{
  "abstract": "Background and aims\n\nReal-world evidence on 12-month treatment effectiveness and persistence with tirzepatide remains limited, particularly under individualized dosing and self-funded treatment conditions. We evaluated 12-month tirzepatide outcomes in routine clinical practice.Methods\n\nThis was a multicenter, retrospective, observational real-world study including 249 adults with overweight or obesity treated with tirzepatide across 13 obesity practices in Greece. Treatment was entirely self-funded, and dose escalation was individualized rather than protocol driven. Treatment persistence, reasons for discontinuation, weight loss, dose trajectories, metabolic outcomes, and predictors of 12-month response were evaluated.Results\n\nAt 12 months, 170/249 patients (68.3%) remained on treatment, 64 (25.7%) had confirmed discontinuation, and 15 (6.0%) were lost to follow-up. Among patients with available weight measurements, mean weight loss was 19.9 ± 8.6% at 12 months, with 88.9%, 50.0%, and 27.2% achieving ≥10%, ≥20%, and ≥25% weight loss, respectively. Mean tirzepatide dose at 12 months was 9.71 mg. Among 179 patients assessed at both 6 and 12 months, 70.4% experienced >2% additional weight loss during the second 6 months, whereas 10.1% experienced >2% weight regain. Six-month percentage weight loss was not significantly associated with additional weight loss between months 6 and 12 after multivariable adjustment (β = -0.110, P = 0.135). Among 139 participants who had not achieved ≥20% weight loss at month 6, early response demonstrated moderate discrimination for achieving this cumulative threshold at month 12 (AUC 0.760, 95% bootstrap CI 0.675-0.837), with an adjusted OR of 1.34 per additional percentage point of 6-month weight loss (P < 0.001).Conclusions\n\nIn a fully self-funded real-world setting, tirzepatide was associated with substantial weight loss and high documented treatment persistence over 12 months. Six-month weight-loss response was associated with the likelihood of achieving ≥20% weight loss at 12 months. These findings do not establish long-term weight maintenance beyond the observation period.",
  "abstract_shown": true,
  "affiliations": [
    "Hellenic Endocrine Network, Ermou 6, Athens, Greece.",
    "Mediterranean Diabetes and Obesity Clinics (MEDOC), Athens, Greece.",
    "Department of Endocrinology, Metropolitan General Hospital, Athens, Greece.",
    "Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, UK.",
    "Division of Medicine, Department of Metabolism & Experimental Therapeutics, University College London Medical School, London, UK.",
    "Diabetes and Obesity Unit, Athens Medical Center, Athens, 15125, Greece.",
    "1st Medical Propedeutic Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.",
    "1st Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece.",
    "2nd Department of Internal Medicine, Research Institute and Diabetes Center, National and Kapodistrian University of Athens Medical School, Athens, Greece."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 17,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Nikolaos Angelopoulos"
    },
    {
      "affs": [
        1
      ],
      "name": "Evangelos Fousteris"
    },
    {
      "affs": [
        0
      ],
      "name": "Dimitra Zianni"
    },
    {
      "affs": [
        0
      ],
      "name": "Ioannis Androulakis"
    },
    {
      "affs": [
        0
      ],
      "name": "Rodis Paparodis",
      "orcid": "0000-0003-2804-0859"
    },
    {
      "affs": [
        2
      ],
      "name": "Dimos Florakis"
    },
    {
      "affs": [
        0
      ],
      "name": "Andreas Rizoulis"
    },
    {
      "affs": [
        3
      ],
      "name": "Ilias Perogamvros"
    },
    {
      "affs": [
        4
      ],
      "name": "Ploutarchos Tzoulis"
    },
    {
      "affs": [
        0
      ],
      "name": "Dimitrios Askitis",
      "orcid": "0000-0003-3844-8348"
    },
    {
      "affs": [
        5
      ],
      "name": "Georgia Argyrakopoulou"
    },
    {
      "affs": [
        5
      ],
      "name": "Evdoxia Gitsi"
    },
    {
      "affs": [
        0
      ],
      "name": "Sarantis Livadas"
    },
    {
      "affs": [
        6
      ],
      "name": "Zadalla Mouslech"
    },
    {
      "affs": [
        0
      ],
      "name": "Valentina Petkova"
    },
    {
      "affs": [
        7
      ],
      "name": "Alexander Kokkinos"
    },
    {
      "affs": [
        8
      ],
      "name": "Vaia Lambadiari"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/czt22n59hxgr6.bib",
  "cited_by": 0,
  "doi": "10.1016/j.obpill.2026.100344",
  "fulltext_url": "https://europepmc.org/articles/PMC13683030",
  "id": "czt22n59hxgr6",
  "issns": [
    "2667-3681"
  ],
  "landing_url": "https://europepmc.org/article/MED/42908672",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2736|Pharmacology and Obesity Treatment"
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  "openalex": "W7221575452",
  "pdf_url": "https://europepmc.org/articles/PMC13683030?pdf=render",
  "pmcid": "PMC13683030",
  "pmid": "42908672",
  "published": "2026-10-12",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/czt22n59hxgr6.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:53Z",
      "native_id": "MED:42908672",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42908672"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2736|Pharmacology and Obesity Treatment",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "12-month weight-loss trajectories and predictors of response to tirzepatide under individualized dosing: A multicenter real-world study.",
  "title_text": "12-month weight-loss trajectories and predictors of response to tirzepatide under individualized dosing: A multicenter real-world study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:53Z",
  "url": "https://research.draconitic.com/paper/czt22n59hxgr6",
  "venue": "Obesity pillars",
  "versions": []
}