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Faq · Plateaus

Not Losing Weight on Tirzepatide?

What the SURMOUNT phase 3 trials reported for tirzepatide, including the side effects, why weight loss slows as body weight falls, and what happened when treatment stopped. Tirzepatide is the active ingredient in Mounjaro, a prescription medicine, and prescribing belongs with a licensed Philippine physician. This page gives no dosing advice.

Philippines Peptides editorial deskUpdated 4 min read

What the Trials Reported

SURMOUNT-1

Outcome. In SURMOUNT-1, a 72-week phase 3 trial of 2,539 adults with BMI of 30 or more, or 27 or more with at least one weight-related complication, excluding diabetes, body weight fell by 15%, 19.5% and 20.9% on the 5 mg, 10 mg and 15 mg arms, against 3.1% on placebo.

Side effects reported in SURMOUNT-1. Discontinuation for adverse events: 4.3%, 7.1% and 6.2% on the 5, 10 and 15 mg arms, against 2.6% on placebo.

Source

SURMOUNT-4

Outcome. In SURMOUNT-4, an 88-week phase 3 trial of 670 adults with BMI of 30 or more, or 27 or more with a weight-related complication, excluding diabetes, body weight changed by -5.5% on the Continued tirzepatide, weeks 36 to 88 arm, against 14% on switched to placebo.

Side effects reported in SURMOUNT-4. Discontinuation for adverse events: 1.8% on the Continued tirzepatide, weeks 36 to 88 arm, against 0.9% on switched to placebo. Diarrhoea: 10.7% on the Continued tirzepatide, weeks 36 to 88 arm, against 4.8% on switched to placebo. Nausea: 8.1% on the Continued tirzepatide, weeks 36 to 88 arm, against 2.7% on switched to placebo. Vomiting: 5.7% on the Continued tirzepatide, weeks 36 to 88 arm, against 1.2% on switched to placebo.

Source

These figures are trial averages, and individual results in the SURMOUNT trials varied around them. The results describe Eli Lilly's registered medicine. They say nothing about research-grade material, whose content is known only from a laboratory report for that batch.

Why Weight Loss Slows

Energy expenditure falls with body weight. A smaller body uses less energy, and studies of large weight loss have measured a fall in resting energy expenditure beyond what the lost weight alone predicts (Fothergill 2016, S-04).

Appetite hormones shift and stay shifted. After diet-induced weight loss, hormones that regulate appetite changed in a direction that favours regain and remained changed a year later (Sumithran 2011, S-03).

Stopping treatment reverses much of the loss. In SURMOUNT-4, participants switched to placebo regained weight while those who continued tirzepatide kept losing, as set out above (S-02).

When to See a Physician

The compound itself is covered in the tirzepatide guide, and the registered medicine, its availability and its price in the Philippines in the Mounjaro guide.

FAQ

Why does weight loss on tirzepatide slow or stop?

Trial results are averages, and individual results in the SURMOUNT trials varied. In SURMOUNT-1, a 72-week phase 3 trial of 2,539 adults with BMI of 30 or more, or 27 or more with at least one weight-related complication, excluding diabetes, body weight fell by 15%, 19.5% and 20.9% on the 5 mg, 10 mg and 15 mg arms, against 3.1% on placebo. As body weight falls, energy expenditure falls with it and appetite-regulating hormones shift, which slows further loss (Fothergill 2016; Sumithran 2011). Tirzepatide is a prescription medicine, and prescribing belongs with a licensed Philippine physician; any question about response or dose belongs with the prescriber.

What happened when tirzepatide was stopped in the trials?

SURMOUNT-4 tested exactly this. In SURMOUNT-4, an 88-week phase 3 trial of 670 adults with BMI of 30 or more, or 27 or more with a weight-related complication, excluding diabetes, body weight changed by -5.5% on the Continued tirzepatide, weeks 36 to 88 arm, against 14% on switched to placebo. On average, participants switched to placebo regained weight.

Sources

Trial figures and adverse events are read from the trials dataset published by our partner and supplier at primaralabs.com/research/trials, each row linked to its primary source.

Updated