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Weight Loss

How much weight can you lose on Zepbound?

Written by
Rob Stransky
Published Oct 26, 2024Updated Oct 1, 202612 min read
How much weight can you lose on Zepbound?

Zepbound (tirzepatide) is an FDA-approved drug for weight loss and chronic weight management in adults with obesity or overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes or high cholesterol).

The availability of other similar drugs like Mounjaro, and Novo Nordisk’s Wegovy (semaglutide) and Ozempic (semaglutide), make it hard to choose the right medication and people often wonder which medication is most effective for losing weight, leading to the question, “How much weight can I lose on Zepbound?”

The active ingredient of Zepbound is tirzepatide, which has shown more effective results in weight loss than Ozempic. In a 72-week trial studying the efficacy of tirzepatide, the average weight loss by participants was in the range of 16% to 22.5% of body weight, or 35.5 to 52 pounds.

This article details how much weight you can lose on Zepbound and how you can maximize the medication’s effect for the best results in your weight loss journey.

How much weight can you lose on Zepbound?

The answer varies by person and clinical trials show that the average weight loss can range from 16% to 22.5% of body weight (35.5 pounds to 52 pounds).

The SURMOUNT-1 clinical trial with more than 2,500 participants studying the safety and efficacy of tirzepatide in weight loss showed that within a year and a half when used in combination with diet and exercise:

  • Participants taking the maximum Zepbound dose, 15 mg weekly, lost an average of 22.5% of their body weight (52 pounds).

  • Participants taking 10 mg weekly lost an average of 21.4% of their body weight (48.9 pounds).

  • Participants taking 5 mg weekly lost an average of 16% of their body weight (35.5 pounds).

  • Comparatively, participants who took a placebo lost an average of 2.4% of their body weight (5.3 pounds), significantly less than those taking tirzepatide.

Participants also reduced an average of 5.5 to 7.3 inches from their waistlines, effectively reducing their body fat by 33.9%, compared to 8.2% with the placebo, and there were improvements in other health areas that can be associated with weight loss, such as lower cholesterol and blood pressure.

The percentage of participants who had a weight reduction of 5% or more was 85%, 89%, and 91% with 5 mg, 10 mg, and 15 mg weekly doses of tirzepatide, respectively. 50% and 57% of participants in the 10 mg and 15 mg groups lost 20% or more of their starting body weight, as compared with 3% in the placebo group. The most common side effects in all groups were gastrointestinal-related like nausea, diarrhea, constipation, vomiting and indigestion.

Eli Lilly and Company’s SURMOUNT-2 trial showed a significant weight loss of up to 15.7% in adults with obesity or overweight and type 2 diabetes using tirzepatide. It showed that people taking tirzepatide 10 mg weekly lost 12.8% of their body weight, and those taking 15 mg weekly lost 14.7% of their weight. In comparison, weight changes in the placebo group were 3.2% during the period.

The phase 3 SURMOUNT-3 trial studied the effectiveness of tirzepatide in adults with obesity or overweight with weight-related comorbidities, excluding type 2 diabetes. The participants received a 10 mg or 15 mg maintenance dose depending on their maximum dose tolerance. Individuals taking tirzepatide lost 64.4 pounds (26.6% of their body weight), whereas the placebo group lost 9 pounds (3.8%) of their total body weight over 84 weeks. The 72-week trial was conducted after 12 weeks of intensive lifestyle changes, including exercise, a low-calorie diet, and counseling sessions.

During the SURMOUNT-4 randomized clinical trial, participants received 10 mg or 15 mg of tirzepatide for 36 weeks and were randomized after 52 weeks. Results showed 25.3% weight loss in the tirzepatide group and 9.9% average weight loss in the placebo group.

Tirzepatide has also been seen to show better results than Ozempic for weight loss over 3 months. The study showed that all three doses of Zepbound (5 mg, 10 mg, and 15 mg) resulted in higher weight loss than Ozempic. Participants taking 5 mg experienced an 8.2% decrease (17 pounds), those taking 10 mg lost 10.0% (21 pounds), and the 15 mg dose led to 11.8% (25 pounds) weight loss. On the other hand, participants taking Ozempic 1 mg showed a mean weight change of 6.2% (13 pounds).

