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Zepbound ® (tirzepatide) injection
2.5 mg/ 5 mg/ 7.5 mg/ 10 mg/ 12.5 mg/ 15 mg
This information is provided in response to your request. Resources may contain information about doses, uses, formulations and populations different from product labeling. See Prescribing Information above, if applicable.
What is the effect of Zepbound® (tirzepatide) on waist circumference in adults with obesity or overweight?
In SURMOUNT-1 and -2, changes from baseline in waist circumference ranged from −11.2 to −19.9 cm across tirzepatide arms. In SURMOUNT-3 and -4, changes from randomization with tirzepatide maximum tolerated dose were −16.8 and −4.6 cm, respectively.
See important safety information, including boxed warning, in the attached prescribing information.
Waist Circumference Changes with Tirzepatide Across SURMOUNT Trials
Change in waist circumference from baseline was assessed in adults with obesity or overweight with at least one weight-related complication, following treatment with tirzepatide 5, 10, and 15 mg compared with placebo in the SURMOUNT clinical trial program. A summary of waist circumference changes from the SURMOUNT-1 to -4 studies can be found in Waist Circumference Summary from SURMOUNT Studies.1-5
Waist Circumference (cm)a | Tirzepatide 5 mg | Tirzepatide 10 mg | Tirzepatide 15 mg | Tirzepatide MTD | Placebo |
SURMOUNT-1 | |||||
Baseline | 113.2 | 114.9 | 114.4 | NA | 114.0 |
Waist circumference mean CFB | -14.6 | -19.4 | -19.9 | NA | -3.4 |
Difference vs placebo (95% CI) | -11.2 (-12.3, -10.0)b | -16.0 (-17.2, -14.9)b | -16.5 (-17.7, -15.4)b | NA | -- |
SURMOUNT-2 | |||||
Baseline | NA | 114.3 | 114.6 | NA | 116.1 |
Waist circumference CFBc | NA | -11.2 | -13.8 | NA | -3.4 |
Difference vs placebo (95% CI) | NA | -7.8 (-9.2, -6.4)d | -10.4 (-11.8, -8.9)d | NA | -- |
SURMOUNT-3 | |||||
Start of intensive lifestyle intervention lead-in | NA | 116.0 | 116.3 | ||
Start of randomization | NA | 109.2 | 109.6 | ||
Waist circumference mean change from randomization | NA | -16.8 | 1.1 | ||
Difference vs placebo (95% CI) | NA | -17.9 (-19.5, -16.3)b | -- | ||
SURMOUNT-4 | |||||
Start of lead-in treatment | NA | 115.2 | NA | ||
Start of randomization | NA | 96.8 | 98.2 | ||
Waist circumference mean change from randomization | NA | -4.6 | 8.3 | ||
Difference vs placebo (95% CI) | NA | -12.9 (-14.1, -11.7)b | -- | ||
Abbreviations: CFB = change from baseline; MTD = maximum tolerated dose (10 or 15 mg); NA = not applicable.
aData are from the efficacy analysis set. All changes are from baseline to study endpoint. Two statistical estimands, efficacy or treatment-regimen, were used to evaluate efficacy data from the phase 3 clinical trials of Preferred Product Name. Efficacy estimand evaluates the treatment effect prior to discontinuation of the study drug (without confounding effects of antihyperglycemic rescue therapy in SURMOUNT-2). Treatment-regimen estimand evaluates the treatment effect irrespective of adherence to the study drug (or initiation of rescue antidiabetic drugs in SURMOUNT-2). Differences in reported data may reflect the application of these estimands. This response presents data reflecting the efficacy estimand. For treatment-regimen estimand results, please refer to the manuscript cited and/or the US prescribing information, where applicable.
bp<.001 vs placebo.
cLeast squares means.
dp<.0001 vs placebo.
Waist-to-Height Ratios in Post-hoc Analysis
Waist-to-height ratio (WHtR) changes from baseline to Week 72 and the distribution of participants across WHtR risk categories in a post-hoc analysis of SURMOUNT-1 and SURMOUNT-2 are shown in Waist-to-Height Risk Categories from Baseline to Week 72 in Participants with BMI <35 kg/m2 in SURMOUNT-1 and SURMOUNT-2 Post-hoc Analysis.6
Figure Description: 31% of tirzepatide-treated participants in SURMOUNT-1 and 10% in SURMOUNT-2 had a waist-to-height ratio ≤0.49.
Enclosed Prescribing Information
References
The published references below are available by contacting 1-800-LillyRx (1-800-545-5979).
1Jastreboff AM, Aronne LJ, Ahmad NN, et al; SURMOUNT-1 Investigators. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387(3):205-216. https://doi.org/10.1056/NEJMoa2206038
2Garvey WT, Frias JP, Jastreboff AM, et al; SURMOUNT-2 investigators. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet. 2023;402(10402):613-626. https://doi.org/10.1016/S0140-6736(23)01200-X
3Wadden TA, Chao AM, Machineni S, et al. Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-3 phase 3 trial. Nat Med. 2023;29(11):2909-2918. https://doi.org/10.1038/s41591-023-02597-w
4Aronne LJ, Sattar N, Horn DB, et al; SURMOUNT-4 Investigators. Continued treatment with tirzepatide for maintenance of weight reduction in adults with obesity: the SURMOUNT-4 randomized clinical trial. JAMA. 2024;331(1):38-48. https://doi.org/10.1001/jama.2023.24945
5Data on file, Eli Lilly and Company and/or one of its subsidiaries.
6Tchang B, Sattar N, Dunn J, et al. Waist-to-height ratio shifts over time in tirzepatide-treated participants - post hoc analysis in SURMOUNT-1 and SURMOUNT-2. Endocr Pract. 2024;30(5 suppl):S68-S69. https://doi.org/10.1016/j.eprac.2024.03.259
Date of Last Review: June 15, 2026