Body weight reduction in women treated with tirzepatide by reproductive stage: a post hoc analysis from the SURMOUNT program.
Level 2 - randomized trial
Post hoc subgroup analysis of randomized controlled trials
PubMed 40074721 · doi:10.1002/oby.24254
What was done
This was a post hoc analysis evaluating female participants from the SURMOUNT-1, -3, and -4 trials who were randomized to tirzepatide (15 mg or maximum tolerated dose) or placebo. Participants without type 2 diabetes living with overweight or obesity were retrospectively classified into pre-, peri-, or post-menopause stages. Assessed endpoints at the end of treatment included percentage body weight change, waist circumference change, the proportion achieving body weight reduction thresholds (≥5%), and waist-to-height ratio (WHtR) category shifts among those with baseline BMI < 35 kg/m².
What was found
In SURMOUNT-1, tirzepatide led to significantly greater mean body weight reductions from baseline compared to placebo across all reproductive stages: premenopause (26% vs. 2%), perimenopause (23% vs. 3%), and postmenopause (23% vs. 3%; p < 0.001 for all). Waist circumference reductions were also greater with tirzepatide versus placebo across groups (premenopause: 22 vs. 4 cm; perimenopause: 20 vs. 5 cm; postmenopause: 20 vs. 4 cm; p < 0.001). Across reproductive stage subgroups, 97% to 98% of tirzepatide-treated participants achieved ≥5% weight loss compared with 29% to 33% on placebo. In participants with baseline BMI < 35 kg/m², 30% to 52% reached a WHtR ≤ 0.49 (indicating low central adiposity) with tirzepatide. Similar results were reported for SURMOUNT-3 and -4, though specific numerical data were not provided in the abstract.
Why it matters
Weight management during midlife and menopause is clinically challenging due to shifts toward central adiposity. These findings indicate that tirzepatide maintains robust weight and waist reduction efficacy in women regardless of their menopausal stage.
Limits
The analysis was post hoc, and menopausal status was categorized retrospectively. The abstract does not report participant counts (n) overall or within specific reproductive stage subgroups. Specific numerical results for the SURMOUNT-3 and SURMOUNT-4 cohorts are omitted from the abstract, and the findings apply only to individuals without type 2 diabetes.
Cited by
- context Studies show that women taking GLP-1 receptor agonists like tirzepatide achieve greater weight loss when also receiving hormone replacement therapy (HRT).