Risk-benefit of tirzepatide, semaglutide, and bariatric surgery in obesity

Objective: Identify the best method for treating overweight/obesity in adults by analyzing their characteristics, benefits, and side effects. Methods: This is an integrative review composed of the following stages: 1. formulation of the guiding question; 2. literature search; 3. data collection; 4. critical analysis of the articles; 5. discussion of the results; 6. presentation of the integrative review. The databases Pubmed, BIREME, and SCIELO were consulted. Inclusion criteria were articles available in full, published in the last 5 years (2020 - 2024 ), in English or Portuguese. Articles were transferred to Rayyan software, where duplicates and those not meeting the inclusion criteria, such as studies on children and review articles, were excluded. Results: The results showed that Tirzepatide, compared to Semaglutide, was superior in reducing BMI, abdominal circumference, and weight percentage. Adverse effects occurred in both studies, mainly gastrointestinal, with no preference for either drug to reduce these effects. Comparison between Semaglutide or Tirzepatide versus Bariatric Surgery was not possible, as no studies addressing this comparison were found. Conclusions: Future research comparing medicinal and surgical approaches for weight reduction in obese patients is necessary to determine the best treatment, considering both weight reduction and undesirable post-treatment effects. More research on weight regain after study completion is also needed