The Mediterranean diet, assessed through the validated PREDIMED score, has proven effects on visceral adiposity and metabolic health and may act synergistically with novel incretin therapies.<h4>Materials and methods</h4>We enrolled 53 patients with overweight/obesity eligible for tirzepatide (BMI ≥ 30 kg/m<sup>2</sup> or BMI ≥ 27 kg/m<sup>2</sup> with comorbidities). This evidence concerns the gene GCG and obesity due to melanocortin 4 receptor deficiency.