A treat‐to‐target approach for obesity management: A post hoc analysis of the SURMOUNT ‐5 trial
Authors' conclusion
In this post hoc analysis of SURMOUNT-5, most participants who reached the proposed TtT thresholds achieved the goal of low disease activity to remission defined by cardiometabolic risk parameters. These data suggest that TtT thresholds in obesity medicine may clarify goals in shared decision-making and improve clinical outcomes.
Study context
- Population
- Participants with obesity randomised in SURMOUNT-5
- Comparison
- Tirzepatide vs semaglutide
- Primary endpoint
- Proportion reaching proposed treat-to-target (TtT) thresholds: WHtR <0.53, BMI <27 kg/m², or a combination
- Follow-up
- Week 72
Primary result
As reported in the abstract
Reached TtT thresholds
Tirzepatide
23.1%-33.9%
Semaglutide
14.2%-20.7%
Further findings
| Outcome | Values | OR of achieving low disease activity to remission | P value |
|---|---|---|---|
| Odds of achieving low disease activity to remission (≥4 of 5 cardiometabolic risk goals): reached WHtR <0.53 vs did not · week 72Post hoc analysis | Reached WHtR <0.53 About 77% | 2.31 | P < 0.001 |
- Odds of achieving low disease activity to remission (≥4 of 5 cardiometabolic risk goals): reached waist to height ratio (WHtR) <0.53 vs did not: higher odds of achieving low disease activity to remission with reaching WHtR <0.53
SF-36v2 physical component score (PCS) normalisation or improvement by reaching body mass index (BMI) <27 kg/m² · week 72
- BMI threshold not statistically associated with assessed SF-36v2 PCS outcomes
Original publication
A treat‐to‐target approach for obesity management: A post hoc analysis of the SURMOUNT ‐5 trial. Diabetes Obes Metab. Published 3 February 2026. doi:10.
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