Medical Weight Loss

Can Medical Weight Loss Improve Energy and Sleep?

Medical Weight Loss

Feeling tired during the day and wired at night is common for people carrying extra weight. Many Laguna Beach patients say they want to lose weight to feel lighter, sleep better, and get their energy back for the beach trail, morning surf, or simply the school commute. Medical weight loss can help. It combines physician guidance, lab testing, medication when appropriate, and steady coaching to support safe, steady fat loss and healthier routines. As weight comes down and metabolic health improves, most people notice more daytime energy and deeper, more reliable sleep.

Why do weight and sleep affect each other?

Extra body fat can disrupt sleep in several ways. It raises the risk of sleep apnea, a condition where breathing stops and starts during the night. Even mild apnea fragments sleep and leaves people exhausted. Fat tissue also releases inflammatory signals that can make sleep lighter and more restless.

On the other hand, poor sleep makes weight control harder. Short nights drive up hunger hormones, increase cravings for quick carbs, and slow calorie burn the next day. That creates a loop: poor sleep worsens weight, and extra weight worsens sleep. Medical weight loss breaks that loop with targeted care.

How can medical weight loss raise daytime energy?

Energy improves for three practical reasons. First, blood sugar becomes steadier with structured meals, protein-forward plans, and medications that improve insulin response. Steady blood sugar prevents the mid-morning and mid-afternoon crashes that drain focus.

Second, losing even 5 to 10 percent of body weight lowers inflammation and reduces the physical effort of moving through the day. Joints ache less. Climbing the stairs at Gelson’s or walking the kids to Top of the World Elementary takes less out of you.

Third, quality sleep often returns as apnea risk falls. Better sleep means better energy. Patients usually notice a lift in the first 4 to 8 weeks as routines settle and water weight shifts. The bigger stamina gains tend to arrive after the first 10 to 20 pounds.

Can medical weight loss improve sleep quality and snoring?

Yes, and the effect can be meaningful. Weight loss reduces fat around the neck and tongue, which helps keep the airway open at night. Many patients report less snoring by the time they have lost 10 to 15 pounds. For those with diagnosed sleep apnea, weight loss can reduce the number of breathing pauses. Some patients need a CPAP machine for a while, then their sleep study improves and equipment settings can be reduced. A few can discontinue CPAP under physician guidance.

Beyond the airway, structured evening routines support sleep too. Finishing the last meal 3 to 4 hours before bed reduces reflux and nighttime awakenings. Limiting alcohol keeps sleep deeper and more stable. With a plan and support, these small changes are easier to keep.

What does a medical weight loss plan include?

An effective plan starts with a medical visit. That visit covers health history, medication review, vital signs, and lab testing to check thyroid, iron, B12, vitamin D, blood sugar, and cholesterol. Hidden issues, like low iron or an underactive thyroid, can drain energy and stall progress. Treating those issues often gives a quick lift.

Plans typically include a simple nutrition framework with clear targets for protein, fiber, and hydration. Most patients follow a flexible, real-food approach that still fits a date night on Forest Avenue. For some, medications such as GLP-1 receptor agonists help reduce appetite, quiet cravings, and support steady loss. These medicines work best with a basic meal plan and weekly check-ins.

Movement is part of the plan, but it does not have to be extreme. Short, brisk walks on the boardwalk or strength sessions with bands at home are enough at first. The goal is consistency, not punishment. As energy rises, people naturally do more.

What results do Laguna Beach patients usually feel first?

People often notice less bloating and steadier energy in the first two weeks. Cravings fade next. Clothes feel looser by week four. Sleep improvements can show up early if late-night snacking and alcohol cutbacks are part of the plan. Snoring reductions tend to follow visible weight loss.

A common story: a patient drops 12 pounds over six weeks, stops waking at 3 a.m., and stops needing the extra afternoon coffee. They start walking the Montage trail after dinner because they want to, not because they “have to.”

Are weight loss medications safe for sleep and energy?

For the right patient, yes. GLP-1 medications can cause mild nausea in the first weeks, which is manageable with dose steps, hydration, and simple food choices. Most patients rest better as evening snacking ends and reflux settles. Some feel a bit flat in the first week while their appetite resets, then energy rebounds as meals stabilize. These effects are reviewed in follow-ups so the plan can adjust quickly.