It has also been concluded that stopping weight loss medications can lead to weight gain. Individuals who remained on tirzepatide lost an additional 5% of their body weight and those on placebo regained 14% of their weight over the next 52 weeks. Further research evaluated that people who stopped taking the weight loss drug regained around two-thirds of the weight they had lost.

Although clinical trials and studies have shown the efficacy and safety of Zepbound and Mounjaro, the weight loss results depend on multiple other factors like your physical activity, diet, dosage, duration of treatment, and others.

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*In a 68-week and 72-week clinical trial studying Wegovy (2.4 mg) and Zepbound (15 mg) in participants without diabetes and with BMI ≥ 30, or BMI ≥ 27 with a weight-related condition, the average weight loss was 15% and 20% respectively, when combined with diet and exercise changes (compared to 2.4% and 3.1% with the placebo, respectively, with diet and exercise alone).

Status: FDA-approved

How much weight can you lose in a month on Zepbound?

It takes a few weeks for Zepbound to reach a stable level in your body and start showing results. Your healthcare practitioner will typically start Zepbound with a low dose of 2.5 mg weekly, increasing the dose every four weeks until reaching the maintenance dose of 5 mg, 10 mg, or 15 mg. Though there is no given amount of weight you lose in a month, you will see positive changes in your body weight within a few weeks.  According to data from randomized controlled trials, you may lose 4% of your starting body weight after one month and 6% of the body weight after two months, on average.

How much weight can you lose on Zepbound in 3 months?

There is no specific amount of weight loss that you could lose in 3 months. However, this obesity medicine should typically help you shed at least 5% of your total body weight in the first 3 months. Depending on the medication dosage, diet and exercise routine, some people may lose more weight, while others might take more time to shed pounds. It’s important to stay patient as the major weight loss benefits of the medication will be realized over a longer period.

How does Zepbound work?

Zepbound is an FDA-approved injection medication for weight loss in people with obesity (body mass index of 30+) and overweight (body mass index of 27+) and a weight-related health condition such as high cholesterol, high blood pressure, or type 2 diabetes.

Zepbound works by mimicking the action of incretin mimetics in the body. Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) are incretin hormones that signal your pancreas to release more insulin. Incretin mimetic drugs regulate blood sugar levels and increase the transit time of food in the stomach.

The active ingredient of Zepbound is tirzepatide (also marketed under the brand name Mounjaro for type 2 diabetes), which is the only single molecule that activates both GIP and GLP-1 receptors in the body which allows the drug to be more effective at improving blood sugar levels and weight loss than other GLP-1 medications. The dual action makes you feel fuller for a longer time and decreases your appetite, helping you lose weight faster with exercise and a low-calorie diet. The medication also plays a significant role in weight loss in type 2 diabetes patients, without increasing the risk of major cardiovascular events in people with type 2 diabetes.

Tips for maximizing weight loss on Zepbound

Eli Lilly, the manufacturer of Zepbound, emphasizes regular exercise and a low-calorie diet to achieve desired results. Though the medication does not come with a specific diet plan or exercise regimen, following a healthy routine can help maximize results.

Healthy diet

Eli Lilly and Company’s Zepbound is suggested to be taken with a low-calorie diet for effective weight loss. Furthermore, a healthy and balanced diet can also help manage the side effects of Zepbound like constipation, diarrhea, nausea, heartburn, and belching.

Research also shows eating fried food can cause an upset stomach and increase your risk of type 2 diabetes mellitus, hypertension, weight gain, and obesity. Foods that are high in sugar can also lead to weight gain and overeating which hinders your potential weight loss while on Zepbound. Maintaining a healthy diet can prevent further health issues.

A clinical trial also observed that men should consume 1,500 calories per day and women should consume 1,200 calories per day to maximize weight loss when on Zepbound.

Exercise

Exercise and physical activity are recommended for individuals who wish to lose weight (with or without obesity medication). Physical activity including flexibility, aerobic, and resistance exercises can be helpful when looking forward to losing weight with Zepbound.

Research shows that consistently exercising for more than 150 minutes per week appears to be more likely to contribute to weight loss and weight maintenance efforts over the long term. Regular workouts and reduced sedentary time can also be beneficial for people with type 2 diabetes.

