A modeling study estimated that if all eligible US adults (93.4 million people) took tirzepatide 15 mg, it could reduce the number of people with obesity by 55 million and prevent 2 million cardiovascular disease events over a decade.
2 million preventable CVD eventsIf all eligible US adults were treated with tirzepatide 15 mg, modeling estimates approximately 2 million cardiovascular disease events could be prevented over the next 10 years.
What the researchers found
Based on NHANES 2015-2018 data, approximately 93.4 million US adults (38% of the adult population) would meet SURMOUNT-1 trial eligibility criteria for tirzepatide treatment.
Applying the weight loss effects observed with tirzepatide 15 mg in SURMOUNT-1: 70.6% (65.9 million people) would achieve at least 15% weight reduction, and 56.7% (53.0 million) would achieve at least 20% weight reduction. This would translate to 58.8% fewer people with obesity — a reduction of 55.0 million individuals.
For cardiovascular impact, estimated 10-year CVD risk dropped from 10.1% to 7.7% after modeling tirzepatide treatment effects — a 2.4% absolute risk reduction (23.6% relative). This translates to approximately 2.0 million preventable cardiovascular disease events over 10 years among the eligible population without existing CVD.
Why it matters
Obesity is the defining public health crisis of our time, affecting over 40% of American adults and driving cardiovascular disease, the leading cause of death. While individual clinical trial results for tirzepatide are impressive, this study puts those results in population-level perspective — showing that broad treatment could eliminate obesity in 55 million people and prevent 2 million heart events. This type of analysis helps policymakers, insurers, and health systems understand the potential return on investment in anti-obesity medications.
How the study worked
Cross-sectional analysis using NHANES 2015-2018 data to identify US adults meeting SURMOUNT-1 trial eligibility criteria (adults ≥18 with overweight/obesity). Weight changes from SURMOUNT-1 trial results at the tirzepatide 15 mg dose were applied to the eligible population to project weight outcomes and changes in obesity prevalence. Ten-year cardiovascular disease risk was calculated using BMI-based Framingham CVD risk scores before and after applying tirzepatide treatment effects on BMI and risk factors. The difference in risk was multiplied by the weighted population to estimate preventable CVD events.
What this study cannot tell us
This is a modeling study, not a clinical trial — it assumes everyone eligible would respond like SURMOUNT-1 trial participants, which is unlikely in the real world. Key limitations include: trial participants are typically more adherent than the general population; the analysis assumes sustained treatment and weight loss over 10 years, but SURMOUNT-1 was a shorter trial; costs and feasibility of treating 93 million people are not addressed; the Framingham risk score may not perfectly capture modern CVD risk; and the analysis doesn't account for drug discontinuation, side effects, or weight regain after stopping treatment.
How to read the evidence
This is a modeling study applying clinical trial data (SURMOUNT-1) to population-level survey data (NHANES). While the underlying clinical trial data is high-quality, the population projections involve significant assumptions about treatment adherence, sustained effects, and generalizability. The estimates represent theoretical maximum impact rather than realistic clinical outcomes.
When this study was published
Published in 2025, this study uses the most recent available data on tirzepatide efficacy. Since publication, additional real-world data and cardiovascular outcome trial results for tirzepatide may have become available, potentially refining these projections.
The bigger picture
The debate over GLP-1-based obesity medications has moved beyond efficacy to questions of cost, access, and population impact. Studies like this help quantify the potential public health benefit, which is essential for insurance coverage decisions and health policy. At approximately $1,000+ per month for tirzepatide, treating 93 million Americans would cost trillions — but preventing 2 million cardiovascular events could offset substantial healthcare spending. This cost-benefit analysis is at the heart of ongoing debates about anti-obesity medication coverage.
Questions still open
- What would the actual cost-effectiveness be if even a fraction of eligible Americans were treated with tirzepatide?
- How would real-world adherence and discontinuation rates affect these population-level projections?
- Would treating a targeted high-risk subset achieve most of the cardiovascular benefit at a fraction of the cost?
Common questions
Could tirzepatide really prevent 2 million heart events?
What makes tirzepatide different from other weight loss peptides?
Read the original research
US Population Eligibility and Estimated Impact of Tirzepatide Treatment on Obesity Prevalence and Cardiovascular Disease Events.
Cardiovascular drugs and therapy, 39(4), 837-847
Citation
Wong, Nathan D; Karthikeyan, Hridhay; Fan, Wenjun. (2025). US Population Eligibility and Estimated Impact of Tirzepatide Treatment on Obesity Prevalence and Cardiovascular Disease Events.. Cardiovascular drugs and therapy, 39(4), 837-847. https://doi.org/10.1007/s10557-024-07583-z