In the largest trial, adults on tirzepatide lost an average of 15.0% to 20.9% of their body weight over 72 weeks, depending on dose. The placebo group lost 3.1%. Adults with type 2 diabetes lost less, and tirzepatide beat semaglutide head to head. For a 250-pound adult, the 15 mg average is about 52 pounds. These are group averages, and individual results vary widely. If you are new to the drug, start with our tirzepatide guide.
Key takeaways
- SURMOUNT-1 (2,539 adults, no diabetes, 72 weeks): -15.0% at 5 mg, -19.5% at 10 mg, -20.9% at 15 mg, versus -3.1% on placebo.
- At 15 mg, 91% lost at least 5% and 57% lost at least 20% of their body weight. On placebo, 35% and 3%.
- With type 2 diabetes (SURMOUNT-2): -12.8% at 10 mg and -14.7% at 15 mg over 72 weeks.
- Head to head (SURMOUNT-5): tirzepatide -20.2% versus semaglutide -13.7% at 72 weeks.
- Stopping matters: in SURMOUNT-4, switching to placebo led to a 14.0% regain over 52 weeks.
Tirzepatide weight loss results by dose
SURMOUNT-1 is the trial behind Zepbound's approval for chronic weight management. Everyone got diet and activity counseling. The drug groups were escalated from 2.5 mg to their assigned dose, following the same 2.5 mg steps the label uses.
| SURMOUNT-1 group | Mean change at 72 weeks | Lost at least 5% | Lost at least 20% | Stopped for adverse events |
|---|---|---|---|---|
| Placebo | -3.1% | 35% | 3% | 2.6% |
| 5 mg | -15.0% | 85% | Not reported in the summary used here | 4.3% |
| 10 mg | -19.5% | 89% | 50% | 7.1% |
| 15 mg | -20.9% | 91% | 57% | 6.2% |
Source: SURMOUNT-1, Jastreboff et al., NEJM 2022 (treatment-regimen estimand).
The "at least 5%" column is the one to read first. It says that most participants on any dose lost a clinically meaningful amount, while roughly one in three on placebo did too, with counseling alone. The "at least 20%" column shows the ceiling: more than half of the 15 mg group got there, which is why the trial made news. The dose schedule is on the tirzepatide dosage chart.
Average weight loss on tirzepatide across all the trials
| Trial | Who | Length | Tirzepatide result | Comparator |
|---|---|---|---|---|
| SURMOUNT-1 | Obesity or overweight, no diabetes | 72 weeks | -15.0% / -19.5% / -20.9% (5 / 10 / 15 mg) | Placebo -3.1% |
| SURMOUNT-2 | Obesity with type 2 diabetes | 72 weeks | -12.8% / -14.7% (10 / 15 mg) | Placebo -3.2% |
| SURMOUNT-3 | After a 12-week intensive lifestyle program | 72 more weeks | -18.4% additional | Placebo +2.5% |
| SURMOUNT-4 | After 36 weeks on tirzepatide (mean -20.9%) | 52 more weeks | Continued: a further -5.5% | Switched to placebo: +14.0% |
| SURMOUNT-5 | Obesity, no diabetes | 72 weeks | -20.2% | Semaglutide -13.7% |
| SURMOUNT-OSA | Obesity with moderate to severe sleep apnea | 52 weeks | -17.7% (not on PAP) / -19.6% (on PAP) | Placebo -1.6% / -2.3% |
| SURMOUNT-1 extension | Obesity with prediabetes | 176 weeks | -22.9% (15 mg) | Placebo -2.1% |
| SURPASS-2 | Type 2 diabetes | 40 weeks | -7.6 / -9.3 / -11.2 kg (5 / 10 / 15 mg) | Semaglutide 1 mg -5.7 kg |
Source: the SURMOUNT and SURPASS publications listed under Sources.
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Try the BMI Calculator →What that means in pounds
Trials report percentages because participants start at different weights. Here is the SURMOUNT-1 arithmetic at three starting points.
| Starting weight | 5 mg average (15.0%) | 10 mg average (19.5%) | 15 mg average (20.9%) |
|---|---|---|---|
| 200 lb | About 30 lb | About 39 lb | About 42 lb |
| 250 lb | About 38 lb | About 49 lb | About 52 lb |
| 300 lb | About 45 lb | About 59 lb | About 63 lb |
Source: arithmetic applied to the SURMOUNT-1 means over 72 weeks. Averages, not individual predictions.
How fast do you lose weight on tirzepatide?
