OBESITY MANAGEMENT - A COMPARATIVE REVIEW OF THE EFFICACY AND SAFETY OF BARIATRIC SURGERY AND TIRZEPATIDE THERAPY

Objective: Obesity is a major global health burden associated with increased morbidity, mortality, and healthcare costs. This review aimed to compare the efficacy and safety of tirzepatide, a novel dual GLP-1/GIP receptor agonist, with bariatric surgery, focusing on their roles in weight reduction, metabolic improvement, and long-term risk–benefit profiles. Methods: A comprehensive literature search was performed using PubMed and official regulatory and professional society sources (FDA, EMA, MHRA, IFSO). Search terms included “obesity,” “bariatric surgery,” “tirzepatide,” and “GLP-1 and GIP receptor agonist.” Only peer-reviewed English-language studies with high levels of evidence, including randomized controlled trials, meta-analyses, systematic reviews, and clinical guidelines, were included. Key Findings: Bariatric surgery, particularly Roux-en-Y gastric bypass and sleeve gastrectomy, was associated with the most profound and durable weight loss (25–28% short-term; 18–25% long-term), alongside significant remission of type 2 diabetes, hypertension, and dyslipidemia. However, its invasive nature and risk of perioperative and late complications necessitate multidisciplinary follow-up. Tirzepatide demonstrated dose-dependent reductions in body weight (~10–20%), improved glycemic control, lipid profiles, and blood pressure, and enhanced quality of life. Its safety profile was favorable, predominantly gastrointestinal, but long-term data remain limited. Conclusions: Bariatric surgery remains the gold standard for severe obesity due to its magnitude and sustainability of benefits. Tirzepatide represents a promising, less-invasive pharmacological option, particularly for patients with moderate obesity or contraindications to surgery. Further research is required to establish its long-term efficacy and safety profile.