From the Guidelines
Tirzepatide for weight loss should be dosed at 15 mg subcutaneously once weekly, as this dose has been shown to result in the greatest weight loss in clinical trials, with a mean weight loss of 20.9% at 72-week follow-up 1. The dosing regimen for tirzepatide typically starts at a lower dose to minimize gastrointestinal side effects, but the goal should be to reach the maximum dose of 15 mg weekly if tolerated.
Key Considerations
- The medication should be used alongside a reduced-calorie diet and increased physical activity for optimal results.
- Common side effects include nausea, diarrhea, vomiting, and constipation, which often improve over time.
- Patients should stay well hydrated and may need to start with smaller, more frequent meals to minimize gastrointestinal discomfort.
- Regular monitoring by a healthcare provider is essential throughout treatment.
Clinical Evidence
- A recent study published in JAMA found that tirzepatide resulted in significant weight loss, with a mean weight loss of 20.9% at 72-week follow-up 1.
- The SURMOUNT-1 trial also showed a dose-dependent weight-loss benefit with tirzepatide, with a mean weight change of up to −20.9% compared with placebo in obese adults without diabetes over 72 weeks 1.
Important Notes
- Tirzepatide was FDA approved for treatment of obesity in November 2023 1.
- The medication works by mimicking two hormones (GLP-1 and GIP) that regulate appetite and food intake, helping patients feel fuller longer and consume fewer calories.
- Bariatric surgery in severe obesity appears to be a safe and effective intervention for further weight loss in patients with weight-related comorbidities 1.
From the Research
Dosing Tirzepatide for Weight Loss
- Tirzepatide is approved at doses of 5,10, and 15 mg for chronic weight management 2.
- The mean dose of weekly tirzepatide at 3 months was 5.6 mg, which increased to 9.7 mg at 1 year in a study of overweight and obese adult patients with type 1 diabetes 3.
- A phase 3 trial found that tirzepatide at doses of 5 mg, 10 mg, and 15 mg resulted in mean percent changes in body weight of -12.3%, -18.7%, and -19.7%, respectively, compared to -1.3% with placebo at 176 weeks 4.
Efficacy and Safety
- Tirzepatide has been shown to significantly reduce body weight and improve insulin sensitivity, as well as reduce the risk of progression to type 2 diabetes 5, 4.
- The most common adverse events associated with tirzepatide are gastrointestinal, which are typically mild to moderate in severity and occur primarily during the dose-escalation period 6, 4.
- Tirzepatide has been found to be well-tolerated with a safety profile similar to GLP-1 receptor agonists 2.
Clinical Implications
- Tirzepatide may be a useful treatment option for overweight and obese patients with type 1 diabetes, with a study finding an average weight loss of 18.5% at 1 year 3.
- The SURMOUNT-1 trial found that tirzepatide resulted in substantial and sustained weight reduction and a markedly lower risk of progression to type 2 diabetes than placebo in persons with obesity and prediabetes 4.