Tirzepatide for Weight Loss: SURMOUNT Results, Eligibility

Tirzepatide is FDA approved for weight loss as Zepbound. In SURMOUNT-1, people on Zepbound lost 20.9% of body weight on average, vs 3.1% on placebo.

Zepbound overview

How long it remains in the body

Its half-life is 5 to 6 days: after 5.5 d, half remains, and after five half-lives (27.5 d), about 3% is left.

How much weight was lost in its main trial

SURMOUNT-1 at 72 weeks found 20.9% weight loss, compared with 3.1% on placebo.

Cost over time

Monthly prices in US dollars include the list price and self-pay offers, each taken from the maker's price page.

Tirzepatide: who qualifies
Who sets the rule	Who qualifies
Mounjaro	Used with diet and exercise, it lowers blood sugar for adults and children 10 and older who have type 2 diabetes.
Mounjaro	It lowers the risk of heart attack, stroke, or heart-related death in high-risk adults with type 2 diabetes.
Zepbound	Adults with obesity, or who are overweight and have a weight-related condition, can use it with diet and activity for weight loss and keeping weight off long term.
Zepbound	For adults with obesity, it treats moderate to severe obstructive sleep apnea.
Medicare GLP-1 Bridge	BMI 35 or higher, no condition needed
Medicare GLP-1 Bridge	For people with CKD 3a+, heart failure, or high blood pressure that is uncontrolled, it lists BMI 30 or higher
Medicare GLP-1 Bridge	Shows BMI 27 or higher for people with PAD, prediabetes, or a previous heart attack or stroke
Typical commercial plan (Aetna policy)	BMI 30 or higher
Typical commercial plan (Aetna policy)	BMI 27 or higher with a weight-related condition
Typical commercial plan (Aetna policy)	first, you must put 6 months into a program covering diet and activity

Sources: FDA (DailyMed) label, 1 2; medicare.gov 1 2; and aetna.com.

Tirzepatide weight loss trials
Trial	Medicine	Who took part	Length	People	Main result	Comparison
SURMOUNT-1	Zepbound	Adults with obesity or overweight, without diabetes	72 weeks	2,539	20.9% weight loss	3.1% on placebo
SURMOUNT-5	Zepbound	Adults with obesity, without type 2 diabetes	72 weeks	751	20.2% weight loss	Not listed

Tirzepatide: label information on weight loss
What changes	What the label says	Labels
Acute Pancreatitis	Can cause inflammation of the pancreas. Get care and stop taking it if severe stomach pain continues and sometimes spreads to your back.	All of them
Acute Gallbladder Disease	Gallstones and gallbladder inflammation can happen. If you have upper right belly pain, a fever, or yellow skin or eyes, report it.	All of them

The DailyMed FDA label provides the warning information.

These come from the label warnings: FDA label on DailyMed.

Medicare Part D excludes a GLP-1 when its only use is weight loss.

People who meet the rules of the Medicare GLP-1 Bridge can see Zepbound listed at $50 per month.

Medicaid usually requires prior authorization when it covers weight-loss GLP-1s.

GLP-1 medicines and weight loss
Medicine	For weight loss	How it is taken	Trial result
Zepbound	FDA approved	weekly injection	20.9% weight loss
Wegovy	FDA approved	weekly injection or daily tablet	14.9% weight loss
Foundayo	FDA approved	daily tablet	11.1% weight loss
Saxenda	FDA approved	daily injection	7.4% weight loss
Mounjaro	Not an approved use	weekly injection	Not listed
Ozempic	Not an approved use	weekly injection	Not listed
Rybelsus	Not an approved use	daily tablet	Not listed
Trulicity	Not an approved use	weekly injection	Not listed
Victoza	Not an approved use	daily injection	Not listed
Byetta	Not an approved use	twice-daily injection	Not listed

Does my weight meet the rule on the label, and does my plan include another weight rule?
Which weight-related conditions listed in my record count?
What weight loss should I expect by the end of the first year?
What will happen if I stop taking it?