Weight Loss on Zepbound 5 mg Dose
Patients on Zepbound (tirzepatide) 5 mg weekly lose an average of 15% of body weight after 72 weeks in clinical trials, compared to 3% on placebo. This equates to about 34 pounds (15.4 kg) for someone starting at 226 pounds (103 kg). These results come from the SURMOUNT-1 trial, where 5 mg was the starting dose maintained for the full study period.[1][2]
How Weight Loss Builds Over Time
Loss starts within 4 weeks, averaging 5-10% by week 20 and reaching 15% by week 72. In SURMOUNT-4, patients who stayed on 5 mg after dose escalation kept losing weight gradually, unlike those who switched to placebo.[1][3]
| Time Point | Average % Weight Loss (5 mg) | Average Pounds Lost (from 226 lb baseline) |
|------------|------------------------------|-------------------------------------------|
| 20 weeks | 10-12% | 23-27 lb |
| 40 weeks | 13-14% | 29-32 lb |
| 72 weeks | 15% | 34 lb |
Comparison to Higher Doses
Higher doses yield more loss: 10 mg averages 19-20% (43 lb), 15 mg averages 21% (48 lb) at 72 weeks. Starting at 5 mg for 4 weeks before escalating reduces side effects while building toward these outcomes.[1][2]
Factors Affecting Individual Results
Real-world loss varies by adherence, diet, exercise, starting BMI (better results over 30), and duration. Women and those with type 2 diabetes lose slightly less than men or nondiabetics. Up to 20% of patients lose under 10%, while 30% exceed 20% on 5 mg.[1][4]
Side Effects and Discontinuation Risks
Common issues like nausea, diarrhea, and vomiting peak early and cause 5-7% dropout on 5 mg, lower than higher doses. Sustained use drives most loss; stopping reverses about half within a year.[1][3]
Who Makes Zepbound and Cost Considerations
Eli Lilly manufactures Zepbound, approved by FDA in November 2023 for obesity (BMI ≥30 or ≥27 with comorbidities). List price is $1,060/month; savings cards cap copays at $25 for eligible insured patients. No generic or biosimilar exists.[2][5]
Sources
[1] NEJM: Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1), https://www.nejm.org/doi/full/10.1056/NEJMoa2206038
[2] Zepbound Prescribing Information (Eli Lilly), https://pi.lilly.com/us/zepbound-uspi.pdf
[3] NEJM: Tirzepatide after Intensive Lifestyle Intervention (SURMOUNT-4), https://www.nejm.org/doi/full/10.1056/NEJMoa2404277
[4] Lilly SURMOUNT Trial Data Summary, https://www.lilly.com/news/media/media-kits/surmount
[5] Drugs.com: Zepbound Pricing, https://www.drugs.com/price-guide/zepbound