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Pharmacy Tirzepatide

A plain-numbers reading desk for the tirzepatide trial record — what SURPASS-2 and SURMOUNT-5 measured head-to-head against semaglutide.

Tirzepatide vs Semaglutide: Sugar and Weight

How Tirzepatide and semaglutide changed sugar and weight

Tirzepatide comes as a weekly shot that copies two gut hormones. This page compares it with semaglutide, which copies 1.

Two named studies, SURPASS-2 for diabetes and SURMOUNT-5 for weight, tested tirzepatide vs semaglutide face to face. One followed people with type 2 diabetes. The other followed people with obesity and no diabetes. Tirzepatide brought larger drops in blood sugar and body weight in both. The studies strongly support a real difference.

A review of old medical records points the same way. That kind of review is less sure than a direct study. The figures come next. You can ask your prescriber which ones fit your health and goals.

Tirzepatide vs semaglutide in SURPASS-2 for type 2 diabetes

SURPASS-2 was a 40-week phase 3 study, meaning a large late test. It and included 1,879 adults with type 2 diabetes. Each person knew which weekly shot was given. Tirzepatide doses were 5, 10, or 15 mg. The semaglutide dose was 1 mg [3].

Change in the blood test for your average sugar:

  • Tirzepatide 5 mg: −2.01
  • Tirzepatide 10 mg: −2.24
  • Tirzepatide 15 mg: −2.30
  • Semaglutide 1 mg: −1.86

The study first asked if tirzepatide worked at least as well as semaglutide. All three doses met that mark and then brought larger drops. The edge ran from 0.15 to 0.44 points [3].

Change in body weight:

  • Tirzepatide 5 mg: −7.8 kg
  • Tirzepatide 10 mg: −10.3 kg
  • Tirzepatide 15 mg: −12.4 kg
  • Semaglutide 1 mg: −6.2 kg

The extra loss was −1.9, −3.6, and −5.5 kg across the three tirzepatide doses [3].

In 2026, the team took a second look at SURPASS-2. It counted how many people met at least 3 health goals. The goals covered an average-sugar test under 7% and blood pressure under 140/90 millimeters of mercury, the standard cuff unit. They also covered bad cholesterol under 1.8 mmol/L, meaning millimoles per liter, and weight loss over 10%. At 5, 10, and 15 mg, 42%, 53%, and 57% met the usual set. Semaglutide reached 34%. A stricter set was met by 15%, 20%, and 29%, against 8% [12]. Your own changes may differ.

Tirzepatide vs semaglutide in SURPASS-2 for type 2 diabetes

Tirzepatide results from the direct weight study SURMOUNT-5

The large late study SURMOUNT-5 included 751 adults. Everyone knew which drug was given. Their height-to-weight number was at least 30. Some were overweight, with that number at least 27 and a weight-linked illness. None had type 2 diabetes. The study compared the drugs face to face.

Each person got the largest amount they could handle for 72 weeks. Tirzepatide was 10 or 15 mg. Semaglutide was 1.7 or 2.4 mg [5].

Average body-weight change at 72 weeks:

  • Tirzepatide: −20.2%
  • Semaglutide: −13.7%
  • Difference: about 6.5 percentage points of body weight

Tirzepatide also cut more from the waist. More people reached weight losses of at least 10%, 15%, 20%, and 25% [5].

In 2026, a second SURMOUNT-5 report asked how people felt and moved. Tirzepatide brought a larger gain in day-to-day movement. General health scores rose 5.45 points, against 4.20 [37]. The report did not show whether that small gap could be felt. People with trouble moving at the start also improved more. Your result may differ from either average.

Tirzepatide results found in old medical records

In 2024, a large study looked back through medical records. It compared people taking tirzepatide with similar people taking semaglutide [8].

Among 13,846 people without type 2 diabetes:

  • New type 2 diabetes was 27% less common with tirzepatide. The 95% range, the paper's best span for the true result, supported a real link
  • Average weight fell −7.7 kg with tirzepatide and −4.8 kg with semaglutide

Among 8,446 people who had type 2 diabetes:

  • Serious heart trouble or death occurred less often. The 95% range supported a real drop, but it doesn't give your personal chance
  • A stroke on its own was also less common
  • People also died less often from any cause

The team made the groups as alike as it could. Unseen differences may still explain part of the results. The findings fit the direct studies and cover tens of thousands of people [8]. They suggest a link but don't prove cause. This isn't a forecast for your health.

What reviews add when drugs lack a direct test

In 2025, a review joined results from 16 studies with 5,997 people. Tirzepatide lowered the average-sugar blood test by −0.45 more points than semaglutide. The paper's 95% range supported a real edge. The review found no clear winner for weight or fasting blood sugar. Different doses and study plans make that finding less sure [9].

Another 2025 review had no face-to-face test. It examined tirzepatide 10 and 15 mg against semaglutide. Reviewers first measured each drug against the placebo group in its own study. A placebo is a shot with no active drug. They then compared those two gaps, which is less sure because the groups differed. The weight studies were called SURMOUNT-2 and STEP 2. Adults had obesity and type 2 diabetes. At 10 and 15 mg, tirzepatide lowered weight, the height-to-weight number, and the average-sugar test more than semaglutide 2.4 mg. The 15 mg dose also brought more losses of at least 5% and at least 15%. Waist size, fasting sugar, and triglycerides, which are fats in your blood, improved more [36].

The full Tirzepatide research page covers the main studies. The tirzepatide weight loss page gives more detail on weight. Your prescriber can tell you which kind of comparison bears on your choice.