Weight loss from Mounjaro has little to do with nausea etc

[Eddy Edson]

A new mediation analysis of the main tirzepatide (Mounjaro) trials: https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.16176

Bottom line: Nausea/vomiting/diarrhoea associated with no more than 3.1% of total weight reduction.

(Contra a common trope in the media.)

Abstract​

Aims​

This analysis evaluated whether gastrointestinal (GI) adverse events (AEs) including nausea, vomiting, diarrhoea (N/V/D) and dyspepsia were associated with weight reduction with tirzepatide across the SURMOUNT-1 to -4 trials.

Materials and Methods​

SURMOUNT-1 to -4 were global Phase 3 clinical trials evaluating the safety and efficacy of tirzepatide among participants with obesity or overweight with or without type 2 diabetes (T2D). Participants were randomly assigned to receive once weekly subcutaneous tirzepatide or placebo. This post hoc analysis investigated weight change at the primary endpoint from baseline among participants who self-reported no N/V/D, any N/V/D or nausea alone. Mediation analyses evaluated the contribution of N/V/D and dyspepsia on weight reduction. Time to first use of antidiarrheal and antiemetic usage was reported by time intervals.

Results​

Baseline characteristics were similar between participants who reported N/V/D and those who did not. More participants reported GI AEs in the tirzepatide treatment arms (27.8%–72.8%) than with placebo (12.2%–32.5%). Most GI AEs were non-serious and occurred during dose escalation. Between 1.0% and 10.5% of tirzepatide-treated participants discontinued treatment due to GI AEs. Weight reduction with tirzepatide was similar among participants reporting no nausea, nausea alone, or any N/V/D. Mediation analyses suggested that N/V/D and dyspepsia were associated with up to 3.1% of total weight reduction. When required, first use of antidiarrheal and antiemetic medication was most commonly reported during dose escalation.

Conclusions​

In this post hoc analysis, GI AEs appeared to contribute slightly to the weight reduction seen with tirzepatide in participants with obesity or overweight with or without T2D.

 

[musical soul]

Hi Eddy… my experience with TZ has been one’ish day of slight nausea… this decreases the longer I stay on any given dose. When it does noticeably ramp up is when I go up a dose; then, two maybe more of nausea plus intermittent nausea…so yes, when you’re nauseous you don’t eat or you eat very little, not really what mounjaro is supposed to work like. But you do lose weight …. I’ve run the gamut and I’m now on 12.5, it’s not worked well for me, not as it’s ‘supposed’ to work that is, no sensation of fulness or satiation. What does lesson is food noise, and an almost ambivalent attitude towards food. I suspect there is so very much more refinement going to be done on ‘weight loss medications’, they will get better and better, I hope so anyway. Best wishes to you.