiovascular events (OR 0.87, 95% CI 0.79 to 0.94) and lower all-cause mortality (OR 0.84, 95% CI 0.75 to 0.93), with no association for the individual components of the composite [12]. A network meta-analysis estimated tirzepatide against placebo at HR 0.79 (95% CI 0.69 to 0.91) for major cardiovascular events in type 2 diabetes [14].
Population: 13,165 adults with type 2 diabetes and atherosclerotic cardiovascular disease, mean age 64.1 [13]; 29,023 participants in 22 RCTs [12]; 11 trials in type 2 diabetes with cardiovascular disease or high risk [14].
Sources: [13], [12], [14]
Caveats: SURPASS-CVOT used an active comparator, not placebo, and was funded by Eli Lilly [13]. The network estimate is indirect, and SURPASS-CVOT was its only tirzepatide trial [14].

Doses studied

SURMOUNT-1 used 5 mg, 10 mg or 15 mg by subcutaneous injection once weekly [1]. SURMOUNT-4 used the maximum tolerated dose of 10 mg or 15 mg weekly [6]. The head-to-head trial used 10 mg or 15 mg of tirzepatide against 1.7 mg or 2.4 mg of semaglutide weekly [2]. SUMMIT and SURPASS-CVOT used up to 15 mg weekly, with SURPASS-CVOT comparing against dulaglutide 1.5 mg [9][13]. SURMOUNT-MAINTAIN continued the maximum tolerated dose of 10 or 15 mg weekly or reduced it to 5 mg [7].

Risks

Reported risks9

StrongCommon

Gastrointestinal effects and stopping treatment

Shown to raise nausea, vomiting, diarrhea and constipation about threefold over placebo, mostly mild to moderate and early. Stopping for side effects rose at higher doses.

The numbers and sources

How common: Common: between 1 in 100 and 1 in 10 people.
Effect: Gastrointestinal events were the most common adverse events, mostly mild to moderate. Adverse events led to discontinuation in 4.3%, 7.1% and 6.2% on 5, 10 and 15 mg, against 2.6% on placebo [1]. In SUMMIT, adverse events, mainly gastrointestinal, led to discontinuation in 6.3% on tirzepatide and 1.4% on placebo [9]. Against dulaglutide, overall adverse event rates looked similar, with more gastrointestinal events on tirzepatide [13]. Pooled against placebo in adults without diabetes, the RR was 3.11 for nausea (95% CI 2.74 to 3.54), 5.94 for vomiting (95% CI 4.50 to 7.85), 2.92 for diarrhea (95% CI 2.53 to 3.37) and 2.85 for constipation (95% CI 2.38 to 3.42). Serious gastrointestinal events (RR 3.07, 95% CI 2.03 to 4.66) and stopping because of adverse events (RR 2.29, 95% CI 1.74 to 3.01) were also more frequent [3]. A second meta-analysis found gastrointestinal events 2.94 times as likely (95% CI 2.61 to 3.32), with no significant rise in biliary, liver or pancreatic events [15]. Across 17 RCTs, permanent discontinuation for any reason was not higher than placebo, while discontinuation for adverse events rose at higher doses [16].
Population: Trial participants in [1], [9] and [13]; 6 RCTs [3]; 13 RCTs of semaglutide and tirzepatide in 26,894 adults without diabetes [15]; 14,645 participants in 17 RCTs [16].
Sources: [1], [9], [13], [3], [15], [16]
Caveats: SURMOUNT-1 reports these events as occurring mainly in the early weeks of treatment [1].

ModerateCommon

Injection site and skin reactions

Injection site reactions occurred in 2% to 7%, more often than with liraglutide or semaglutide, and rose with dose.

The numbers and sources

How common: Common: between 1 in 100 and 1 in 10 people.
Effect: Injection site reactions, including redness, itching and bleeding, were reported in 2 to 7% on tirzepatide, more often than with liraglutide or semaglutide, with signs of dose dependence. Uncommon reactions reported across these drugs included angioedema, hypersensitivity, blistering disease and vasculitis [30].
Population: 101 studies, including 32 RCTs, 20 pharmacovigilance studies and 43 case reports or series [30].
Sources: [30]
Caveats: Mixed designs, not pooled [30].

ModerateUncommon

Acute pancreatitis

Acute pancreatitis occurred in 0.22% of trial participants, with no difference between doses.

