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Mild to moderate obesity or earlier‑stage risk: Patients who need strong but not maximal weight loss and already have improving labs with GLP‑1–level therapy. Patients prioritizing tolerability and evidence comfort: Those who want a powerful, predictable medication with the longest real‑world CV and liver outcomes data and are wary of “turning the dial all the way down” on appetite. Patients navigating stricter coverage or budget limits: Situations where formularies, step‑therapy rules, or savings cards make semaglutide the more realistic long‑term option, even if tirzepatide could deliver a few extra points of weight loss. How to Decide: Tirzepatide vs
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