Stimulant-based weight pills are generally avoided if sleep is a priority. They can make falling asleep harder. A medical program focuses on tools that support both weight and sleep, not one at the expense of the other.

What lifestyle shifts make the biggest difference locally?

Living in Laguna Beach brings natural advantages. Sunlight in the morning sets the body clock and helps sleep that night. A 10-minute walk at Main Beach or along Heisler Park right after breakfast can lock in that rhythm. Simple local habits work well:

  • Morning light exposure for 10 minutes and a short walk most days
  • Four “anchors” for meals: protein, fiber, water, and color on the plate
  • Cut alcohol to two nights a week or less to reduce sleep disruption
  • Early dinner on weeknights and kitchen closed by 8 p.m.
  • Device wind-down 60 minutes before bed and a cool, dark room

These steps support medical weight loss and add up to better energy and sleep without feeling strict.

What if a patient is doing everything right but still feels tired?

There are fixable reasons for stubborn fatigue. Lab results may show low iron, B12, or vitamin D, all common and easy to treat. Thyroid function might be borderline. Sleep apnea may still be present and needs a home sleep test and treatment. Some medications, like certain antidepressants or beta blockers, can affect energy and weight. A medical program looks for these roadblocks, and there is usually a clear next step.

Here is the encouraging part: addressing one hidden issue often lifts energy within days to weeks. Patients appreciate seeing a plan that explains why they felt stuck and how to move forward.

How fast should someone expect to lose weight without harming sleep?

Most adults do well with a pace of about 0.5 to 2 pounds per week. Faster drops can happen at the start due to water shifts, especially if carbs and salt decrease. Sleep problems can flare when people crash diet or push intense evening workouts. A steady plan that protects protein intake, hydration, and a consistent bedtime keeps the body calm and willing to burn fat.

What sets a Laguna Beach medical weight loss program apart for sleep and energy goals?

Local care means local routines. Surf early? The plan accounts for pre-surf fuel and post-surf recovery so morning energy holds. Work in Newport but live in Laguna? The commute is built into the meal timing. Eat out often? Menus at Nick’s, South of Nick’s, and Driftwood Kitchen have go-to choices that fit the plan without feeling deprived.

Follow-up is also key. Brief weekly touchpoints keep progress real and stress low. Patients need flexibility during festival season, school breaks, or travel. The plan bends but does not break.

What signs show the plan is improving energy and sleep?

Track simple markers, not just the scale. Fewer naps. Less afternoon caffeine. Falling asleep within 20 minutes and waking once or not at all. Lower resting heart rate over a few weeks. Fewer headaches. Clearer mornings. These are early wins that often appear before major scale changes.

When should someone consider a formal sleep evaluation?

If a partner notices loud snoring, breathing pauses, or gasping at night, a sleep study is worth it. Morning headaches, dry mouth, or waking unrefreshed despite 7 to 8 hours are also clues. A home sleep test is straightforward, and many patients complete it within a week. Treating apnea accelerates weight loss and restores daytime energy, so it is worth screening early.

What does a first visit at Dolce MD look like?

A typical first visit takes about an hour. It includes a discussion of goals, review of medical history and medications, vitals, and body composition. Labs are ordered the same day. You leave with a simple, written plan and a short list of grocery items and local meal options. If medication is appropriate, the doctor explains how it works, expected benefits, side effects, and costs. Follow-up visits or calls happen weekly at first, then every two to four weeks.

Patients often say the plan feels easier than expected because it fits their real life. That is the goal: fewer decisions, clearer steps, and steady encouragement.

Ready to feel rested and energetic again?

If energy is low or sleep feels broken, medical weight loss can help reset both. You deserve care that fits your life in Laguna Beach and supports real change without extremes. Book a visit with Dolce MD to review your goals, get a clear plan, and start feeling better week by week. Your future self will thank you for taking this step.