The numbers and sources

How common: Uncommon: between 1 in 1,000 and 1 in 100 people.
Effect: Acute pancreatitis occurred in 0.22% of trial participants, with no difference between doses (15 mg against 5 mg RR 0.70, 95% CI 0.27 to 1.82) [23].
Population: 15,471 participants in 19 RCTs [23].
Sources: [23]
Caveats: All trials were industry funded with short to moderate follow-up, and precision was limited [23].

ModerateHow often is not known

Lean mass loss

Lean mass made up about 25% of weight lost in one substudy, the same share as on placebo, and 15% to 60% in others. A 2026 review called it uncertain.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Sources measure the loss and describe it differently. In a SURMOUNT-1 substudy, tirzepatide changed body weight by -21.3%, fat mass by -33.9% and lean mass by -10.9%, against -5.3%, -8.2% and -2.6% on placebo. About 75% of weight lost was fat and 25% lean on both tirzepatide and placebo [17]. A network meta-analysis found GLP-1 drugs reduced lean mass by 0.86 kg (95% CI 0.42 to 1.30), about 25% of weight lost, while relative lean mass was unchanged. Tirzepatide 15 mg and semaglutide 2.4 mg produced the most weight and fat loss and ranked among the least lean-sparing [18]. A review reports that in some trials lean mass made up 40 to 60% of total weight lost, and in others about 15% or less. It notes that lean mass includes organs, bone and water [19]. A 2026 meta-analysis found the muscle evidence too heterogeneous and imprecise for firm conclusions, with low to very low certainty [20].
Population: 160 adults with DXA scans, 73% women [17]; 22 RCTs with 2,258 adults [18]; trials summarized in a narrative review [19]; 19 studies, 2 comparative for muscle [20].
Sources: [17], [18], [19], [20], [21]
Caveats: [19] is a narrative review, not a systematic one. Lean mass by DXA is not the same as muscle, and few trials measured strength or function [20]. Across 6 RCTs, self-reported physical function improved against placebo (SF-36 physical function MD 2.26 points, 95% CI 1.76 to 2.76), but heterogeneity was very high (I² 99.8%) [21].

LimitedHow often is not known

Thyroid C-cell tumors

The label warns that tirzepatide causes thyroid C-cell tumors in rats, and that it is unknown whether it causes them in humans.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: The label carries a boxed warning that tirzepatide causes thyroid C-cell tumors in rats at clinically relevant exposures, and that it is unknown whether it causes them in humans, including medullary thyroid carcinoma. It is contraindicated with a personal or family history of medullary thyroid carcinoma or with MEN 2 [25]. In pooled trials, calcitonin rose more on 10 and 15 mg than placebo, and no papillary thyroid carcinoma was reported [24].
Population: Rats (animal) [25]; 13,761 trial participants [24].
Sources: [25], [24]
Caveats: The tumor finding is from animals. Human relevance has not been determined [25].

ModerateHow often is not known

Dizziness

Shown to raise dizziness by about two thirds in people with type 2 diabetes, more at age 60 and under. Headache did not differ.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: In type 2 diabetes, dizziness was more common on tirzepatide (RR 1.64, 95% CI 1.04 to 2.57). Headache did not differ (RR 1.00, 95% CI 0.65 to 1.55) [27].
Population: 10,615 patients in 12 RCTs [27].
Sources: [27]
Caveats: Subgroup analysis suggested higher risk at age 60 and under [27].

LimitedHow often is not known

Acute kidney injury from dehydration (label warning)

The label reports acute kidney injury, some needing dialysis, mostly in people dehydrated from nausea, vomiting or diarrhea, and tells prescribers to monitor kidney function.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: The label reports postmarketing cases of acute kidney injury, some requiring hemodialysis, in people treated with GLP-1 receptor agonists or Zepbound. Most occurred in people whose nausea, vomiting or diarrhea led to dehydration. The label tells prescribers to monitor kidney function in people reporting those reactions, especially when starting and raising the dose [25].
Population: Postmarketing reports summarized in the label [25].
Sources: [25]
Caveats: These are reports, not rates from a controlled comparison.

LimitedHow often is not known

Birth control pills and other medicines taken by mouth (label)

The label warns that tirzepatide lowers birth control pill levels and tells users to switch to or add a non-oral method for 4 weeks after starting and each dose increase.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: The label states that tirzepatide delays stomach emptying, which lowers exposure to oral hormonal contraceptives. The delay is largest after the first dose and lessens over time. It tells people using birth control pills to switch to a non-oral method, or add a barrier method, for 4 weeks after starting and for 4 weeks after each dose increase. Contraceptives not taken by mouth are not expected to be affected. It names warfarin among medicines with a narrow therapeutic range to monitor [25].
Population: Clinical pharmacology studies, as reported in the label [25].
Sources: [25]
Caveats: The label does not report pregnancy rates on combined use.

