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The thickened, fibrotic tissue that forms absorbs semaglutide erratically and may reduce the medications effectiveness
Since liraglutide retains the native alanine at position 2, it is not directly protected from enzymatic degradation, although palmitoylation and subsequent association with serum albumin results in steric protection [26]
10.1038/35048069 Nat
The first head-to-head clinical trial (SURMOUNT-5, published in NEJM 2025) showed tirzepatide produced 20.2% average weight loss at 72 weeks versus 13.7% for semaglutide approximately 47% greater relative weight loss
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