Resistance training can help avoid skin sagging and “Ozempic butt” when taking GLP-1 receptor agonist medications like Mounjaro, Ozempic, Wegovy, and Zepbound.

Stress reduction

According to research on stress-induced weight changes, stress also influences your weight and BMI. Various factors related to stress can induce abnormalities in food intake behavior and diet, leading to weight gain and obesity.

Another research that studied the effects of chronic social stress on obesity mentions that chronic stress can enhance weight gain and fat deposition through changes in feeding behavior like dietary preferences and the pattern of food intake.

The stress-eating mechanisms are also related to cortisol secretion under stressful conditions that push you to eat comforting foods (usually high in carbs and fats), that can cause weight gain.

Managing your stress by limiting the stressors and taking the time to relax can help avoid impulse eating. Moreover, the American Psychological Association suggests meditation and physical activity to manage the stressors.

If needed, consult a healthcare provider so they can suggest a suitable regimen to help you feel relaxed.

Better sleep

A review of 31 cross-sectional studies showed that a decrease in sleep duration is linked to overweight and obesity.

Furthermore, a report by JAMA Network mentioned that people who sleep less take more calories and crave high-calorie foods. Another meta-analysis of studies found that the risk of obesity increased by 9% for each 1-hour decrease in sleep duration, compared to 7 hours of sleep daily.

Thus, it is suggested to sleep for at least 7 hours daily to reduce unhealthy cravings and avoid unhealthy sleeping habits to promote weight loss with Zepbound.

Factors that influence weight loss on Zepbound

Studies have shown Zepbound to be effective in chronic weight management, but you must consider a few factors when taking Zepbound for weight loss.

Time

The amount of weight you lose with Zepbound will depend on the duration of taking the medication. Clinical research concluded that individuals using Zepbound for longer may lose more weight. People taking tirzepatide after randomization lost 25.3% of the starting weight over 88 weeks. As such, it’s important to be patient as the maximum weight loss benefits will be realized over an extended time when taking Zepbound.

Dose

When taking Zepbound for weight loss and management in obesity and overweight, your doctor will start with a low dose (e.g. 2.5 mg weekly) to manage gastrointestinal side effects like diarrhea, constipation, and nausea. Over the next few weeks, they will increase the dose up to the required maintenance dose. The SURMOUNT-1 clinical trial studied the efficacy and safety of tirzepatide once weekly for obesity. Results concluded that people lost the highest amount of weight (20.9%) on average with the highest Zepbound dose (15 mg). During the same trial, individuals taking 5 mg tirzepatide once weekly lost 15% of their total body weight and those taking 10 mg lost 19.5%.

Diet

The amount of weight you lose over a period also depends on your diet and calorie intake. People who continue to eat fried foods and dense calories might not lose significant weight. However, lifestyle changes including dietary modifications can help lose more weight when taking Zepbound. A study analyzing the impact of lifestyle changes showed that people with positive lifestyle changes during pharmacological treatment of obesity lost 10.8% of their body weight compared to 4.1% weight loss with the drug alone.

Exercise

Eli Lilly recommends regular exercise along with dietary changes to achieve the best results when taking Zepbound. Regular physical activity and reducing your sedentary time can help with weight loss and type 2 diabetes over the long term. Aerobic, flexibility, and resistance training can help you manage weight better with weight loss drugs.

Stress

Stress has been known to be associated with weight gain due to changes in the body that lead to unhealthy food cravings and binge eating. Unhealthy food choices and taking more calories than required leads to an increase in the body mass index, resulting in weight gain.

Relieving stress by avoiding stressors, meditation, physical activity, and indulging in pleasurable activities can prevent stress eating and improve weight loss. You may also take medical advice from a healthcare provider to find the best-suited ways to manage stress better.

Sleep

Sleep has also been associated with weight changes. A review of 31 cross-sectional studies showed that shorter sleep duration is associated with overweight and obesity. Moreover, research shows that poor bedtime habits may also cause weight gain.

Another study mentioned that reduced duration of sleep or low-quality sleep increases snacking, especially on fat and carbohydrate-rich foods, leading to weight gain. Participants who slept only 5.5 hours lost 55% less body fat and 60% more fat-free mass compared to participants who slept 8.5 hours per night, emphasizing the importance of proper sleep for losing weight.

