SURMOUNT-1 Trial: Tirzepatide for Treating Obesity and Preventing Diabetes
Gerti Tashko, MD
Your Comprehensive Endocrinologist | Board Certified in Lipidology, Hypertension, and Obesity
Tirzepatide (Mounjaro or Zepbound) has emerged as a game-changing treatment for obesity and diabetes prevention. This three-year study, an extension of the SURMOUNT-1 trial, shows its ability to maintain long-term weight loss. It also significantly reduces the risk of type 2 diabetes in people with obesity and prediabetes. Conducted on a large scale, the trial underscores the potential of tirzepatide as a highly effective option for addressing two critical health issues.
Study Overview
The trial included 2,539 adults with obesity, 1,032 of whom also had prediabetes. Participants were randomly assigned to receive weekly doses of tirzepatide (5 mg, 10 mg, or 15 mg) or a placebo for 176 weeks, followed by a 17-week off-treatment phase. Researchers assessed key outcomes such as percentage weight loss and the development of type 2 diabetes. These results provide valuable insights into tirzepatide’s efficacy over a long period.
Impressive Weight Loss Outcomes
Tirzepatide consistently outperformed the placebo in promoting significant weight loss. At the end of the 176-week treatment period:
The weight loss observed with tirzepatide aligns with earlier findings from shorter studies but sets itself apart by demonstrating long-term effectiveness. Sustaining weight loss is a significant challenge in obesity management, and tirzepatide’s success over three years is particularly noteworthy.
Diabetes Prevention Results
In addition to weight loss, tirzepatide dramatically reduced the progression to type 2 diabetes. Among participants treated with tirzepatide, only 1% developed diabetes during the 176-week treatment period. After the 17-week off-treatment phase, this number rose slightly to 2%. In contrast, 13% of placebo recipients developed diabetes during the treatment phase, increasing to 14% after stopping treatment.
The results translate to a 93% lower risk of developing type 2 diabetes during treatment and an 88% lower risk even after stopping tirzepatide.
These findings underscore tirzepatide’s dual role in not only addressing obesity but also delaying or preventing diabetes progression.
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Safety Profile and Side Effects
The study also evaluated tirzepatide’s safety over the three-year period. The most common side effects were mild to moderate gastrointestinal symptoms, such as nausea, vomiting, or diarrhea. These symptoms primarily occurred during the first 20 weeks of the trial, a period when participants’ doses were being gradually increased. Most participants adapted to the medication over time, and no significant new safety concerns were identified throughout the study.
COVID-19 was noted as an adverse event in some cases, but this was unrelated to tirzepatide. Importantly, the overall safety profile aligns with previous trials, further supporting tirzepatide’s use for long-term treatment.
Why This Matters
Obesity is a major driver of numerous health conditions, including type 2 diabetes, cardiovascular disease, and certain cancers. Losing even a modest amount of weight can lead to significant health benefits. The ability of tirzepatide to deliver substantial, sustained weight loss provides hope for individuals who have struggled with traditional weight management methods. Additionally, its effectiveness in preventing type 2 diabetes addresses one of obesity’s most concerning complications.
This study also highlights the importance of treating obesity as a chronic disease rather than a short-term condition. Long-term approaches like tirzepatide can lead to meaningful improvements in health outcomes over time.
Summary
Tirzepatide offers a powerful new option for treating obesity and preventing type 2 diabetes. Over three years, it demonstrated significant and sustained weight loss while dramatically reducing diabetes risk.
The medication was well-tolerated, with manageable side effects that subsided over time. For individuals with obesity and prediabetes, tirzepatide represents a potentially transformative treatment that addresses two interconnected health challenges.
As more research explores its full potential, tirzepatide could redefine how we approach obesity and diabetes prevention.