Body Composition Changes With Standard Versus Low-Dose Tirzepatide Titration in Women With Lipedema: A Retrospective Observational Study.
- 1Scientific Department, Educational Organization in Lipedema (ABRALIPRO), São Paulo, BRA.
- 2Nutrition Department, Instituto Paula Frederich, São Paulo, BRA.
Abstract
Purpose
This study aimed to compare 12-week changes in body composition and anthropometric parameters between standard-dose and lower-dose tirzepatide escalation regimens in women with lipedema, with particular emphasis on changes in fat mass and skeletal muscle mass.Patients and methods
This retrospective observational study included 100 women with lipedema receiving tirzepatide during routine clinical care. Participants were classified into lower-dose (n = 50) and standard-dose (n = 50) groups according to their prescribed dosing regimens, which differed in cumulative drug exposure. Body composition, anthropometric measurements, and skinfold thickness were assessed at baseline and after 12 weeks. An exploratory composite responder criterion was defined as a ≥5% reduction in fat mass combined with a <5% reduction in skeletal muscle mass, as estimated by bioelectrical impedance analysis (BIA). Between-group comparisons were unadjusted.Results
Both regimens were associated with reductions in body weight, fat mass, and body fat percentage (all within-group p < 0.001). No statistically significant between-group differences were detected in these changes. The lower-dose regimen was associated with a smaller reduction in BIA-estimated skeletal muscle mass than the standard-dose regimen (-0.7 vs. -2.0 kg; p < 0.001). The exploratory composite responder criterion was met by 68% (34/50) of participants in the lower-dose group and 22% (11/50) in the standard-dose group (OR = 7.53; 95% CI: 3.08-18.44; p < 0.001). No statistically significant between-group differences were detected in anthropometric measurements or skinfold thickness changes.Conclusion
Both tirzepatide dosing regimens were associated with reductions in body weight and adiposity in women with lipedema. The lower-dose regimen was associated with a smaller reduction in BIA-estimated skeletal muscle mass and a higher proportion of participants meeting the exploratory composite responder criterion. These findings require confirmation in prospective controlled studies, given the non-randomized design, differences in cumulative drug exposure, and potential residual confounding.
Related
- Real-world effectiveness and safety of low-dose tirzepatide in Japanese people with type 2 diabetes: a multicenter, retrospective, single-arm, observational study—East Shizuoka Tirzepatide (ESTATE) study
- Changes in Eating Behavior and Food Preferences After Semaglutide or Tirzepatide Initiation: A Prospective Observational Pilot Study
- Early Body-Composition Trajectory During Tirzepatide Treatment for Obesity: A Real-World Bioimpedance Cohort Study
- Symptom improvement was not significantly associated with weight loss, dose, or treatment duration in women with lipoedema treated with tirzepatide: a retrospective cohort study of prospectively collected outcomes
- Diabetic Retinal Disease Onset and Progression During Established Semaglutide or Tirzepatide Treatment: A Retrospective Comparative Cohort Study With a Descriptive Regional Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) Review.
BibTeX
@article{souza2026body,
title = {{Body Composition Changes With Standard Versus Low-Dose Tirzepatide Titration in Women With Lipedema: A Retrospective Observational Study.}},
author = {Paula Frederichi de Souza and Gustavo Patriani and Camila Maria Ribeiro Pacheco},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116779},
url = {https://europepmc.org/article/MED/42921232},
note = {CC BY},
}
RIS
TY - JOUR
TI - Body Composition Changes With Standard Versus Low-Dose Tirzepatide Titration in Women With Lipedema: A Retrospective Observational Study.
AU - Paula Frederichi de Souza
AU - Gustavo Patriani
AU - Camila Maria Ribeiro Pacheco
PY - 2026
DA - 2026/09/23
JO - Cureus
DO - 10.7759/cureus.116779
UR - https://europepmc.org/article/MED/42921232
AB - Purpose This study aimed to compare 12-week changes in body composition and anthropometric parameters between standard-dose and lower-dose tirzepatide escalation regimens in women with lipedema, with particular emphasis on changes in fat mass and skeletal muscle mass.Patients and methods This retrospective observational study included 100 women with lipedema receiving tirzepatide during routine clinical care. Participants were classified into lower-dose (n = 50) and standard-dose (n = 50) groups according to their prescribed dosing regimens, which differed in cumulative drug exposure. Body composition, anthropometric measurements, and skinfold thickness were assessed at baseline and after 12 weeks. An exploratory composite responder criterion was defined as a ≥5% reduction in fat mass combined with a <5% reduction in skeletal muscle mass, as estimated by bioelectrical impedance analysis (BIA). Between-group comparisons were unadjusted.Results Both regimens were associated with reductions in body weight, fat mass, and body fat percentage (all within-group p < 0.001). No statistically significant between-group differences were detected in these changes. The lower-dose regimen was associated with a smaller reduction in BIA-estimated skeletal muscle mass than the standard-dose regimen (-0.7 vs. -2.0 kg; p < 0.001). The exploratory composite responder criterion was met by 68% (34/50) of participants in the lower-dose group and 22% (11/50) in the standard-dose group (OR = 7.53; 95% CI: 3.08-18.44; p < 0.001). No statistically significant between-group differences were detected in anthropometric measurements or skinfold thickness changes.Conclusion Both tirzepatide dosing regimens were associated with reductions in body weight and adiposity in women with lipedema. The lower-dose regimen was associated with a smaller reduction in BIA-estimated skeletal muscle mass and a higher proportion of participants meeting the exploratory composite responder criterion. These findings require confirmation in prospective controlled studies, given the non-randomized design, differences in cumulative drug exposure, and potential residual confounding.
SN - 2168-8184
ER -