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declares additional funding for this work through the UK Medical Research Council (MRC) (MR/T033371/1), and NIHR Development and Skills Enhancement Award (NIHR301616)

Supporting Information Supporting Table 1 depicts the quality of evidence using the GRADE assessment for the primary outcome of weight loss with three doses of tirzepatide vs GLP-1 agonists or placebo

Replacement needles Needles will be included for each dose

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135 It is noteworthy that MASLD patients exhibit diverse clinical characteristics, including biochemical markers, histology, and clinical outcomes due to varying body types, 136,137 which can lead to different treatment benefits