LimitedHow often is not known

Low blood sugar with insulin or sulfonylureas (label)

The label warns that use with insulin or a sulfonylurea may raise the risk of low blood sugar, including severe low blood sugar.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: The label states that use with insulin or an insulin secretagogue, such as a sulfonylurea, may raise the risk of hypoglycemia, including severe hypoglycemia [25].
Population: As reported in the label [25].
Sources: [25]
Caveats: A label warning, without a rate given here.

Mixed results2

ModerateHow often is not known

Serious adverse events and death

Serious adverse events and deaths were about as common as on placebo. Against semaglutide, serious adverse events were more frequent.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Against placebo, serious adverse events did not differ in two meta-analyses (OR 0.98, 95% CI 0.82 to 1.17, and RR 0.93, 95% CI 0.76 to 1.13) [22][3]. All-cause mortality did not differ either (OR 1.02, 95% CI 0.57 to 1.81) [22]. Against semaglutide, serious adverse events were more frequent on tirzepatide (RR 1.83, p = 0.007) [5].
Population: 8,043 participants randomized to tirzepatide or placebo in 21 RCTs of people at increased cardiovascular risk [22]; 6 RCTs without diabetes [3]; 10 head-to-head studies [5].
Sources: [22], [3], [5]
Caveats: The mortality result was rated very low certainty [22]. The semaglutide comparison included observational studies [5].

ModerateHow often is not known

Heart rhythm

Mixed results: any heart rhythm problem was more frequent than on placebo in adults with obesity, while atrial fibrillation did not differ significantly.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: In adults with overweight or obesity, atrial fibrillation did not differ significantly from placebo (OR 2.20, 95% CrI 0.81 to 6.75), while any arrhythmia was more frequent (OR 1.84, 95% CrI 1.04 to 3.90) [26]. In type 2 diabetes, atrial fibrillation did not differ (RR 1.39, 95% CI 0.53 to 3.67) [27].
Population: 6,515 participants in 10 RCTs [26]; 10,615 patients with type 2 diabetes in 12 RCTs [27].
Sources: [26], [27]
Caveats: Event rates were low [26].

Checked, no increase found3

Moderate

Depression and suicidal thoughts

Suicidal thoughts were about as common as on placebo, 0.6% in each group, in adults with obesity without major psychiatric illness.

The numbers and sources

How common: Uncommon: between 1 in 1,000 and 1 in 100 people.
Effect: In three pooled SURMOUNT trials, 0.6% in each group reported suicidal ideation, and nonfatal suicidal behavior occurred in 0.1% on tirzepatide and none on placebo. Depression scores at 72 weeks were 0.6 points lower on tirzepatide (PHQ-9) [28]. A systematic review of GLP-1 drugs and tirzepatide found no consistent evidence of higher suicide risk, with mixed pharmacovigilance findings [29].
Population: 4,056 adults with obesity and no known major psychiatric illness [28]; 16 studies, including 2 RCTs, 5 observational studies and 8 pharmacovigilance analyses [29].
Sources: [28], [29]
Caveats: The pooled trial analysis was post hoc and excluded people with major psychiatric illness [28].

Moderate

Cancer

Cancer was about as common as on placebo, insulin or GLP-1 drugs over 26 to 72 weeks, with no rise in any cancer type.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Over 26 to 72 weeks, any cancer did not differ between tirzepatide and pooled controls (RR 0.78, 95% CI 0.53 to 1.16), with or without diabetes, and no specific cancer type rose [24].
Population: 13,761 participants in 13 RCTs [24].
Sources: [24]
Caveats: Controls were placebo, insulin or GLP-1 drugs, pooled [24].

Moderate

Kidney effects

Kidney problems were about as common as on placebo, insulin or GLP-1 drugs, and urine albumin fell at 10 and 15 mg.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Tirzepatide did not raise adverse kidney events, urinary tract infection, kidney stones, acute kidney injury or kidney cancer against placebo, insulin or GLP-1 drugs. Urine albumin fell more than on placebo with 10 mg (MD -26.95%) and 15 mg (MD -18.03%) [31].
Population: 14,471 participants in 15 RCTs over 26 to 72 weeks [31].
Sources: [31]
Caveats: Short trials. Kidney function (eGFR) did not differ from insulin [31].

