SynthesisFrontiers in endocrinology2025

Efficacy and safety of tirzepatide for weight loss in patients with obesity or type 2 diabetes: a systematic review and meta-analysis.

Qiru Tian, Yi Song, Yan Deng, Shike Lin

Erratum issuedAbstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Frontiers in endocrinology, 2025. The graph read 10 numbers from its abstract, feeding 2 cells of the map: it supports the treatment in 2. An erratum has been issued. Cited by 6 papers, 1 of them a synthesis that pooled it.

10numbers the graph read from it
2cells of the map it votes in
6citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

Ratios

← favours the treatmentfavours the comparator →
24101 · no effect
Discontinuations due to side effectstirzepatide at higher doses vs tirzepatide at lower doses (implied reference)favours the comparator · obesity, t2dfeeds one cell of the map
OR 2.31p < 0.0001
Discontinuations due to side effects increased at higher doses (OR=2.31; p < 0.0001).
Adverse eventstirzepatide vs placebofavours the comparator · obesity, t2dfeeds one cell of the map
OR 1.34p < 0.0001
Adverse events were more frequent with tirzepatide than placebo (OR=1.34; p < 0.0001), largely driven by gastrointestinal symptoms, whereas serious adverse events did not differ.
Achieving clinically meaningful weight loss ≥ 15%tirzepatide vs placebofavours the treatment · obesity, t2dfeeds one cell of the map
OR 18.1p < 0.0001
Tirzepatide also markedly increased the odds of achieving clinically meaningful weight loss: ≥ 5% (OR=11.32; p < 0.0001), ≥ 10% (OR=14.77; p < 0.0001), and ≥ 15% (OR=18.07; p < 0.0001.
Achieving clinically meaningful weight loss ≥ 5%tirzepatide vs placebofavours the treatment · obesity, t2dfeeds one cell of the map
OR 11.3p < 0.0001
Tirzepatide also markedly increased the odds of achieving clinically meaningful weight loss: ≥ 5% (OR=11.32; p < 0.0001), ≥ 10% (OR=14.77; p < 0.0001), and ≥ 15% (OR=18.07; p < 0.0001.
Achieving clinically meaningful weight loss ≥ 10%tirzepatide vs placebofavours the treatment · obesity, t2dfeeds one cell of the map
OR 14.8p < 0.0001
Tirzepatide also markedly increased the odds of achieving clinically meaningful weight loss: ≥ 5% (OR=11.32; p < 0.0001), ≥ 10% (OR=14.77; p < 0.0001), and ≥ 15% (OR=18.07; p < 0.0001.

Differences

← favours the treatmentfavours the comparator →
-19.20 · no effect
Weight losstirzepatide at 5 mg vs placebo, in non-diabetic participantsfavours the treatment · obesity, t2dfeeds one cell of the map
Δ -12.1-13.5 to -10.7< 0.00001
Non-diabetic participants experienced greater absolute losses of -12.10 kg (95% CI: -13.47 to -10.72; p < 0.00001), -15.94 kg (95% CI: -17.25 to -14.62; p < 0.00001), and -17.86 kg (95% CI: -19.19 to -16.54; p < 0.00001) at the respective doses.
Weight reductiontirzepatide vs placebofavours the treatment · obesity, t2dfeeds one cell of the map
Δ -10.4-10.8 to -9.99< 0.00001
Results: Tirzepatide induced a mean weight reduction of -10.39 kg versus placebo (95% CI: -10.80 to -9.99; p < 0.00001).
Weight losstirzepatide at 5 mg vs placebo, in patients with type 2 diabetesfavours the treatment · obesity, t2dfeeds one cell of the map
Δ -6.17-7.16 to -5.17< 0.00001
Subgroup analyses by diabetes status showed that patients with type 2 diabetes lost -6.17 kg (95% CI: -7.16 to -5.17; p < 0.00001) at 5 mg, -8.57 kg (95% CI: -9.41 to -7.74; p < 0.00001) at 10 mg, and -9.60 kg (95% CI: -10.32 to -8.89; p < 0.00001) at 15 mg.
Weight losstirzepatide at 15 mg vs placebo, in non-diabetic participantsfavours the treatment · obesity, t2dfeeds one cell of the map
Δ -17.9-19.2 to -16.5< 0.00001
Non-diabetic participants experienced greater absolute losses of -12.10 kg (95% CI: -13.47 to -10.72; p < 0.00001), -15.94 kg (95% CI: -17.25 to -14.62; p < 0.00001), and -17.86 kg (95% CI: -19.19 to -16.54; p < 0.00001) at the respective doses.
Weight losstirzepatide at 10 mg vs placebo, in non-diabetic participantsfavours the treatment · obesity, t2dfeeds one cell of the map
Δ -15.9-17.3 to -14.6< 0.00001
Non-diabetic participants experienced greater absolute losses of -12.10 kg (95% CI: -13.47 to -10.72; p < 0.00001), -15.94 kg (95% CI: -17.25 to -14.62; p < 0.00001), and -17.86 kg (95% CI: -19.19 to -16.54; p < 0.00001) at the respective doses.