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"Mounjaro" redirects here; not to be confused with Manjaro.
Tirzepatide
Top: Tirzepatide molecular structure
Bottom: Structure using peptide three-letter code
Clinical data
Pronunciation /tɜːrˈzɛpətaɪd/
tur-ZEP-ə-tyde
Trade names Mounjaro, Zepbound
Other names LY3298176, GIP/GLP-1 RA
AHFS/Drugs.com Monograph
MedlinePlus a622044
License data
Pregnancy
category		  
Routes of
administration		 Subcutaneous
Drug class Antidiabetic, GLP-1 receptor agonist
ATC code  
Legal status
Legal status  
Pharmacokinetic data
Bioavailability 80%
Protein binding Albumin
Metabolism Proteolytic cleavage, β-oxidation of fatty diacid section and amide hydrolysis
Elimination half-life 5 days
Excretion Urine and faeces
Identifiers
  • (2S)-2-[[20-[[(5S)-6-[[(2S,3S)-1-[[(2S)-1-[[(2S)-5-amino-1-[[(2S)-6-amino-1-[[(2S)-1-[[(2S)-1-[[(2S)-1-[[(2S)-5-amino-1-[[(2S)-1-[[(2S)-1-[[(2S,3S)-1-[[(2S)-1-[[2-[[2-[(2S)-2-[[(2S)-1-[[(2S)-1-[[2-[[(2S)-1-[(2S)-2-[(2S)-2-[(2S)-2-[[(2S)-1-amino-3-hydroxy-1-oxopropan-2-yl]carbamoyl]pyrrolidine-1-carbonyl]pyrrolidine-1-carbonyl]pyrrolidin-1-yl]-1-oxopropan-2-yl]amino]-2-oxoethyl]amino]-3-hydroxy-1-oxopropan-2-yl]amino]-3-hydroxy-1-oxopropan-2-yl]carbamoyl]pyrrolidin-1-yl]-2-oxoethyl]amino]-2-oxoethyl]amino]-1-oxopropan-2-yl]amino]-3-methyl-1-oxopentan-2-yl]amino]-4-methyl-1-oxopentan-2-yl]amino]-3-(1H-indol-3-yl)-1-oxopropan-2-yl]amino]-1,5-dioxopentan-2-yl]amino]-3-methyl-1-oxobutan-2-yl]amino]-1-oxo-3-phenylpropan-2-yl]amino]-1-oxopropan-2-yl]amino]-1-oxohexan-2-yl]amino]-1,5-dioxopentan-2-yl]amino]-1-oxopropan-2-yl]amino]-3-methyl-1-oxopentan-2-yl]amino]-5-[[(2S)-2-[[(2S)-2-[[2-[[(2S,3S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S,3R)-2-[[(2S)-2-[[(2S,3R)-2-[[2-[[(2S)-2-[[2-[[(2S)-2-amino-3-(4-hydroxyphenyl)propanoyl]amino]-2-methylpropanoyl]amino]-4-carboxybutanoyl]amino]acetyl]amino]-3-hydroxybutanoyl]amino]-3-phenylpropanoyl]amino]-3-hydroxybutanoyl]amino]-3-hydroxypropanoyl]amino]-3-carboxypropanoyl]amino]-3-(4-hydroxyphenyl)propanoyl]amino]-3-hydroxypropanoyl]amino]-3-methylpentanoyl]amino]-2-methylpropanoyl]amino]-4-methylpentanoyl]amino]-3-carboxypropanoyl]amino]-6-oxohexyl]amino]-20-oxoicosanoyl]amino]-5-[2-[2-[2-[2-[2-(carboxymethoxy)ethoxy]ethylamino]-2-oxoethoxy]ethoxy]ethylamino]-5-oxopentanoic acid
CAS Number  
PubChem CID  
IUPHAR/BPS  
DrugBank  
ChemSpider  
UNII  
KEGG  
ChEBI  
ChEMBL  
ECHA InfoCard 100.369.612 Edit this at Wikidata
Chemical and physical data
Formula C225H348N48O68
Molar mass 4813.527 g·mol−1
