Tirzepatide achieves 18.1% weight loss in patients with recurrent weight gain after bariatric procedures

Recurrent weight gain following bariatric surgery (BS) or endoscopic bariatric therapy (EBT) presents a significant long-term challenge, often undermining the initial success of these interventions. Current management strategies can be complex and may not always achieve sustained weight loss. Tirzepatide, a dual agonist targeting the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors, has demonstrated substantial efficacy in treating primary obesity. However, its specific role and effectiveness in addressing weight regain after bariatric procedures have remained largely unexplored, representing a critical gap in clinical evidence.

This observational cohort study evaluated the efficacy and safety of tirzepatide in 34 patients (26 females, 8 males) who experienced recurrent weight gain after either BS (n=32) or EBT (n=2). Patients received once-weekly subcutaneous tirzepatide at a dosing range of 2.5-10 mg/week. Anthropometric data, including body mass index (BMI) categories and waist circumference, were collected at baseline and after 24 weeks of treatment. Adverse events were also monitored to assess tolerability.

After 24 weeks of treatment, patients demonstrated a significant mean percentage total body weight loss (%TBWL) of 18.1 ± 5.6% (p < 0.0001). This substantial weight reduction was accompanied by a significant decrease in waist circumference (p < 0.0001). The majority of patients experienced a shift to lower BMI categories, with most achieving an overweight or normal weight status. Adverse events were exclusively gastrointestinal, including constipation, diarrhea, and nausea. These events were generally mild and importantly, did not lead to any treatment discontinuations, indicating good tolerability. > After 24 weeks, patients treated with tirzepatide achieved a mean total body weight loss of 18.1 ± 5.6% (p < 0.0001).