Tirzepatide and semaglutide drive significant weight loss in Indian cohort; younger, GLP-1 naive respond faster.
Background
Obesity and type 2 diabetes (T2D) are escalating health crises in India, necessitating effective weight management strategies. While newer glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists have demonstrated substantial efficacy in global clinical trials, real-world data on their performance in the Indian population remains scarce. This gap in evidence hinders personalized therapy and setting realistic expectations for patients initiating these potent metabolic regulators that act on GLP-1R and GIPR pathways.
Study Design
This retrospective cohort study analyzed data from 150 overweight or obese participants (74 with T2D, 76 without T2D) at a tertiary center in New Delhi, India. All participants received either semaglutide or tirzepatide in routine clinical practice over 6 months. Key outcomes included percentage weight loss, achievement of predefined weight-loss thresholds, and time-to-event for achieving ≥10% weight loss. Non-parametric tests and Cox proportional hazard regression were employed to identify determinants of weight loss and time-to-event.
Results
GLP-1/GIP receptor agonists proved effective for weight loss in this real-world Indian cohort, yielding a median weight loss of 8.2% (interquartile range: 4.93-13.66%). Participants without T2D achieved significantly greater weight loss than those with T2D (11.21% vs 5.48%, P < 0.001). Tirzepatide demonstrated superior efficacy compared to semaglutide, with patients on tirzepatide experiencing 8.60% median weight loss versus 5.62% for semaglutide (P = 0.023).
Key Findings
- Median weight loss across the cohort was 8.2%.
- Participants without T2D lost significantly more weight (11.21%) than those with T2D (5.48%, P < 0.001).
- Tirzepatide led to greater weight loss (8.60%) compared to semaglutide (5.62%, P = 0.023).
- 41.3% of participants achieved ≥10% weight loss, with a median time-to-event of 9.5 months.
- Younger age, tirzepatide use, and GLP-1 treatment naivety were linked to faster achievement of ≥10% weight loss.
Why It Matters
This real-world data from an Indian cohort provides crucial insights for personalizing GLP-1/GIP agonist therapy and managing patient expectations. The finding that tirzepatide leads to greater weight loss than semaglutide suggests it may be a preferred option for individuals seeking more aggressive weight reduction. Furthermore, younger patients and those naive to GLP-1 treatment are likely to achieve ≥10% weight loss faster, allowing clinicians to tailor treatment plans and counseling. This study highlights the importance of considering patient characteristics like diabetes status and prior GLP-1 exposure when initiating these powerful anti-obesity medications.
semaglutide
tirzepatide
weight-loss
obesity
type-2-diabetes
india