New weight loss medications could reduce eye disease burden in obese populations

Obesity is a worldwide problem that is increasing. It also is associated with ocular problems. A recent study found that in addition to weight loss, the newer weight loss medications may provide additional ocular benefits over their intended use for weight reduction.¹

First author Yu-Nan Huang, MD, from the Department of Pediatrics, School of Medicine, and the Institute of Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan, and co-authors compared the ocular outcomes between the older, more traditional weight loss formulations and newer weight loss medications to investigate the ocular outcomes.

They explained that the basis for this study is that the relationships among obesity, metabolic dysfunction, and ocular pathology are complicated and warrant further investigation.^2,3 “Multiple eye disorders, that is, cataracts, oculomotor binocular dysfunction, visual impairment and blindness, ametropic accommodative dysfunction, and visual disturbances, have been linked to obesity and its therapeutic interventions,^4,5” they stated.

In light of this, they conducted a propensity-score matched cohort study to evaluate the ocular safety profiles of tirzepatide and semaglutide, the newer formulations, with phentermine/topiramate, naltrexone/bupropion, and phentermine among patients who had been treated for obesity. The investigators analyzed the data in the health records of over 2 million people with obesity in the TriNetX US network using these weight-loss medications between 2023 and 2025.

The study included matched pairs of obese individuals with a body mass index (BMI) of 27 kg/m² or greater and compared the ocular outcomes associated with the various anti-obesity medications.

Health record findings

The investigators reported that among 25,060 matched pairs of patients in whom tirzepatide with semaglutide were compared, no differences were identified across the ocular outcomes. When they compared the findings with naltrexone/bupropion, the patients treated with tirzepatide had lower rates of cataract development (hazard ratio [HR], 0.46, 95% confidence interval [CI], 0.23–0.92, p = 0.025) and oculomotor dysfunction (HR, 0.31; 95% CI, 0.16–0.60, p = 2.3 × 10⁻⁴). Semaglutide also demonstrated similar patterns. Both medications exhibited favorable profiles for visual disturbances, with tirzepatide demonstrating lower rates versus phentermine (HR, 0.45; 95% CI, 0.31–0.68, p = 7 × 10⁻⁵). Sensitivity analyses among the patients who had a BMI of 30 kg/m² or higher yielded consistent results.

In commenting on their findings Dr. Huang and colleagues pointed out that the results suggested that the newer weight-loss formulations, which release metabolic hormones, ie, incretins, after eating to stimulate insulin secretion, may provide benefits that extend beyond weight reduction. This information could be helpful to patients and their doctors for making informed decisions about obesity treatments, considering both weight management and ocular health protection.

“These findings carry clinical significance for obesity management. As the prevalence rates of obesity rise alongside ocular complications, anti-obesity medications that offer metabolic as well as ocular benefits may reduce the eye disease burden in affected populations. Tirzepatide and semaglutide, the newer formulations, demonstrated favorable ocular safety profiles compared to traditional anti-obesity treatments. These results support incorporating ocular considerations into decisions surrounding obesity management and indicate that the newer incretin-based therapies may offer benefits beyond metabolic effects,” Huang and colleagues concluded.

References

1. Huang YN, Chen JC, Li PH, et al. Comparative ocular outcomes of tirzepatide versus other anti-obesity medications in people with obesity. Commun Med. 2025;5:329. https://doi.org/10.1038/s43856-025-01066-4

2. Bosello F, Vanzo A, Zaffalon C, et al. Obesity, body fat distribution and eye diseases. Eat. Weight Disord. 2024;29:33. doi: 10.1007/s40519-024-01662-8.

3. Rohm T V, Meier D T, Olefsky J M., Donath M Y. Inflammation in obesity, diabetes, and related disorders. Immunity. 2022;55:31–55. doi: 10.1016/j.immuni.2021.12.013.

4. Cheung N, Wong T Y. Obesity and eye diseases. Surv Ophthalmol. 2007;52:180–195. doi: 10.1016/j.survophthal.2006.12.003

5. Ling CNY, Lim SC, Jonas JB, Sabanayagam C. Obesity and risk of age-related eye diseases: a systematic review of prospective population-based studies. Int J Obes. 2021;45, 1863–1885. https://doi.org/10.1038/s41366-021-00829-y