Comparação entre Tirzepatida e Semaglutida na redução de peso em pacientes adultos com obesidade: uma revisão integrativa da literatura

Introduction: Obesity is a multifactorial chronic condition associated with metabolic and cardiovascular comorbidities and reduced quality of life. Given the limitations of conventional approaches, GLP-1 receptor agonists and dual GIP/GLP-1 agonists have gained prominence in pharmacological treatment. Objective: To compare the efficacy, adherence, adverse effects, and systemic impacts of semaglutide and tirzepatide, in addition to weight reduction, in adults with obesity through an integrative literature review. Methods: A search was conducted in PubMed, BVS, LILACS, and Wiley Online Library, including publications from 2015 to 2025. Randomized clinical trials, cohort studies, meta-analyses, and systematic reviews directly comparing the two drugs were included. Results and Discussion: The analyzed studies demonstrated that tirzepatide is more effective than semaglutide in promoting weight loss, with reductions ranging from 11% to 19.2% of body weight, whereas semaglutide achieved reductions between 5.7% and 12.9%. Tirzepatide also provided greater improvements in metabolic markers, including insulin resistance, lipid profile, blood pressure, and abdominal circumference. Both medications presented similar safety profiles, with predominantly mild to moderate gastrointestinal adverse effects. Cost-effectiveness analyses indicated that tirzepatide offers better cost-benefit performance, particularly in terms of quality-adjusted life years (QALYs). Conclusion: Although both drugs represent important advances in obesity pharmacotherapy, tirzepatide demonstrated superior clinical efficacy and metabolic benefits. However, factors such as cost, access, and individual patient characteristics should be considered in therapeutic decision-making. Long-term and nationally representative studies are recommended to assess the applicability of these findings within the Brazilian public health context.