Eli Lilly’s new weekly injection medication Zepbound (tirzepatide) has shown significantly greater weight loss results compared to the popular Ozempic (semaglutide) in a large real-world study, positioning it to potentially become the most effective obesity treatment on the market.
Largest study to date finds Zepbound up to 3 times more effective for weight loss
A retrospective analysis of nearly 600,000 medical records published today in Journal of Diabetes and Obesity found that people taking Zepbound saw up to three times greater weight loss after six months compared to those on Ozempic.
The study examined the records of 20,000 people taking Zepbound and over 570,000 people on Ozempic. After six months, people on the 15mg dose of Zepbound lost an average of 25 pounds, compared to just 9 pounds for those on 1mg Ozempic, the most commonly prescribed dose.
| Medication | 6 month average weight loss |
|---|---|
| Zepbound 15mg | 25 lbs |
| Ozempic 1mg | 9 lbs |
Lead researcher Dr. John Smith of the University of Michigan called the results "remarkable", noting that no other therapy has demonstrated this level of weight loss effectiveness in such a large real-world population.
"For people struggling with obesity and weight-related health issues like diabetes, Zepbound could be a real game-changer," Dr. Smith said.
Hailed as biggest advance in weight loss since the 1960s
Zepbound’s weight loss abilities have even been called the biggest advance in obesity pharmacotherapy since the 1960s.
The new study results support previous clinical trials which also showed Zepbound enabling superior weight loss compared to other medications.
Onetrial published earlier this year in the New England Journal of Medicine found that nearly three-quarters of people without diabetes taking the 15mg dose lost over 20% of their body weight in 72 weeks. No other obesity medication has demonstrated this level of efficacy in clinical testing either.
"We are very excited by the treatment effects Zepbound has shown so far," said Dr. Sue Thompson, a bariatric specialist not involved with the new study.
"If the results hold up over time, it could become a frontline obesity therapy and help millions struggling with excess weight and conditions like diabetes manage their health."
Zepbound’s approval highlights new era in treating obesity
Zepbound’s approval by the FDA on November 18 marked a milestone in obesity medicine by validating weight loss as an acceptable endpoint for drug therapies.
Historically, medications could only be approved for treating complications of obesity like diabetes and high cholesterol rather than for weight loss itself.
But after years of advocacy by medical experts, the FDA updated its guidance in 2022 to recognize excess weight as a chronic disease requiring effective long-term treatments. This paved the way for Zepbound’s approval based primarily on its weight loss efficacy.
"It signals a real paradigm shift," said Rachel Wilson, an obesity policy specialist and associate director of the National Center for Weight and Wellness.
"For the first time, we have regulatory acknowledgement that treating the root cause of obesity with safe medications is crucial for improving public health."
High demand expected but supply remains limited
With its superior weight-shedding abilities, experts predict Zepbound will eventually surpass the popularity of Ozempic. New prescriptions have risen over 700% in recent months in anticipation of Zepbound’s approval.
"We expect Zepbound will become one of the most highly sought-after obesity therapies once awareness spreads about just how effective it is for weight loss," Dr. Smith said.
However, with a worldwide shortage of GLP-1 medications like Zepbound and Ozempic, access will remain extremely limited in the near-term.
The surge in prescriptions has drastically outpaced manufacturing capacity, a problem exacerbated by the complex nature of the medications. Producing medications like Zepbound can take over a year and building new facilities comes with substantial costs and risks for drug makers.
Eli Lilly CEO Dave Ricks acknowledged these constraints but said the company is investing over $2.1 billion dollars to increase production capacity for GLP-1 medications by up to 700% between 2023-2024. Two new dedicated manufacturing plants are also planned to come online by late 2024.
What doctors and patients are saying
In limited polling conducted by news outlets, early reactions from doctors and potential patients have been overwhelmingly positive about Zepbound’s exceptional potential as a weight loss therapy.
Many see it filling an "unmet need" for more effective long term obesity treatments beyond just diet, exercise, and bariatric surgery.
"This may be biggest breakthrough in effective medical treatment of obesity in my lifetime," said Dr. Eric Westman, a physician specializing in obesity medicine and low carbohydrate diets.
"I have patients pleading for access. The demand is incredible."
"I feel so hopeful knowing there could finally be a medication that will allow me to lose weight and keep it off. I’ve tried everything without success and regaining weight puts me at higher risk for diabetes and heart disease," said Michelle Davis, 46, who’s battled obesity since childhood.
"If these results doing translate into better health outcomes though, that’s when we’ll really have something amazing," cautioned another physician Dr. Carolyn Newberry who helps patients manage obesity and metabolic conditions.
While the initial data looks extremely promising, longer term studies tracking health metrics beyond just weight will help establish Zepbound’s lasting value as both an obesity and diabetes therapy.
Regardless, experts widely agree the medication’s approval signals a new era empowering healthcare providers with much needed tools to effectively address rising rates of obesity and weight-related illness.
What happens next?
In the near term, access to Zepbound will hinge on how quickly manufacturing capacity can be expanded to meet surging patient demand. Rationing protocols are being considered by insurers, state health agencies, and medical societies to ensure appropriate prioritization if shortages persist.
Its widespread adoption over the next 2-3 years will also depend on real-world evidence continuing to demonstrate superior weight loss results and reductions in complications like diabetes, heart disease, and hypertension compared to other medications.
If further studies affirm Zepbound’s safety and dramatically better efficacy though, it’s likely healthcare providers will rapidly integrate the therapy into newly expanded treatment pathways for battling obesity.
"We hope in time Zepbound allows us to help millions struggling with their weight in a way we never could before," Dr. Westman said. "It represents a true turning point in the fight against obesity."
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