Tirzepatide May Help Maintain Weight Loss

Dr. Sanjay Kalra, Treasurer, International Society of Endocrinology (ISE), Vice President, Bharti Hospital, Karnal, India

Continuing tirzepatide may help maintain weight loss, while reducing the dose to 5 mg may also be a useful option instead of stopping treatment.

A phase 3b, placebo-controlled trial published in The Lancet examined whether continuing tirzepatide could help maintain weight loss in adults with obesity. The trial included a 60-week weight-loss period followed by a 52-week weight-maintenance period. After the initial period, participants who had reached a maximum tolerated dose (MTD) of 10 or 15 mg once weekly were assigned to continue the MTD, reduce the dose to 5 mg, or switch to placebo.

A total of 378 participants were randomly assigned to the weight-maintenance phase: 140 continued tirzepatide at MTD, 144 received 5 mg tirzepatide, and 94 received placebo. Overall, 345 participants (91%) completed the study. The mean age was 46.6 years and 65% of participants were female. At baseline, mean body weight was 113.8 kg and mean body mass index (BMI) was 40.1 kg/m².

At week 112, the model-based change in body weight from baseline was −21.9% with tirzepatide MTD, −16.6% with 5 mg tirzepatide, and −9.9% with placebo. The differences between both tirzepatide groups and placebo were statistically significant (p < 0.0001 for all comparisons).

Weight regain requiring rescue treatment was more common after switching to placebo.

The most common adverse events with tirzepatide were gastrointestinal events. These were mostly mild to moderate and occurred mainly during dose escalation. Overall, the findings showed that continuing tirzepatide helped maintain weight loss, with the greatest reduction seen among those who continued treatment at their maximum tolerated dose. Reducing the dose to 5 mg also maintained more weight loss than switching to placebo.

(Reference: Horn DB, Aronne LJ, Wharton S, Bays HE, le Roux CW, Srinath R, Gomez-Valderas E, Arad AD, Das S, Dunn JP, Ribeiro A. Tirzepatide for maintenance of bodyweight reduction in people with obesity in the USA (SURMOUNT-MAINTAIN): a multicentre, double-blind, randomised, placebo-controlled trial. The Lancet. 2026 Jun 6;407(10545):2305-18.