Dana Mihaela Ciobanu 1, Adriana Fodor 1, Georgeta Victoria Inceu 1 *, Cornelia Bala 1
1 Department of Diabetes and Nutrition Diseases, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
* Correspondence to: Georgeta Victoria Inceu, Department of Diabetes and Nutrition Diseases, Iuliu Hațieganu University of Medicine and Pharmacy, 2-4 Clinicilor Street, Cluj-Napoca, Romania. E-mail: inceu.victoria@umfcluj.ro; Phone: +40264296829
Abstract
The article reviews the effects of incretin-based therapies on obesity complications, focusing on semaglutide and tirzepatide. Obesity is a prevalent chronic condition linked to serious health issues such as cardiovascular disease, diabetes, and metabolic syndrome. The increasing global obesity rates necessitate effective long-term management strategies. Incretin-based therapies have emerged as promising anti-obesity medications, demonstrating significant benefits in weight loss and metabolic health. Clinical trials, including the STEP and SURPASS programs, reveal that both semaglutide and tirzepatide lead to substantial improvements in metabolic risk factors, such as glycemic control, insulin resistance, blood pressure, and lipid profiles. In terms of specific obesity-related complications, semaglutide demonstrated a significant reduction of major cardiovascular events in patients with established cardiovascular disease and overweight or obesity. Both therapies have notably improved heart failure outcomes, especially in patients with preserved ejection fraction. Emerging data also suggest positive effects on metabolic dysfunction-associated steatotic liver disease (MASLD) and comorbidities like obstructive sleep apnea and knee osteoarthritis, highlighting their multifaceted benefits. As incretin-based therapies continue to evolve, selecting the appropriate treatment is crucial in the presence of obesity complications. Current clinical guidelines recommend semaglutide for patients with cardiovascular disease and either semaglutide or tirzepatide for those with heart failure. This article emphasizes the need for informed decision-making in choosing anti-obesity medications, as they hold potential not only for weight management but also for improving associated health outcomes. Overall, incretin-based therapies represent a significant advancement in tackling obesity and its complications effectively.