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Bulk-forming laxatives such as ispaghula husk (Fybogel) can be effective when fluid intake is adequate, particularly for small, hard stools
In the STEP-1 trial of 1,961 adults (Wilding and colleagues, Once-Weekly Semaglutide in Adults with Overweight or Obesity, New England Journal of Medicine, 2021), participants on semaglutide 2.4 mg lost an average of 14.9 percent of their body weight at 68 weeks, compared to 2.4 percent on placebo
While both options support significant weight reduction, tirzepatide has shown slightly higher results in trials, making it a strong choice if weight loss is your primary goal
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