On the other hand, sleeping more than 7 hours and a better sleep quality increased the likelihood of successful weight loss by 33% in a 6-month weight loss program for women.

Other health conditions

Losing weight can be challenging when you have other health conditions that require specific medication. People taking insulin to manage diabetes often find it hard to lose weight and may gain weight when relying on obesity medication only. Therefore, you must exercise regularly and follow a low-calorie diet for efficient weight loss with Zepbound. Studies also show that insulin-resistant men without diabetes mellitus lose more lean mass and gain less fat mass than insulin-sensitive men.

Women with PCOS may also find it harder to lose weight because of hormonal imbalance. Other health conditions that might influence weight changes include hypothyroidism, chronic stress, and depression, eventually increasing how long it takes to lose weight with the medication.

Other medications

Like insulin, some other medications like anticonvulsant drugs, including valproate and carbamazepine have been seen to lead to weight gain in patients. Other studies show that people taking medical therapies for depression, mood disorders, and other psychiatric illnesses may also gain significant weight during the treatment. People using chronic corticoid therapy have been seen to gain up to 70% of body weight, making it harder to lose weight.

However, researchers have not found any clinically significant effect of oral drugs co-administered with any of the GLP-1 receptor agonists.

Bottom line

Zepbound (tirzepatide) is a prescription injectable medication approved by the U.S. Food and Drug Administration for weight loss in obesity and overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes or high cholesterol).

Eli Lilly and Company’s SURMOUNT-2 trial showed a significant weight loss in the range of 16% to 22.5%, or 35.5 pounds to 52 pounds in adults with obesity or overweight and type 2 diabetes using Zepbound (tirzepatide). Additionally, the SURMOUNT-4 trial showed 25.3% weight loss in the tirzepatide group and 9.9% average weight loss in the placebo group. The active ingredient of Zepbound, tirzepatide, has shown more effective results in weight loss than Ozempic.

Though studies have shown effectiveness in weight loss, numerous factors affect weight loss, including duration of taking the medication, diet, exercise, stress, sleep, other health conditions, and other medications you’re taking. You can maximize weight loss with Zepbound by maintaining a low-calorie diet, exercising regularly, reducing stress, and sleeping for at least 7 hours daily.

Sources (13)

  1. The New England Journal of Medicine: Tirzepatide Once Weekly for the Treatment of Obesity

    https://www.nejm.org/doi/full/10.1056/NEJMoa2206038

  2. JAMA Network: Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity, The SURMOUNT-4 Randomized Clinical Trial

    https://jamanetwork.com/journals/jama/fullarticle/2812936

  3. ClinicalTrials.gov: A Study of Tirzepatide (LY3298176) in Participants With Obesity or Overweight (SURMOUNT-1)

    https://clinicaltrials.gov/study/NCT04184622

  4. National Library of Medicine: Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial

    https://pubmed.ncbi.nlm.nih.gov/38078870/

  5. Lilly Trials: A Study of Tirzepatide (LY3298176) in Participants With Obesity or Overweight for the Maintenance of Weight Loss (SURMOUNT-4)

    https://trials.lilly.com/en-US/trial/268141

  6. JAMA Network: Semaglutide vs Tirzepatide for Weight Loss in Adults With Overweight or Obesity

    https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2821080

  7. Nature Medicine: Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-3 phase 3 trial

    https://www.nature.com/articles/s41591-023-02597-w

  8. Lilly Investors: Lilly's tirzepatide achieved up to 15.7% weight loss in adults with obesity or overweight and type 2 diabetes in SURMOUNT-2

    https://investor.lilly.com/news-releases/news-release-details/lillys-tirzepatide-achieved-157-weight-loss-adults-obesity-or

  9. National Library of Medicine: Tirzepatide Once Weekly for the Treatment of Obesity

    https://pubmed.ncbi.nlm.nih.gov/35658024/

  10. The Lancet: Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial

    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01200-X/abstract

  11. Zepbound: What is Zepbound

    https://zepbound.lilly.com/what-is-zepbound

  12. Zepbound: The science of weight loss

    https://zepbound.lilly.com/obesity-excess-weight

  13. Zepbound official website

    https://zepbound.lilly.com/

The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.

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