A man with C6 quadriplegia and obesity lost 31 pounds in 3 months on tirzepatide with improved lipid profile, after years of unsuccessful weight loss attempts with diet and exercise — the first reported case of tirzepatide use in spinal cord injury.
31 pounds lost in 3 monthsA man with quadriplegia who couldn't lose weight despite years of trying with dietitians and exercise lost 31 pounds on tirzepatide — demonstrating the drug's potential for an underserved population with unique metabolic challenges.
What the researchers found
A male in his 40s with C6 AIS B spinal cord injury (15 years prior, BMI 32) lost 31 pounds after 3 months of tirzepatide treatment. His lipid profile improved. Prior interventions (multiple dietitians, increased physical activity) had failed to achieve weight loss. The only adverse effect was heartburn. This represents the first reported case of tirzepatide use in a spinal cord injury patient.
Why it matters
Approximately 300,000 Americans live with spinal cord injuries, and obesity affects the majority due to metabolic changes and exercise limitations. Cardiometabolic disease is a leading cause of death in this population. Yet SCI patients have been excluded from virtually all GLP-1 agonist and tirzepatide clinical trials. This case report provides the first evidence that tirzepatide can work safely in this underserved population, where the need for effective weight management tools is arguably greater than in the general population.
How the study worked
Single case report of a patient with chronic C6 quadriplegia and obesity treated with tirzepatide as adjunct to lifestyle interventions. Outcomes measured included body weight, BMI, lipid profile, and adverse effects over 3 months of treatment.
What this study cannot tell us
Single case report (n=1) — the lowest level of clinical evidence. The 3-month follow-up is short; long-term efficacy, weight maintenance, and safety in SCI are unknown. No control comparison. The patient's specific SCI characteristics (C6, AIS B) may not represent all SCI levels and severities. The impact on SCI-specific complications (pressure injuries, respiratory function, spasticity) was not assessed. Cost and insurance coverage considerations for this population were not discussed.
How to read the evidence
Single case report — the lowest level of clinical evidence. While it cannot establish efficacy for the SCI population broadly, it provides the first signal that tirzepatide is tolerated and effective in this patient group, justifying further investigation.
When this study was published
Published in 2025, this is the first case report of tirzepatide use in spinal cord injury, representing early exploration of this drug in a medically underserved population.
The bigger picture
As GLP-1 and dual-agonist drugs are prescribed to millions, the question of whether they work in populations with unique metabolic challenges — like SCI, where the nervous system's control of metabolism is disrupted — becomes important. This case suggests that tirzepatide's mechanism of action is effective even when the metabolic dysfunction is neurologically driven rather than purely lifestyle-related. It opens the door for formal studies in this neglected population.
Questions still open
- Does tirzepatide improve cardiometabolic risk markers beyond weight and lipids in SCI patients — such as insulin resistance and inflammatory markers?
- Are there unique safety considerations for tirzepatide in SCI patients, such as effects on bowel function or autonomic dysreflexia?
- Would a clinical trial of tirzepatide in SCI patients show population-level benefits comparable to those seen in the general population?
Common questions
Can tirzepatide help people with spinal cord injuries lose weight?
Why is obesity so common after spinal cord injury?
Read the original research
Treatment of obesity in spinal cord injury with tirzepatide: a case report.
Spinal cord series and cases, 11(1), 4
Citation
Juszczak, Michael; Shem, Kazuko. (2025). Treatment of obesity in spinal cord injury with tirzepatide: a case report.. Spinal cord series and cases, 11(1), 4. https://doi.org/10.1038/s41394-025-00699-w