A three-year international study has shown that tirzepatide, a once-weekly injection, can help people with overweight or obesity—but not diabetes—lose a significant amount of weight and keep it off. The research, part of the SURMOUNT-1 phase 3 trial, was presented this week at the European Congress on Obesity (ECO) in Malaga, Spain.

Led by Dr Luca Busetto of the University of Padova, Italy, the study followed 700 participants (64% women, average age of 48) over 176 weeks. These individuals had a body mass index (BMI) above 27 and were prediabetic. Results showed that participants who stuck to the treatment lost between 10% and 31% of their starting weight, depending on how their bodies responded.

Notably, those who lost the most weight tended to be women and had fewer obesity-related health problems. Even those who didn’t reach the highest levels of weight loss still achieved enough to significantly reduce their health risks.

Tirzepatide acts by mimicking two natural hormones—GLP-1 and GIP—that help regulate insulin levels, appetite, and feelings of fullness. By slowing stomach emptying and signalling satiety to the brain, the drug reduces hunger, making it easier for users to eat less.

The medication is already approved in the United States (as Zepbound) and Europe (as Mounjaro) for people with obesity or overweight and at least one related health condition like high blood pressure or cholesterol issues.

The study revealed three main weight loss patterns among participants. Some reached a weight loss plateau early but still maintained about a 10% loss over time. Others plateaued later but achieved greater reductions—up to 30%. Importantly, most participants hit a weight plateau by the third year.

“Everyone hits a weight loss plateau eventually, regardless of the method. Our body uses multiple hormones to protect against continued weight loss,” Dr Busetto noted. Still, a steady loss of just 5% body weight can lower the risk of developing type 2 diabetes and improve cholesterol and blood pressure levels. A 15% loss offers even more significant health benefits. 

India is facing a rising obesity epidemic. According to NFHS-5 (2019–21), nearly 24% of Indian women and 23% of men aged 15–49 are overweight or obese. Urban areas see even higher rates. The ICMR-INDIAB study (2023) warned of a sharp rise in metabolic diseases linked to abdominal obesity, even in people with normal BMI.

Tirzepatide may offer hope, but affordability and access remain barriers. A month’s supply in the US costs around $1,000 (?83,000). Even if prices are lower in India, they may still be out of reach for most, especially since many insurance schemes do not cover obesity treatment.

While drugs like tirzepatide bring much-needed innovation to obesity management, they cannot replace the role of public health. India must address deeper drivers—urban food deserts, sedentary jobs, aggressive junk food marketing, and weak nutrition education.

The real breakthrough will come when effective medication is paired with accessible lifestyle support, regulatory reforms, and equitable healthcare access. Otherwise, promising drugs will remain tools for the few, not solutions for the many.