Tirzepatide

Also: Mounjaro, Zepbound, LY3298176

Summary

Tirzepatide is a synthetic peptide that activates two hormone receptors at once: GIP and GLP-1, both involved in insulin release and appetite. It is a licensed medicine in the UK, the US and Australia, which makes it the most heavily regulated substance covered on this site, and it has the largest trial programme of anything here.

What it targets

Acting on the GIP and GLP-1 receptors together influences insulin secretion, appetite and how full a meal feels. In the SURMOUNT-1 trial, 2,539 adults with obesity, or overweight plus a weight-related condition but not diabetes, were randomised to one of three tirzepatide levels or placebo for 72 weeks; both co-primary endpoints, percentage weight change and the proportion losing at least 5 percent of body weight, favoured tirzepatide at every level. A three-year extension followed the participants who also had prediabetes, reporting weight change to week 176, progression to type 2 diabetes and what happened over 17 weeks off treatment. Two further phase 3 trials tested it in moderate-to-severe obstructive sleep apnoea with obesity, measuring breathing interruptions per hour of sleep, and a 731-person trial tested it in heart failure with preserved ejection fraction and obesity against cardiovascular outcomes and quality of life. The programme is funded by the manufacturer throughout.

body weight in obesity (phase 3, 2,539 people)progression to type 2 diabetes (3-year extension)obstructive sleep apnoea with obesity (two phase 3 trials)heart failure with preserved ejection fraction (731 people)

Clinical Research

Tirzepatide Once Weekly for the Treatment of Obesity
Jastreboff AM, Aronne LJ, Ahmad NN, et al. (2022). New England Journal of Medicine. human 2,539 adults with obesity, or overweight with a weight-related complication, excluding diabetes; phase 3, double-blind, placebo-controlled, 72 weeks
Tirzepatide for Obesity Treatment and Diabetes Prevention
Jastreboff AM, le Roux CW, Stefanski A, et al. (2025). New England Journal of Medicine. human 1,032 SURMOUNT-1 participants who had both obesity and prediabetes, followed to 176 weeks plus a 17-week period off treatment
Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity
Malhotra A, Grunstein RR, Fietze I, et al. (2024). New England Journal of Medicine. human adults with moderate-to-severe obstructive sleep apnoea and obesity across two phase 3 trials, one in people not using positive airway pressure and one in people already using it; 52 weeks
Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity
Packer M, Zile MR, Kramer CM, et al. (2025). New England Journal of Medicine. human 731 patients with heart failure, an ejection fraction of at least 50 percent and obesity; international, double-blind, placebo-controlled, at least 52 weeks

All research on Tirzepatide →