12-month weight-loss trajectories and predictors of response to tirzepatide under individualized dosing: A multicenter real-world study.
9 affiliations
- 1Hellenic Endocrine Network, Ermou 6, Athens, Greece.
- 2Mediterranean Diabetes and Obesity Clinics (MEDOC), Athens, Greece.
- 3Department of Endocrinology, Metropolitan General Hospital, Athens, Greece.
- 4Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, UK.
- 5Division of Medicine, Department of Metabolism & Experimental Therapeutics, University College London Medical School, London, UK.
- 6Diabetes and Obesity Unit, Athens Medical Center, Athens, 15125, Greece.
- 71st Medical Propedeutic Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
- 81st Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece.
- 92nd Department of Internal Medicine, Research Institute and Diabetes Center, National and Kapodistrian University of Athens Medical School, Athens, Greece.
Abstract
Background and aims
Real-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
This 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
At 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
In 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.
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BibTeX
@article{angelopoulos202612month,
title = {{12-month weight-loss trajectories and predictors of response to tirzepatide under individualized dosing: A multicenter real-world study.}},
author = {Nikolaos Angelopoulos and Evangelos Fousteris and Dimitra Zianni and Ioannis Androulakis and Rodis Paparodis and Dimos Florakis and Andreas Rizoulis and Ilias Perogamvros and Ploutarchos Tzoulis and Dimitrios Askitis and Georgia Argyrakopoulou and Evdoxia Gitsi and Sarantis Livadas and Zadalla Mouslech and Valentina Petkova and Alexander Kokkinos and Vaia Lambadiari},
journal = {Obesity pillars},
year = {2026},
month = oct,
doi = {10.1016/j.obpill.2026.100344},
url = {https://europepmc.org/article/MED/42908672},
note = {CC BY},
}
RIS
TY - JOUR
TI - 12-month weight-loss trajectories and predictors of response to tirzepatide under individualized dosing: A multicenter real-world study.
AU - Nikolaos Angelopoulos
AU - Evangelos Fousteris
AU - Dimitra Zianni
AU - Ioannis Androulakis
AU - Rodis Paparodis
AU - Dimos Florakis
AU - Andreas Rizoulis
AU - Ilias Perogamvros
AU - Ploutarchos Tzoulis
AU - Dimitrios Askitis
AU - Georgia Argyrakopoulou
AU - Evdoxia Gitsi
AU - Sarantis Livadas
AU - Zadalla Mouslech
AU - Valentina Petkova
AU - Alexander Kokkinos
AU - Vaia Lambadiari
PY - 2026
DA - 2026/10/12
JO - Obesity pillars
DO - 10.1016/j.obpill.2026.100344
UR - https://europepmc.org/article/MED/42908672
AB - Background and aims Real-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 This 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 At 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 In 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.
SN - 2667-3681
ER -