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The STEP program trials with semaglutide (a GLP-1-only agonist) and the SURMOUNT trials with tirzepatide (dual GIP/GLP-1 agonist) represent the strongest weight loss efficacy data in the history of pharmacotherapy for obesity

But for a large number of patients, the medications fall short, fail entirely, or come with side effects that make long-term use impossible

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For each eligible study, two authors (MM and AN) independently extracted data, which was then reviewed by a third author (JV) using a piloted spreadsheet, in accordance with Cochrane Collaboration guidelines ( Where relevant data were missing, attempts were made to contact corresponding authors