BMJ review of 262 trials: semaglutide the only obesity drug linked to lower mortality

A network meta-analysis in The BMJ pooled 262 randomised trials with 99,791 adults with overweight or obesity, comparing 19 drugs. At one year, tirzepatide and cagrilintide-semaglutide (CagriSema) produced the largest weight loss with moderate to high certainty evidence, but larger benefits generally came with more side effects and discontinuation. Subcutaneous semaglutide was the only drug associated with lower all-cause mortality (risk ratio 0.81, 95% CI 0.72 to 0.93), an estimate driven largely by cardiovascular outcome trials in high-risk people, and most drugs did not meaningfully improve quality of life.