EFFICACY AND SAFETY OF SEMAGLUTIDE AND TIRZEPATIDE IN THE TREATMENT OF OBESITY: A SYSTEMATIC REVIEW

Abstract

Obesity is a chronic, multifactorial condition that impacts health and quality of life and is associated with several comorbidities, including type 2 diabetes, hypertension, dyslipidemia, and cardiovascular diseases. Despite traditional interventions based on diet, physical activity, and multidisciplinary follow-up, many individuals fail to achieve satisfactory or sustainable weight loss, particularly in cases of moderate to severe obesity. In this context, glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, and dual-action drugs, such as tirzepatide (GLP-1/GIP), have emerged as promising pharmacological alternatives, capable of reducing appetite, modulating energy metabolism, and improving metabolic parameters. This study consisted of a systematic literature review conducted according to the Whittemore and Knafl method and the recommendations of the Joanna Briggs Institute, with searches in PubMed, BVS, and LILACS, covering publications from the last five years. Original studies assessing the efficacy and safety of semaglutide or tirzepatide in adults with obesity were included. Results indicate that both drugs promote significant weight loss, reduction in waist circumference, and improvement in metabolic parameters, with greater efficacy observed for tirzepatide, especially at higher doses. Adverse events were predominantly gastrointestinal, generally mild to moderate, and the risk of optic nerve disorders in patients with type 2 diabetes is low but warrants monitoring. Studies also highlight economic advantages and the feasibility of remote weight management programs. In conclusion, semaglutide and tirzepatide represent significant advances in obesity management, although future research should evaluate long-term, head-to-head comparisons, ophthalmologic safety, and efficacy across diverse populations, contributing to safer and more individualized clinical decision-making.