  • CC[C@H](C)[C@H](N=C(O)[C@H](CC(C)C)N=C(O)[C@H](Cc1c[nH]c2ccccc12)N=C(O)[C@H](CCC(=N)O)N=C(O)[C@@H](N=C(O)[C@H](Cc1ccccc1)N=C(O)[C@H](C)N=C(O)[C@H](CCCCN=C(O)COCCOCCN=C(O)COCCOCCN=C(O)CC[C@H](N=C(O)CCCCCCCCCCCCCCCCCCC(=O)O)C(=O)O)N=C(O)[C@H](CCC(=N)O)N=C(O)[C@H](C)N=C(O)[C@@H](N=C(O)[C@H](CCCCN)N=C(O)[C@H](CC(=O)O)N=C(O)[C@H](CC(C)C)N=C(O)C(C)(C)N=C(O)[C@@H](N=C(O)[C@H](CO)N=C(O)[C@H](Cc1ccc(O)cc1)N=C(O)[C@H](CC(=O)O)N=C(O)[C@H](CO)N=C(O)[C@@H](N=C(O)[C@H](Cc1ccccc1)N=C(O)[C@@H](N=C(O)CN=C(O)[C@H](CCC(=O)O)N=C(O)C(C)(C)N=C(O)[C@@H](N)Cc1ccc(O)cc1)[C@@H](C)O)[C@@H](C)O)[C@@H](C)CC)[C@@H](C)CC)C(C)C)C(O)=N[C@@H](C)C(O)=NCC(O)=NCC(=O)N1CCC[C@H]1C(O)=N[C@@H](CO)C(O)=N[C@@H](CO)C(O)=NCC(O)=N[C@@H](C)C(=O)N1CCC[C@H]1C(=O)N1CCC[C@H]1C(=O)N1CCC[C@H]1C(O)=N[C@@H](CO)C(=N)O
  • InChI=1S/C225H348N48O68/c1-23-126(10)183(264-198(311)146(64-50-52-88-226)246-202(315)157(109-180(297)298)252-199(312)152(103-124(6)7)261-223(337)225(21,22)269-217(330)185(128(12)25-3)266-209(322)163(120-278)257-200(313)153(107-138-74-78-141(282)79-75-138)250-203(316)158(110-181(299)300)253-207(320)162(119-277)259-216(329)187(134(18)280)267-206(319)155(106-136-60-44-41-45-61-136)254-215(328)186(133(17)279)262-174(289)114-237-193(306)147(83-87-179(295)296)260-222(336)224(19,20)268-192(305)143(227)104-137-72-76-140(281)77-73-137)214(327)242-131(15)190(303)244-148(80-84-168(228)283)196(309)245-145(65-51-53-89-231-175(290)121-340-100-99-339-97-91-233-176(291)122-341-101-98-338-96-90-232-170(285)86-82-150(221(334)335)243-171(286)70-46-38-36-34-32-30-28-26-27-29-31-33-35-37-39-47-71-178(293)294)195(308)240-130(14)191(304)248-154(105-135-58-42-40-43-59-135)205(318)263-182(125(8)9)212(325)247-149(81-85-169(229)284)197(310)251-156(108-139-111-234-144-63-49-48-62-142(139)144)201(314)249-151(102-123(4)5)204(317)265-184(127(11)24-2)213(326)241-129(13)189(302)236-112-172(287)235-115-177(292)270-92-54-66-164(270)210(323)258-161(118-276)208(321)256-160(117-275)194(307)238-113-173(288)239-132(16)218(331)272-94-56-68-166(272)220(333)273-95-57-69-167(273)219(332)271-93-55-67-165(271)211(324)255-159(116-274)188(230)301/h40-45,48-49,58-63,72-79,111,123-134,143,145-167,182-187,234,274-282H,23-39,46-47,50-57,64-71,80-110,112-122,226-227H2,1-22H3,(H2,228,283)(H2,229,284)(H2,230,301)(H,231,290)(H,232,285)(H,233,291)(H,235,287)(H,236,302)(H,237,306)(H,238,307)(H,239,288)(H,240,308)(H,241,326)(H,242,327)(H,243,286)(H,244,303)(H,245,309)(H,246,315)(H,247,325)(H,248,304)(H,249,314)(H,250,316)(H,251,310)(H,252,312)(H,253,320)(H,254,328)(H,255,324)(H,256,321)(H,257,313)(H,258,323)(H,259,329)(H,260,336)(H,261,337)(H,262,289)(H,263,318)(H,264,311)(H,265,317)(H,266,322)(H,267,319)(H,268,305)(H,269,330)(H,293,294)(H,295,296)(H,297,298)(H,299,300)(H,334,335)/t126-,127-,128-,129-,130-,131-,132-,133+,134+,143-,145-,146-,147-,148-,149-,150-,151-,152-,153-,154-,155-,156-,157-,158-,159-,160-,161-,162-,163-,164-,165-,166-,167-,182-,183-,184-,185-,186-,187-/m0/s1
    From Pubchem
  • Key:BTSOGEDATSQOAF-MCNPHUAVSA-N

