A 2-Years Comparative Analysis of Tirzepatide, Semaglutide, Qsymia, Contrave, and Phentermine on Ocular Health in Individuals with Obesity: A Propensity-Score Matched Cohort Study

This landmark propensity-score matched study examined ocular outcomes of modern anti-obesity medications in nearly 5 million non-diabetic individuals with obesity. Through analysis of TriNetX US network data, we discovered that Tirzepatide significantly reduced cataract risk versus other treatments, showing a striking 59% lower risk compared to Semaglutide (HR: 0.41, 95% CI: 0.19–0.85). Semaglutide users experienced markedly fewer visual disturbances than those on Contrave (HR: 0.58, 95% CI: 0.41–0.82) or Phentermine (HR: 0.62, 95% CI: 0.46–0.82). Both GLP-1 receptor agonists demonstrated protection against age-related cataracts, with Tirzepatide showing exceptional benefits versus Contrave (HR: 0.17, 95% CI: 0.07–0.42). While these protective effects remained robust across patient subgroups, Tirzepatide's benefits diminished in those with impaired kidney function. Multiple sensitivity analyses and negative controls validated these compelling findings.