Early‐Onset Obesity and Tirzepatide Treatment: A Post Hoc Analysis of the SURMOUNT Clinical Trials
Authors' conclusion
In this post hoc analysis, participants with early- versus later-onset obesity exhibited a mixed profile of metabolic health at baseline, including a higher degree of central adiposity and lower HbA1c and SBP. Improvements in BW and cardiometabolic markers with tirzepatide were similar between subgroups.
Study context
- Population
- Participants from SURMOUNT-1, SURMOUNT-3 and SURMOUNT-4 randomized to tirzepatide or placebo
- Participants
- 3,782 participants
- Comparison
- Early- vs later-onset obesity, treated with tirzepatide
- Primary endpoint
- Baseline characteristics and changes in BW and cardiometabolic risk factors
- Follow-up
- 72/88 weeks
Methodological detailssubgroup analysis
- Subgroup analysis
Primary result
As reported in the abstract
Improvements with tirzepatide in SURMOUNT-1 · 72 weeks
- Body weight (BW) change, early- vs later-onset
- −23% vs. −22%
- Waist circumference (WC) change, early- vs later-onset
- −22 vs. −19 cm
- HbA1c change, early- vs later-onset
- −0.51% vs. −0.52%
- Triglycerides change, early- vs later-onset
- −32% vs. −31%
- Systolic blood pressure (SBP) change, early- vs later-onset
- −8 vs. −8 mmHg
Further findings
| Outcome | P value |
|---|---|
| Baseline characteristics (SURMOUNT-1) | all p ≤ 0.004 |
- Baseline characteristics (SURMOUNT-1) — Mean obesity duration, early- vs later-onset
- 20 ± 12 vs. 11 ± 8 years
- Baseline characteristics (SURMOUNT-1) — BMI, early- vs later-onset
- 40 ± 7 vs. 37 ± 6 kg/m²
- Baseline characteristics (SURMOUNT-1) — WC, early- vs later-onset
- 118 ± 16 vs. 112 ± 14 cm
- Baseline characteristics (SURMOUNT-1) — HbA1c, early- vs later-onset
- 5.48% ± 0.4% vs. 5.60% ± 0.4%
- Baseline characteristics (SURMOUNT-1) — Triglycerides, median, early- vs later-onset
- 120 vs. 130 mg/dL
- Baseline characteristics (SURMOUNT-1) — SBP, early- vs later-onset
- 121 ± 13 vs. 125 ± 13 mmHg
- Baseline characteristics (SURMOUNT-1): longer obesity duration, higher BMI and WC, lower HbA1c, triglycerides and SBP with early-onset
Improvements in SURMOUNT-3 and SURMOUNT-4
- Similar improvements were observed
Original publication
Early‐Onset Obesity and Tirzepatide Treatment: A Post Hoc Analysis of the SURMOUNT Clinical Trials. Obesity (Silver Spring). Published 27 July 2025. doi:10.
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