Tirzepatide[12] is an antidiabetic medication used to treat type 2 diabetes[9][13][14][15] and for weight loss.[10][16] Tirzepatide is administered via subcutaneous injections (under the skin).[9][13] In the United States, it is sold under the brand name Mounjaro for diabetes treatment[9] and Zepbound for weight loss and treatment of obstructive sleep apnea.[10][17]

Tirzepatide is a gastric inhibitory polypeptide (GIP) analog and a GLP-1 receptor agonist.[10] The most common side effects include nausea, vomiting, diarrhea, decreased appetite, constipation, upper abdominal discomfort, and abdominal pain.[9][13][18]

Developed by Eli Lilly and Company, tirzepatide was approved for treatment of diabetes in the U.S. in May 2022,[9][13] in the European Union in September 2022,[11] in Canada in November 2022,[19] and in Australia in December 2022.[2] The U.S. Food and Drug Administration (FDA) considers it a first-in-class medication.[20][21] The FDA approved it for weight loss in November 2023.[16][22] Also in November 2023, the U.K. Medicines and Healthcare products Regulatory Agency revised the indication for tirzepatide (as Mounjaro) to include the treatment for weight management and weight loss.[8][23] In December 2024, the FDA revised the indication for tirzepatide (as Zepbound) to include the treatment of moderate to severe obstructive sleep apnea.[10][17] In 2023, tirzepatide was the 110th-most commonly prescribed medication in the U.S., with more than six million prescriptions.[24][25]

Medical uses

[edit]

Tirzepatide (as Mounjaro) is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes.[9][13]

Tirzepatide (as Zepbound) is indicated, alongside a reduced-calorie diet and increased physical activity, for long-term weight reduction in adults with obesity or overweight with at least one weight-related comorbidity.[10][16] Zepbound is also approved for the treatment of moderate-to-severe obstructive sleep apnea in adults with obesity.[10]

Contraindications

[edit]

Tirzepatide is contraindicated for use in people with a personal or family history of medullary thyroid cancer and people with multiple endocrine neoplasia syndrome type 2.[13]

Adverse effects

[edit]

Preclinical, phase I, and phase II clinical trials indicated that tirzepatide exhibits adverse effects similar to those of other established GLP-1 receptor agonists, such as dulaglutide (sold as Trulicity) and semaglutide (sold as Wegovy, Ozempic, and Rybelsus). These effects occur largely in the gastrointestinal tract.[26] The most frequently observed are nausea, diarrhea, and vomiting, which increased in incidence with the dosage amount (that is, the higher the dose, the higher the likelihood of side effects). The number of patients who discontinued taking tirzepatide also increased as the dosage increased, with patients taking 15 mg having a 25% discontinuation rate vs 5.1% for 5 mg patients and 11.1% for dulaglutide.[27][clarification needed] To a slightly lesser extent, patients also reported reduced appetite.[26] Other side effects reported were dyspepsia, constipation, abdominal pain, dizziness, and hypoglycemia.[28][29]

A systematic review published in 2024 found that tirzepatide is well tolerated and not associated with pancreatitis.[30]

Pharmacology

[edit]

Tirzepatide is an analog of gastric inhibitory polypeptide (GIP), a human hormone that stimulates the release of insulin from the pancreas. Tirzepatide is a linear polypeptide of 39 amino acids that has been chemically modified by lipidation to improve its uptake into cells and its stability to metabolism.[31] It completed phase III trials globally in 2021.[32][33]

Mechanism of action

[edit]

Tirzepatide has a greater affinity to GIP receptors than to GLP-1 receptors, and this dual agonist behavior has been shown to produce greater reductions of hyperglycemia compared to a selective GLP-1 receptor agonist.[14] Signaling studies reported that tirzepatide mimics the actions of natural GIP at the GIP receptor.[34] At the GLP-1 receptor, though, tirzepatide shows bias toward cAMP (a messenger associated with regulation of glycogen, sugar, and lipid metabolism) generation rather than β-arrestin recruitment. This combination of preference toward GIP receptor and distinct signaling properties at GLP-1 suggest this biased agonism increases insulin secretion.[34] Tirzepatide has been reported to increase levels of adiponectin, an adipokine involved in the regulation of both glucose and lipid metabolism, with a maximum increase of 26% from baseline after 26 weeks, at the 10 mg dosage.[14]

