Tirzepatide produces 23-26% weight loss regardless of menopausal status in women | Research

The takeaway

Post hoc analysis of SURMOUNT trials shows tirzepatide produced significant weight loss in all reproductive stages: premenopause (26%), perimenopause (23%), and postmenopause (23%), with improved waist circumference and adiposity markers versus placebo.

23-26% weight loss across menopause
Tirzepatide produced substantial weight loss regardless of reproductive stage—addressing menopausal weight gain that conventional management struggles with

What the researchers found

SURMOUNT-1 tirzepatide vs placebo: premenopause -26% vs -2%, perimenopause -23% vs -3%, postmenopause -23% vs -3% (all p significant). Significant WC and WHtR improvements. ~50% with baseline BMI ≥40 reached WHtR ≤0.49. Consistent across SURMOUNT-3 and -4.

Why it matters

Women gain weight and redistribute fat during menopause with limited options. Demonstrating tirzepatide works equally well regardless of menopausal status provides confidence for prescribers.

How the study worked

Post hoc analysis of 3 SURMOUNT RCTs. Women retrospectively categorized by reproductive stage. Tirzepatide 15 mg or MTD vs placebo. Body weight, WC, WHtR at end of study treatment.

What this study cannot tell us

Post hoc analysis (not pre-specified). Retrospective menopause categorization. Cannot determine if hormonal status affects drug mechanism. SURMOUNT excluded T2DM (SURMOUNT-1,3,4).

How to read the evidence

Post hoc analysis of 3 well-designed RCTs. Good subgroup evidence but not pre-specified.

When this study was published

Published in 2025.

The bigger picture

Menopause-related weight gain and fat redistribution increase cardiovascular risk. Tirzepatide's consistent efficacy across reproductive stages addresses a critical women's health gap.

Questions still open

Does hormone replacement therapy interact with tirzepatide's effects?
Is the slightly lower weight loss in peri/post-menopause clinically significant?
Should tirzepatide be specifically recommended for menopausal weight gain?

Common questions

Does menopause affect how well tirzepatide works?

No. This analysis of 3 major clinical trials found tirzepatide produced similar weight loss in premenopausal (26%), perimenopausal (23%), and postmenopausal (23%) women. All groups also showed significant reductions in waist circumference and belly fat. Menopause does not diminish the drug's effectiveness.

Can tirzepatide help with menopause-related weight gain?

Yes. This study specifically showed tirzepatide reduces central adiposity (belly fat)—the type of fat gain most common during and after menopause. About half of the most obese women achieved a healthy waist-to-height ratio, regardless of their menopausal status.

Read the original research

Body weight reduction in women treated with tirzepatide by reproductive stage: a post hoc analysis from the SURMOUNT program.

Obesity (Silver Spring, Md.), 33(5), 851-860

View on PubMed ↗Publisher’s paper ↗

Citation

Tchang, Beverly G; Mihai, Andreea Ciudin; Stefanski, Adam; García-Pérez, Luis-Emilio; Mojdami, Donna; Jouravskaya, Irina; Gurbuz, Sirel; Taylor, Rebecca; Karanikas, Chrisanthi A; Dunn, Julia P. (2025). Body weight reduction in women treated with tirzepatide by reproductive stage: a post hoc analysis from the SURMOUNT program.. Obesity (Silver Spring, Md.), 33(5), 851-860. https://doi.org/10.1002/oby.24254