SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1593134
This article is part of the Research TopicIncretin-based Therapies in the Treatment of Metabolic Syndrome: Expanding Roles Beyond Weight ManagementView all 4 articles
Efficacy and safety of tirzepatide for weight loss in patients with obesity or type 2 diabetes: a systematic review and meta-analysis
Provisionally accepted
- 1Hainan Vocational University of Science and Technology, Haikou, Hainan Province, China
- 2The Chinese University of Hong Kong, Shatin, China
- 3Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangx, China
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This meta-analysis aims to evaluate efficacy and safety of tirzepatide for weight loss, including its dose-response relationship and adverse event profile.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.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).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.
Keywords: tirzepatide, Weight Loss, Meta-analysis, Obesity, type 2 diabetes, adverse events
Received: 18 Mar 2025; Accepted: 24 Jun 2025.
Copyright: © 2025 Tian, Song, DENG and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: YAN DENG, The Chinese University of Hong Kong, Shatin, China
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