The trials give two fixed points. SURMOUNT-1 reached its means at 72 weeks. SURMOUNT-4's lead-in reached a mean of 20.9% at 36 weeks. So a large share of the total loss happened in the first 36 weeks, and the curve flattened afterward. Remember that the first 4 weeks are at the 2.5 mg starting dose, and that the label requires at least 4 weeks on each step before increasing, so reaching 10 or 15 mg takes 13 to 21 weeks at the fastest. The weekly arithmetic is on tirzepatide average weight loss per week, and the early timeline on how fast tirzepatide works.
What changes the result
Four factors show up in the trial data. Dose: higher doses lost more on average in SURMOUNT-1. Diabetes: SURMOUNT-2 participants lost less than SURMOUNT-1 participants at the same doses. Lifestyle: SURMOUNT-3 shows the drug adds to an intensive lifestyle program rather than replacing it, and the label indication is as an adjunct to a reduced-calorie diet and increased activity. Staying on treatment: SURMOUNT-4 shows what stopping does. Side effects are the usual reason people stop or stay at a lower dose; in SURMOUNT-1, nausea, diarrhea, vomiting and constipation were the most common, mostly mild to moderate, and mostly during escalation.
Tirzepatide versus semaglutide
SURMOUNT-5 is the only head-to-head trial in adults with obesity and no diabetes: -20.2% with tirzepatide versus -13.7% with semaglutide at 72 weeks. In type 2 diabetes, SURPASS-2 compared tirzepatide with semaglutide 1 mg over 40 weeks and found greater weight loss (up to -11.2 kg versus -5.7 kg) and larger A1c reductions. Our semaglutide vs tirzepatide comparison goes through both.
What this means for compounded tirzepatide
These results are from trials of tirzepatide as approved in Zepbound and Mounjaro. Compounded tirzepatide is not FDA approved and is not interchangeable with those products; no trial has tested a compounded version, so the honest statement is that prescribers use the same molecule at the same doses and a licensed provider decides whether it is appropriate. At FormBlends, compounded tirzepatide is $149 for the first month, then $239 a month, or $214 a month with Subscribe & Save, with the same price at every dose. See pricing or begin at start.
Frequently Asked Questions
How much weight can you lose on tirzepatide?
On average, 15.0% to 20.9% of body weight over 72 weeks in SURMOUNT-1, depending on dose. For a 250-pound adult that is about 38 to 52 pounds. Adults with type 2 diabetes averaged 12.8% to 14.7%.
What are typical tirzepatide weight loss results?
At 15 mg in SURMOUNT-1, 91% lost at least 5% and 57% lost at least 20%. That means most people lose a meaningful amount and a bit over half lose a fifth of their body weight, while some lose much less.
What is the average weight loss on tirzepatide compared with semaglutide?
In SURMOUNT-5, tirzepatide averaged -20.2% and semaglutide -13.7% at 72 weeks in adults with obesity. In SURPASS-2, in type 2 diabetes, tirzepatide lost up to 11.2 kg versus 5.7 kg for semaglutide 1 mg.
How fast do you lose weight on tirzepatide?
SURMOUNT-4 participants had lost a mean of 20.9% by week 36, which matches what SURMOUNT-1 reached at week 72. Loss is front-loaded once you are on a maintenance dose, then flattens.
Does everyone lose weight on tirzepatide?
No. In SURMOUNT-1, 9% of the 15 mg group did not reach a 5% loss, and 15% of the 5 mg group did not. Dose, diabetes, side effects and lifestyle all shift the result.
Sources
- Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1), Jastreboff et al., New England Journal of Medicine, 2022.
- Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2), Garvey et al., The Lancet, 2023.
- Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity (SURMOUNT-3), Wadden et al., Nature Medicine, 2023.
- Continued Treatment With Tirzepatide for Maintenance of Weight Reduction (SURMOUNT-4), Aronne et al., JAMA, 2024.
- Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5), Aronne et al., New England Journal of Medicine, 2025.
- Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity (SURMOUNT-OSA), Malhotra et al., New England Journal of Medicine, 2024.
- Tirzepatide for Obesity Treatment and Diabetes Prevention (SURMOUNT-1 3-year), Jastreboff et al., New England Journal of Medicine, 2025.
- Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes (SURPASS-2), Frias et al., New England Journal of Medicine, 2021.
Next steps
Read tirzepatide tips for better results and tirzepatide average weight loss per week next. Browse the tirzepatide hub for every other tirzepatide question. Talk to a clinician about what a realistic goal looks like for you. Compounded tirzepatide is not FDA approved and is not interchangeable with Zepbound or Mounjaro; a licensed provider decides whether it is appropriate for you.
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