Safety and Effectiveness of Tirzepatide in Patients With Obesity at Hospital de Clínicas, Paraguay

Inclusion Criteria: * Age ≥18 years * BMI ≥27 kg/m² with weight-related comorbidities OR BMI ≥35 kg/m² * Clinical indication for tirzepatide per treating physician * Paraguayan citizenship or permanent residence * Residence in Asunción or Metropolitan Area or possibility to assist to regular visits * Ability to attend visits for 12 months * Ability to provide written informed consent Exclusion Criteria: * Type 1 diabetes or secondary diabetes * Known hypersensitivity to tirzepatide * Personal or family history of medullary thyroid carcinoma or MEN 2 syndrome * Acute pancreatitis in last 12 months or chronic pancreatitis * Severe gastrointestinal disease * Bariatric surgery in last 12 months * Pregnancy or breastfeeding * Severe renal impairment (eGFR \<30 mL/min/1.73m²) * Severe hepatic impairment (Child-Pugh B or C) * Unstable cardiovascular disease * Active cancer (except non-melanoma skin cancer completely resected) * Current use of other GLP-1 receptor agonists * Participation in another interventional trial within 30 days