Claims tested and not found

That the weight stays off after stopping. People switched to placebo after 36 weeks regained 14.0% of body weight over the next 52 weeks [6]. A Bayesian re-analysis of 6 studies of semaglutide or tirzepatide in 1,776 people estimated regain of 1.04 kg a month after stopping, with half the loss regained by a projected 7.5 months [32].

Sources

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Aronne LJ, Horn DB, le Roux CW, et al. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. New England Journal of Medicine. 2025. https://doi.org/10.1056/NEJMoa2416394
Kommu S, Sharma PP, Gabor RM. Efficacy and Safety of Tirzepatide on Weight Loss in Patients Without Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Obesity Reviews. 2025. https://doi.org/10.1111/obr.13961
Cerchi E, Santo PADE, de Oliveira MC, et al. Effects of tirzepatide on weight management in patients with and without diabetes: a systematic review and meta-analysis. International Journal of Obesity. 2025. https://doi.org/10.1038/s41366-025-01920-4
Paccola GP, de Oliveira RF, Mochetti MM, et al. Comparative Efficacy of Tirzepatide Versus Semaglutide for Weight Loss in Adults With Overweight or Obesity: A Systematic Review and Meta-Analysis of Head-to-Head Studies. Clinical Obesity. 2026. https://doi.org/10.1111/cob.70111
Aronne LJ, Sattar N, Horn DB, et al. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial. JAMA. 2024. https://doi.org/10.1001/jama.2023.24945
Horn DB, Aronne LJ, Wharton S, et al. Tirzepatide for maintenance of bodyweight reduction in people with obesity in the USA (SURMOUNT-MAINTAIN): a multicentre, double-blind, randomised, placebo-controlled trial. The Lancet. 2026. https://doi.org/10.1016/s0140-6736(26)00656-2
Martin CK, Carmichael OT, Carnell S, et al. Tirzepatide on ingestive behavior in adults with overweight or obesity: a randomized 6-week phase 1 trial. Nature Medicine. 2025. https://doi.org/10.1038/s41591-025-03774-9
Packer M, Zile MR, Kramer CM, et al. Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity. New England Journal of Medicine. 2025. https://doi.org/10.1056/nejmoa2410027
Sebastian SA, Ayyalu T, Bimal T, et al. Efficacy and safety of Tirzepatide in patients with heart failure with preserved ejection fraction: A systematic review and meta-analysis. Disease-a-Month. 2026. https://doi.org/10.1016/j.disamonth.2026.102099
He YM, Zeng C, Zhang YF, et al. Effect of Tirzepatide on Heart Failure in Type 2 Diabetes Mellitus and Obesity: A Systematic Review and Meta-Analysis. Diabetes/Metabolism Research and Reviews. 2025. https://doi.org/10.1002/dmrr.70097
Spiazzi BF, Zingano CP, Colpani V, et al. Tirzepatide, cardiovascular outcomes and mortality in obesity and diabetes: a systematic review and meta-analysis. Diabetes Research and Clinical Practice. 2026. https://doi.org/10.1016/j.diabres.2026.113431
Nicholls SJ, Pavo I, Bhatt DL, et al. Cardiovascular Outcomes with Tirzepatide versus Dulaglutide in Type 2 Diabetes. New England Journal of Medicine. 2025. https://doi.org/10.1056/nejmoa2505928
Shokravi A, Seth J, Mancini GBJ. Comparative efficacy of tirzepatide and glucagon-like peptide-1 receptor agonists on cardiovascular outcomes in patients with type 2 diabetes: a systematic review and network meta-analysis. Cardiovascular Diabetology. 2026. https://doi.org/10.1186/s12933-026-03113-3
Safwan M, Bourgleh MS, Alotaibi SA, et al. Gastrointestinal safety of semaglutide and tirzepatide vs. placebo in obese individuals without diabetes: a systematic review and meta analysis. Annals of Saudi Medicine. 2025. https://doi.org/10.5144/0256-4947.2025.129
Kamrul-Hasan ABM, Pappachan JM, Dutta D, et al. Reasons for discontinuing tirzepatide in randomized controlled trials: A systematic review and meta-analysis. World Journal of Diabetes. 2025. https://doi.org/10.4239/wjd.v16.i4.101731
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