Mazdutide vs Tirzepatide

Mazdutide

Chinese-developed GLP-1 / glucagon co-agonist (IBI362, licensed from Eli Lilly's LY3305677). Solid Phase 2 data, approved in China for diabetes in 2024, investigational elsewhere.

Best for

Best if you specifically want the glucagon mechanism and its lipid/liver effects, and are following the China-led development.

Tirzepatide

Dual GIP and GLP-1 agonist. Beats Semaglutide head-to-head on weight loss and glycaemic control, and is becoming the default first-line choice when both are available.

Best for

Best for almost everyone else — globally approved, GIP-based, with by far the larger evidence base.

Mazdutide

Approved in China by NMPA in 2024 for type 2 diabetes based on the DREAMS-1 and DREAMS-2 trials. The published Phase 2 obesity data (Lancet Regional Health, 2023) showed 11–15% weight loss at 6 mg over 24 weeks in Chinese adults with obesity. Phase 3 trials in the obesity indication are still in progress. The Western evidence base is much thinner than for Tirzepatide because the trials have been Asia-led.

Tirzepatide

FDA-approved 2022 for type 2 diabetes (Mounjaro) and 2023 for chronic weight management (Zepbound); EMA approval followed. The SURPASS 1–5 diabetes trials and SURMOUNT 1–4 obesity trials constitute the largest randomised dataset of any dual incretin. SURMOUNT-1 vs STEP 1 is the cleanest head-to-head proxy, and SURPASS-2 was a direct comparison: Tirzepatide came out ahead on both weight and HbA1c.