When comparing semaglutide and tirzepatide for weight loss, it matters whether we are looking at trial efficacy or real-world use. Trials test ideal dosing and steady treatment, but in practice many patients stop early, stay on treatment inconsistently, or use lower doses than the trials studied. That means head-to-head results can look better in highly adherent patients than they do in everyday care. Tolerability also matters, because gastrointestinal side effects are a common reason people stop these medicines. And the weight loss itself may not last after treatment ends. The evidence says weight regain can happen after stopping semaglutide or tirzepatide, so comparative results should be read as on-treatment effects, not proof of durable weight loss once therapy is discontinued.
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