Eficácia da tirzepatida no controle do peso e da composição corporal em adultos com obesidade e/ou diabetes tipo 2: uma revisão integrativa

Abstract

Objective: To analyze the efficacy of tirzepatide in the treatment of obesity and T2DM in adults within the context of general lifestyle interventions, discussing its effects on body composition, physiological mechanisms, and clinical applicability. Methods: This is an integrative literature review conducted according to PRISMA guidelines. Searches were performed in PubMed/MEDLINE, ScienceDirect, Virtual Health Library (BVS), and SciELO using descriptors related to tirzepatide, obesity, type 2 diabetes, and dietary intervention. Studies published between 2020 and 2025 in English or Portuguese and involving adult populations were included. A total of 15 studies met the eligibility criteria and were included in the final analysis.

Results: The findings indicate that tirzepatide promotes significant weight loss and glycemic control, with superior outcomes compared to placebo and, in specific scenarios, compared to agents such as semaglutide at certain doses. Substudies demonstrate that weight loss occurs predominantly through fat mass reduction, alongside decreased intramuscular fat. Mechanistic evidence suggests integrated effects on satiety, energy intake, and glucose-lipid metabolism, although without definitive mechanistic superiority over other incretin-based therapies. Real-world studies indicate favorable treatment persistence and a potential reduction in the risk of developing T2DM, although these findings are subject to observational biases. Conclusion: Tirzepatide shows robust evidence of efficacy in weight reduction and metabolic improvement in individuals with obesity and T2DM. However, current literature does not allow the identification of specific dietary strategies that optimize its effects, highlighting an important research gap. Its use should be considered within a continuous multidisciplinary care model, including nutritional and behavioral support. Keywords: Tirzepatide; Obesity; Type 2 diabetes mellitus; Body composition; Nutritional intervention.