Zepbound Not Working? The Checklist, in Order
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 in brief
The half-life is 5 to 6 days. After 5.5 d, half is gone, and about 3% is left at five half-lives (27.5 d).
For SURMOUNT-1 after 72 weeks, the body weight result was 20.9%, compared with 3.1% on placebo.
Monthly figures are given in US dollars: list prices and self-pay offers. Every number comes from the maker's price page.
Sources: FDA label (DailyMed), Eli Lilly 1 2, cnbc.com.
Zepbound 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 with obesity or overweight who also have type 2 diabetes |
| SURMOUNT-2 | Tirzepatide 15 mg weekly | 14.7% | 3.2% | 72 | Adults with obesity or overweight who also have type 2 diabetes |
| SURMOUNT-5 | Tirzepatide 10 or 15 mg weekly (Zepbound) | 20.2% | semaglutide (Wegovy) | 72 | Adults with obesity, without type 2 diabetes |
The sources are SURMOUNT-1 (FDA label (DailyMed)), SURMOUNT-2 (PubMed), and SURMOUNT-5 (PubMed).
What makes it stall and what helps
- Check where you stand on the dose steps. Every trial listed above shows less weight loss at the lower doses.
- In the past month, count each dose you missed and each one you took late.
- For a few days, write down the food and drinks you have. When portions shrink, liquid calories and grazing add up.
- Have protein with every meal and keep up your strength exercise, so most of the weight you lose comes off as fat.
- Sleep and stress change appetite, so look at both.
- Ask your pharmacist if any other medicine you take could lead to weight gain.
- If your progress has stalled for months, discuss checking your thyroid or blood sugar and switching medicines with your prescriber.
How many people ended up stopping in the trials
| 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).