Tirzepatide Not Working? Causes by Dose and Week, and Fixes
Results vary a lot by dose and by person. In SURMOUNT-1, the average loss ran from 15% on tirzepatide 5 mg weekly to 20.9% on tirzepatide 15 mg weekly, against 3.1% on placebo. If you have lost little after several months on your full dose, talk to your prescriber.
- Average loss, top dose
- 20.9%
- On placebo
- 3.1%
- Trial length
- 72 weeks
- Trial
- SURMOUNT-1
Zepbound overview
Its half-life is 5 to 6 days. After 5.5 d, half remains, and about 3% remains after five half-lives (27.5 d).
In SURMOUNT-1 over 72 weeks, people lost 20.9% of body weight, compared with 3.1% on placebo.
Monthly prices in US dollars include the list price and self-pay offers, all taken from the maker's price page.
Sources: FDA label (DailyMed), Eli Lilly 1 2, cnbc.com.
Tirzepatide not working: the numbers first
| Trial | Dose group | Average weight lost | Placebo or comparison | Weeks | Who was in it |
|---|---|---|---|---|---|
| SURMOUNT-1 | Tirzepatide 5 mg weekly | 15% | 3.1% | 72 | Adults with obesity or overweight, without diabetes |
| SURMOUNT-1 | Tirzepatide 10 mg weekly | 19.5% | 3.1% | 72 | Adults with obesity or overweight, without diabetes |
| SURMOUNT-1 | Tirzepatide 15 mg weekly | 20.9% | 3.1% | 72 | Adults with obesity or overweight, without diabetes |
| SURMOUNT-2 | Tirzepatide 10 mg weekly | 12.8% | 3.2% | 72 | Adults who had obesity or overweight, with type 2 diabetes |
| SURMOUNT-2 | Tirzepatide 15 mg weekly | 14.7% | 3.2% | 72 | Adults who had obesity or overweight, with type 2 diabetes |
| SURMOUNT-5 | Tirzepatide 10 or 15 mg weekly (Zepbound) | 20.2% | semaglutide (Wegovy) | 72 | Adults with obesity, without type 2 diabetes |
Data sources: SURMOUNT-1 (FDA label (DailyMed)), SURMOUNT-2 (PubMed), SURMOUNT-5 (PubMed).
What makes it stall and what helps
- See where you are in the dose steps. Each trial above found less weight loss at the lower doses.
- During the past month, count any doses you missed or took late.
- Keep a record of what you eat and drink for a few days. When portions shrink, liquid calories and grazing add up
- Eat protein at every meal and continue strength exercise, so most of your weight loss comes from fat.
- Check your sleep and stress, since both affect appetite.
- Ask your pharmacist whether any other medicine you take may cause weight gain.
- If your weight has stalled for months, speak with your prescriber about thyroid or blood sugar tests and changing medicines
How many trial participants quit?
| Trial | Dose group | What happened | Drug | Placebo |
|---|---|---|---|---|
| SURMOUNT-1 | Tirzepatide 5 mg weekly | Stopped for side effects | 4.3% | 2.6% |
| SURMOUNT-1 | Tirzepatide 10 mg weekly | Stopped for side effects | 7.1% | 2.6% |
| SURMOUNT-1 | Tirzepatide 15 mg weekly | Stopped for side effects | 6.2% | 2.6% |
Source: SURMOUNT-1 (PubMed).