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

GIP/GLP-1 & amylin agonists×body weight & composition

SupportsOpen on the map →What to test next →

29 readable studies in this cell: 28 favour the treatment, 1 find no difference, 0 favour the comparator.

Belief with this paper
1.00replicated · 19 families support, 0 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
Δ -17.3-18.1 to -16.6
NCT041846222,539 enrolled · 2019
Δ -13.5-14.6 to -12.5
NCT037306622,002 enrolled · 2018
Δ -9.00-9.80 to -8.30
NCT039879191,879 enrolled · 2019
Δ -1.70-2.60 to -0.70
NCT038829701,444 enrolled · 2019
Δ -9.80-10.8 to -8.80
NCT045379231,428 enrolled · 2020
Δ -10.7-11.5 to -9.90
Δ -10.4-11.2 to -9.50
NCT04657003938 enrolled · 2021
Δ -10.1-11.5 to -8.80
NCT04093752917 enrolled · 2019
Δ -6.50-7.40 to -5.60
NCT04660643783 enrolled · 2021
Δ -21.4-22.9 to -20.0
NCT05822830751 enrolled · 2023
Δ -6.50-8.10 to -4.90
NCT04847557731 enrolled · 2021
Δ -11.6-12.8 to -10.4

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

GIP/GLP-1 & amylin agonists×adverse events & safety

SupportsOpen on the map →What to test next →

4 readable studies in this cell: 2 favour the treatment, 2 find no difference, 0 favour the comparator.

Belief with this paper
0.00contested · 0 families support, 3 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT0498257592 enrolled · 2021
Δ -0.30-0.79 to 0.19
NCT0408133755 enrolled · 2020
Δ -0.03-0.05 to -0.02
NCT0405055342 enrolled · 2020
Δ -0.89-4.10 to 2.33

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Article
  5. Review
  6. Article
6 · The record

Corrections and comments

7 · Who and what money

Authors and funding

4 authors.

Qiru TianSchool of Basic Medical Sciences, Hainan Vocational University of Science and Technology, Haikou, China.
Yi SongFaculty of Medicine, Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Yan DengFaculty of Medicine, Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Shike LinOffice of Science and Technology, Youjiang Medical University for Nationalities, Baise, Guangxi, China.

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

Background: This meta-analysis aims to evaluate efficacy and safety of tirzepatide for weight loss, including its dose-response relationship and adverse event profile. Methods: Studies were retrieved from high-impact journals and included phase 1 to phase 3 trials. Participants received tirzepatide at 5,10, or 15 mg doses or a placebo control. Weighted mean differences (WMD) and odds ratios (OR) with 95% confidence intervals (CIs) were used to evaluate treatment effects, and heterogeneity was assessed using I² statistic. Results: Tirzepatide induced a mean weight reduction of -10.39 kg versus placebo (95% CI: -10.80 to -9.99; p < 0.00001). Subgroup analyses by diabetes status showed that patients with type 2 diabetes lost -6.17 kg (95% CI: -7.16 to -5.17; p < 0.00001) at 5 mg, -8.57 kg (95% CI: -9.41 to -7.74; p < 0.00001) at 10 mg, and -9.60 kg (95% CI: -10.32 to -8.89; p < 0.00001) at 15 mg. Non-diabetic participants experienced greater absolute losses of -12.10 kg (95% CI: -13.47 to -10.72; p < 0.00001), -15.94 kg (95% CI: -17.25 to -14.62; p < 0.00001), and -17.86 kg (95% CI: -19.19 to -16.54; p < 0.00001) at the respective doses. Tirzepatide also markedly increased the odds of achieving clinically meaningful weight loss: ≥ 5% (OR=11.32; p < 0.0001), ≥ 10% (OR=14.77; p < 0.0001), and ≥ 15% (OR=18.07; p < 0.0001. Adverse events were more frequent with tirzepatide than placebo (OR=1.34; p < 0.0001), largely driven by gastrointestinal symptoms, whereas serious adverse events did not differ. Discontinuations due to side effects increased at higher doses (OR=2.31; p < 0.0001). Conclusions: Tirzepatide induces significant, dose-dependent weight loss, with higher doses yielding greater reductions. While gastrointestinal side effects were common, they were generally mild to moderate and did not increase serious adverse events. These findings support tirzepatide as an effective weight management therapy, though strategies to mitigate gastrointestinal symptoms may improve adherence.

Indexed as

Anti-Obesity AgentsDiabetes Mellitus, Type 2ObesityTirzepatideWeight LossHumansTreatment OutcomeAnti-Obesity AgentsTirzepatideadverse eventsmeta-analysisobesitytirzepatidetype 2 diabetesweight loss

Identifiers

PMID40747302
PMCPMC12310450

What Socratic holds

Texttitle and abstract
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.