Comparative effects of drugs for adults with overweight or obesity: systematic review and network meta-analysis

08 Jul 20264 min read0 viewsJournal Feed

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AbstractObjective. To provide an up-to-date evidence summary about the comparative benefits and harms of drugs for adults with overweight or obesity to inform decision making for policymakers, payers, clinicians, and patients.
DesignSystematic review and network meta-analysis of 24 outcomes using frequentist random effects models and bayesian dose-response models, the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach, and the Cochrane Risk of Bias 2 tool. Data sourcesMedline, Embase, and Cochrane Library, searched up to 12 November 2025.Study selectionRandomised controlled trials of 12 weeks’ duration or longer comparing one or more drugs with lifestyle modification, placebo, or another drug.
Results. This network meta-analysis comprised 262 trials (99 791 participants) evaluating 19 drugs with follow-up from 12 to 172 weeks.
Compared with lifestyle modification alone, at one year, moderate to high certainty evidence shows substantial weight loss with tirzepatide (mean difference -14.9%, 95% confidence interval -16.0% to -13.9%), cagrilintide-semaglutide (CagriSema, -14.8%, -16.9% to -12.7%), oral semaglutide (-10.9%, -12.7% to -9.1%), orforglipron (-9.9%, -12.4% to -7.5%), subcutaneous semaglutide (-9.8%, -10.6% to -9.1%), and phentermine-topiramate (-8.1%, -9.7% to -6.5%).

BMJ published a clinical update in Research Highlights on 08 Jul 2026.

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