Practical Considerations for the Use of GLP-1 and Dual GIP/GLP-1 Receptor Agonists in Obesity: A Clinician-Oriented Guide

Obesity is a chronic and frequently relapsing disease associated with a substantial burden of cardiometabolic morbidity and mortality. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), along with newer dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 receptor agonists (GIP/GLP-1 RAs), have emerged as effective pharmacological treatments for obesity, producing clinically meaningful weight loss and improving several markers of metabolic health. However, the effective use of these agents requires more than prescribing alone: patients must be selected appropriately, contraindications must be assessed, counseling must be provided, doses must be titrated gradually, side effects must be managed, and long-term follow-up must be maintained. This practical guideline offers clinicians a step-by-step framework, from determining eligibility and performing baseline evaluation to initiating therapy, monitoring response, managing commonly encountered side effects, and maintaining weight loss in the months and years that follow. Practical differences between semaglutide and tirzepatide are also summarized to support day-to-day prescribing decisions.

Keywords: Dual GIP/GLP-1 receptor agonists, GLP-1 receptor agonists, obesity, semaglutide, tirzepatide, weight management