Tirzepatide for the Maintenance of Body Weight Reduction in People with Obesity: The SURMOUNT-MAINTAIN Trial

Presenter

Horn, D. B.

SURMOUNT‑MAINTAIN (Study of Tirzepatide [glucose‑dependent insulinotropic polypeptide/glucagon‑like peptide‑1 receptor dual agonist] for weight maintenance) was a Phase 3b randomized trial in adults with obesity (body mass index ≥30 kg/m² or ≥27 kg/m² with complications).  

After 60 weeks of tirzepatide 10/15 mg (maximum tolerated dose [MTD]), participants are randomly assigned to continue MTD, reduce the dose to 5 mg, or switch to placebo for an additional 52 weeks. At Week 112, weight change was −21.9% (MTD), −16.6% (5 mg), vs −9.9% (placebo) (all p<0.001 vs placebo Participants maintained 96.5% of weight loss achieved during the Weight‑Loss Period with tirzepatide MTD, 67.9% and 42.8% of weight loss achieved during the Weight‑Loss Period with 5 mg and placebo, respectively. Rescue therapy was required in 7.9% (MTD) vs 65.9% (placebo). 

Continued tirzepatide, especially at MTD, provides sustained and clinically meaningful weight‑loss maintenance with acceptable safety. Reducing tirzepatide to 5 mg was superior to placebo and may offer an alternative to discontinuation, though benefits varied with some weight regain. 

Real-World Effectiveness and Metabolic Outcomes of Tirzepatide in Adults with Obesity

Presenter: Angelopoulos, N.

This prospective real-world study evaluated tirzepatide in 95 adults with obesity over 6 months. 

Patients experienced significant weight loss (−8.2 kg at 3 months; −16.7 kg at 6 months, ~14% total). Improvements were seen in HbA1c, LDL cholesterol, and liver markers (AST, GGT, HSI), indicating better glycemic, lipid, and hepatic outcomes. Renal function remained stable. Despite heterogeneous patients and variable dose-escalations in routine practice, tirzepatide showed consistent benefits. These findings confirm that the substantial weight loss and metabolic benefits observed in clinical trials translate effectively into real-world obesity care.

Tirzepatide Improves Mental and Psychosocial Health-Related Quality of Life in the Real-World Setting

Presenter: Pérez Pevida

Tirzepatide has shown effective weight loss in overweight/obese patients, with improvement in health-related quality of life (HRQoL). However, there is limited real-world data on mental and psychosocial HRQoL.

In a 6-month prospective, real-world study in 107 obese/overweight adults with comorbidities, the effect of tirzepatide on HRQoL was evaluated using Short Form Health Survey (SF-36v2), EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L), International Physical Activity Questionnaire (IPAQ), and Impact of Weight on Self-Perception (IW-SP) scale. Tirzepatide 7.5 mg produced a mean weight loss of 18.04 kg (95% achieved ≥5% and 60% achieved ≥15% weight loss). Glycaemic, lipid profiles and HRQoL improved significantly. A statistically significant improvement was observed in the IW-SP, indicating better weight-related self-perception after the treatment.

Patient-reported outcomes showed marked gains across SF-36 domains, EQ-5D-5L dimensions and physical activity scores. Tirzepatide demonstrated robust weight reduction, metabolic improvements, and psychosocial benefits, highlighting its potential to address physical and mental aspects.

Switching to Tirzepatide from a GLP-1 RA Resulted in Weight Reduction: Results from 2 Real-World Databases

Presenter: Gibble, T. H.

Two real-world databases (Optum Market Clarity [MC] and the Healthcare Integrated Research Database [HIRD]) were used to study weight reduction among individuals switching to tirzepatide from a GLP‑1 receptor agonist medication for obesity.

Mean weight loss with tirzepatide was 13.1% (MC) and 12.9% (HIRD). At 12 months, 78.9% (MC) and 83.8% (HIRD) achieved ≥5% weight loss, while 21.1% (MC) and 19.6% (HIRD) achieved ≥20% reduction. 71.5% (MC) and 72.1% (HIRD) of individuals were started on tirzepatide 2.5 mg; and 81.3% (MC) and 75.4% (HIRD) were on a ≥10 mg dose. Study highlighted tirzepatide’s effectiveness in real-world settings following GLP-1 RA therapy.

Sequential Swallowable Intragastric Balloon (Allurion) and Low-Dose Tirzepatide Therapy Produces Major Fat Mass–Driven Weight Loss with Excellent Tolerability 

Presenter: Flagiello, L.

Swallowable intragastric balloons and incretin-based therapies are established treatment options for people with obesity. Nevertheless, real-world data on the sequential combination of a swallowable intragastric balloon followed by low-dose dual GIP/GLP-1 receptor agonist (tirzepatide) and their impact on body composition is scarce. 

In a prospective cohort of 79 adults with obesity, a 12‑month program combining a 4‑month swallowable Allurion intragastric balloon and 8 months of low‑dose tirzepatide (2.5–5.0 mg) achieved substantial weight loss. Baseline mean weight for the study participants was 121.65 kg (BMI 40.92 kg/m²); at 12 months, weight decreased to 94.32 kg (BMI 31.59 kg/m²), with mean total-body weight loss (TBWL) of 27.33 kg (22.44%). Fat mass declined by 16.6 kg and 6.97 percentage points, while lean mass (LM) percentage rose by 6.94 points despite a 9.44 kg absolute reduction in LM. No serious adverse events or discontinuations occurred. Low-dose tirzepatide resulted in substantial weight loss predominantly driven by fat mass reduction with good tolerability. 

Real-World Comparison of Short-Term Adverse Events, Treatment Persistence, and Efficacy of Tirzepatide and Semaglutide: A Nationwide Multicenter Study 

Presenter

Hepşen, S.

Currently, there is a dearth of real-world data comparing safety, tolerability, and effectiveness of semaglutide (SEMA) and tirzepatide (TIR) in patients with obesity. This nationwide multicenter study compared short‑term adverse events, discontinuation, body weight loss (BWL), and metabolic outcomes between SEMA and TIR in patients with obesity. 

The study population comprised of 2,549 patients with obesity (SEMA, n=1,434, median treatment duration: 16 weeks; TIR, n=1,115, median treatment duration: 12 weeks). Adverse events, predominantly, gastrointestinal occurred in 50.9% of the patients in the SEMA group and 51.0% in the TIR group (TIR; p=0.524). Treatment discontinuation due to pancreatic events were more frequent with SEMA (p=0.006), others were comparable. At 6 months, patients in the TIR group achieved greater reduction in median BWL, as compared to those in the SEMA group (14.4% vs. 12.6%), with higher proportions of patients achieving ≥5%, ≥10%, and ≥15% loss in the TIR group. Treatment with SEMA was associated with greater reductions in fasting plasma glucose and low-density lipoprotein cholesterol at 6 months, and a modest increase in high-density lipoprotein cholesterol, as compared to TIR. The changes in other glucose and lipid parameters were similar between groups. The median HbA1c reduction at 6 months was −0.9% and −0.8% in the SEMA and TIR groups, respectively. Overall, the tolerability was comparable, but TIR yielded greater early BWL. 

33^rd European Congress on Obesity (ECO 2026), 12^th -15^th May 2026, Istanbul, Turkey.