Chemistry

[edit]

Structure

[edit]

Tirzepatide is an analog of the human GIP hormone with a C20 fatty diacid portion attached, used to optimise the uptake and metabolism of the compound.[31] The fatty-diacid section (eicosanedioic acid) is linked via a glutamic acid and two (2-(2-aminoethoxy)ethoxy)acetic acid units to the side chain of the lysine residue. This arrangement allows for a much longer half-life, extending the time between doses, because of its high affinity to albumin.[35]

Synthesis

[edit]

The synthesis of tirzepatide was first disclosed in patents filed by Eli Lilly and Company in 2016.[36] This uses standard solid phase peptide synthesis, with an allyloxycarbonyl protecting group on the lysine at position 20 of the linear chain of amino acids, allowing a final set of chemical transformations in which the sidechain amine of that lysine is derivatized with the lipid-containing fragment.

Large-scale manufacturing processes have been reported for this compound.[37]

History

[edit]

Eli Lilly and Company first applied for a patent for a method of glycemic control using tirzepatide in 2016.[36] After passing phase III clinical trials, Eli Lilly applied to the U.S. Food and Drug Administration (FDA) for approval in 2021, with a priority review voucher.[38]

After completing the SURPASS-2 trial (NCT03987919), the company announced in April 2022 that tirzepatide had successfully met its clinical endpoints in obese and overweight participants without diabetes.[39]

In industry-funded preliminary trials, tirzepatide showed minor improvement of reductions (2.01%–2.30% depending on dosage) in glycated hemoglobin tests relative to the injected GLP-1 analog semaglutide (1.86%).[40] A 10 mg dose has also been shown to be effective in reducing insulin resistance, with a reduction of around 8% from baseline, measured using HOMA2-IR (computed with fasting insulin).[14] Fasting levels of insulin-like growth factor (IGF) binding proteins such as IGFBP1 and IGFBP2 increased after tirzepatide treatment, increasing insulin sensitivity.[14]

The FDA approved tirzepatide based on evidence from nine clinical trials of 7,769 participants with type 2 diabetes, of whom 5,415 received tirzepatide.[41] The trials were conducted at 673 sites in 24 countries, including Argentina, Australia, Brazil, Canada, India, Israel, Japan, Mexico, Russian Federation, South Korea, Taiwan, European Union, and the United States (including Puerto Rico).[41] All nine trials were used to assess its safety, and five were used to evaluate its efficacy.[41] The five used in efficacy evaluation included 6,263 adult participants with type 2 diabetes.[41] Four additional trials (NCT03131687, NCT03311724, NCT03861052, and NCT03861039) were included in the safety evaluation, for a total of 7,769 adult participants with type 2 diabetes; therefore, the number of participants representing efficacy findings may differ from the number representing safety findings due to different pools of study participants analyzed for efficacy and safety.[41] Tirzepatide's benefits for the treatment of adult participants with type 2 diabetes were primarily evaluated in five clinical trials.[41] In two of these (NCT03954834 and NCT04039503), participants were randomly assigned to receive either tirzepatide or placebo injection weekly.[41] Neither the patient nor the healthcare provider knew which treatment was being given until after the trials were completed.[41] Treatment was given for 40 weeks.[41] In the other three trials (NCT3987919, NCT03882970, and NCT03730662), participants were randomly assigned to receive either tirzepatide or another antidiabetic medication, and the patient and provider knew which medication was being given.[41] Treatment was given for 40 weeks to 104 weeks.[41] In each trial, HbA1c was measured from the start to the end of the trial and compared between the tirzepatide group and the other groups.[41]

Tirzepatide's efficacy for chronic weight management (weight reduction and maintenance) in combination with a reduced-calorie diet and increased physical activity was established in two randomized, double-blind, placebo-controlled trials of adults with obesity or overweight with at least one weight-related condition.[16] These studies measured weight reduction after 72 weeks in 2,519 participants who received either 5 mg, 10 mg, or 15 mg of tirzepatide once weekly and 958 participants who received weekly placebo injections.[16] In both trials, after 72 weeks of treatment, participants who received tirzepatide at all three dose levels experienced a statistically significant reduction in body weight compared to those who received placebo, and greater proportions of participants who received tirzepatide achieved at least 5% weight reduction compared to placebo.[16]

