SELECT, STEP, SURPASS, SURMOUNT & FLOW: What the Landmark Semaglutide and Tirzepatide Trials Actually Prove (2026)
By Dr. Frank Yap, MD | Medically reviewed by One Day MD Review Team | Last updated: August 2026 Quick Answer SELECT showed that semaglutide 2.4 mg cuts major cardiovascular events by 20% in people with overweight/obesity and existing heart disease who do not have diabetes. The STEP program (STEP 1–5, STEP 8, and the newer STEP UP trials) established semaglutide's weight-loss profile, with losses ranging from roughly 10% to over 20% of body weight depending on dose, population, and duration. The SURPASS program showed that tirzepatide — a dual GIP/GLP-1 agonist — produces larger HbA1c and weight reductions than semaglutide in type 2 diabetes, and the newly published SURPASS-CVOT (December 2025) confirmed tirzepatide is at least as cardioprotective as dulaglutide. FLOW showed semaglutide cuts major kidney disease events by 24% in people with type 2 diabetes and chronic kidney disease, which led the FDA to approve a dedicated kidney-protection indic...
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