In August 2024, the SURMOUNT-1 three-year study (176-week treatment period) found that tirzepatide reduced the risk of developing type 2 diabetes by 94% in adults with pre-diabetes and obesity or overweight.[42]

Meta-analysis

[edit]

A 2021 meta-analysis found that over one year of clinical use, tirzepatide was superior to dulaglutide, semaglutide, insulin degludec, and insulin glargine in improving blood sugar and obesity.[43]

In a phase III double-blind, randomized, controlled trial supported by Eli Lilly, nondiabetic adults with a body mass index of 30 or more, or 27 or more and at least one weight-related complication, excluding diabetes, were randomized to receive once-weekly, subcutaneous tirzepatide (5 mg, 10 mg, or 15 mg) or placebo. The mean percentage change in weight at week 72 was −15.0% (95% confidence interval [CI], −15.9 to −14.2) with 5-mg weekly doses of tirzepatide, −19.5% (95% CI, −20.4 to −18.5) with 10-mg doses, and −20.9% (95% CI, −21.8 to −19.9) with 15-mg doses. Weight change in the placebo group was −3.1% (95% CI, −4.3 to −1.9).[44][45][46]

Society and culture

[edit]
[edit]

The U.S. Food and Drug Administration (FDA) granted the application for tirzepatide priority review designation.[13] The FDA approved Mounjaro for use in the U.S. in 2022.[13]

In July 2022, the Committee for Medicinal Products for Human Use of the European Medicines Agency adopted a positive opinion, recommending granting a marketing authorization for the medicinal product Mounjaro, intended for the treatment of type 2 diabetes.[47] Tirzepatide was approved for medical use in the European Union in September 2022.[11][48]

In December 2024, the FDA approved tirzepatide (Zepbound) as the first medication to be used in the treatment of moderate to severe obstructive sleep apnea.[17][49][50] The FDA granted the application for tirzepatide (Zepbound) fast track, priority review, and breakthrough therapy designations for the treatment of moderate to severe obstructive sleep apnea.[17] The FDA granted the approval of Zepbound to Eli Lilly.[17]

Shortage

[edit]

In the U.S., some compounding pharmacies prepare compounded versions of a drug on the FDA's drug shortages list if the compounded drug meets certain conditions detailed in federal law.[51][52][53] The FDA declared a shortage of tirzepatide in December 2022.[54] It declared the shortage over in October 2024, but enforcement was delayed until the end of 2024, after a lawsuit by compounding pharmacies challenged the declaration.[55][56]

The U.S. National Association of Boards of Pharmacy says there are tens of thousands of online pharmacies operating out of compliance with state and federal regulations or the association's recommendations.[57] The FDA has not evaluated these for safety and effectiveness and they are thus considered not to have been shown to be safe or effective.[58]

Research

[edit]

In a phase III trial, tirzepatide demonstrated clinically significant benefits among participants with obesity and heart failure with preserved ejection fraction.[59][60] Over two years of follow-up, tirzepatide decreased participants' risk of major cardiovascular (CV) complications—a combined endpoint including urgent heart failure visits, hospitalizations, more frequent diuretic treatment, and CV mortality—by 38% compared to a placebo.[61] An observational study on patients with obesity and type 2 diabetes and heart failure with preserved ejection fraction reported that tirzepatide had a lower risk of hospitalization for heart failure and all-cause death combined than sitagliptin.[62][63] In a 72-week, phase IIIb open-label head-to-head trial of adults with obesity without diabetes, tirzepatide at the maximum tolerated dose produced greater mean weight loss than semaglutide and larger reductions in waist circumference, while gastrointestinal adverse events were the most common with both drugs.[64]

After stopping treatment with tirzepatide for obesity, people on average regain more than half (53%) of the weight they lost during treatment within a year.[65][66]

A systematic review and meta-analysis published in 2024 found that tirzepatide demonstrates benefits in the management of metabolic dysfunction–associated steatotic liver disease.[67]

References

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