Using Zepbound for weight loss

Struggling with weight loss? You’re not alone. The Centers for Disease Control and Prevention (CDC) estimates that nearly 42% of Americans are obese. More people in the U.S. are trying weight-loss injectable medications like Zepbound because of its proven effectiveness for weight loss. For example, in one clinical trial, 1 in 3 participants lost more than 25% of their body weight while taking Zepbound for weight loss. Here we take an in-depth look at how Zepbound helps you lose weight, how much it costs, and what to expect when you take it. 

Uncover a new you with Zepbound for weight loss. Schedule an appointment with a provider on Klarity today to see if Zepbound or another weight loss drug is right for you. 

What is Zepbound for weight loss?

Zepbound (tirzepatide) is approved by the U.S. Food and Drug Administration (FDA)for weight management when paired with a healthy diet and exercise routine. It’s a weight loss injection for adults with a body mass index (BMI) of:

• 30 or greater, or
• 27 or greater with a diagnosis of at least one weight-related health condition, such as high blood pressure, high cholesterol, type 2 diabetes mellitus, obstructive sleep apnea, or cardiovascular disease. 

Zepbound’s active ingredient tirzepatide is also the active ingredient in Mounjaro. Mounjaro is a brand-name drug FDA-approved in May 2022 to lower blood sugar in adults with type 2 diabetes along with diet and exercise. People may use Mounjaro off-label for weight loss. Healthcare providers can prescribe a medication off-label at their discretion, if they deem it safe and appropriate for their patients.  

Next,  Mounjaro’s manufacturer, Eli Lilly, sought approval from the FDA to market tirzepatide separately for use as a weight management medication, along with diet and exercise. The FDA approved tirzepatide for weight loss under the brand name Zepbound in November 2023.

How does Zepbound work for weight loss?

Zepbound has a dual mechanism of action. It’s a glucagon-like peptide-1 (GLP-1) receptor agonist and a glucose-dependent insulinotropic polypeptide (GIP) receptor agonist. Let’s break that down.

GLP-1 agonists mimic GLP-1, a hormone that your body naturally produces. GLP-1 works to help your body produce more insulin. This lowers your blood sugar, which is why GLP-1 agonists are often prescribed for people with diabetes. 

GLP-1 agonists also work by delaying stomach contents from emptying into the small intestine. This causes you to feel full quicker and longer so you don’t overeat.

GIP is an incretin hormone that helps control blood sugar levels in the body. It also works in tandem with GLP-1 to help you feel full quicker and longer. Using a dual GLP-1 and GIP agonist like Zepbound promotes satiety and reduces hunger, which can help you lose weight by causing you to eat less.

While Zepbound works for weight loss, it does not replace the benefits of a healthy lifestyle. For best results, Zepbound should be used alongside a balanced, reduced-calorie diet and regular exercise.

How effective is Zepbound for weight loss?

Clinical trials have proven Zepbound’s effectiveness for weight loss in obese and overweight adults. We’ve broken down the findings from each trial for you. 

SURMOUNT-2. The SURMOUNT-2 trial compared Zepbound to a placebo in adults with obesity and type 2 diabetes for 72 weeks. Of the 938 participants in the trial, 312 were randomly assigned to take 10 milligrams of Zepbound, 311 took 15 milligrams of Zepbound, and 315 took a placebo. At week 72, those receiving 10 milligrams of Zepbound experienced an average loss in body weight of 13.4%. Those receiving 15 milligrams of Zepbound lost an average of 15.7% body weight. Participants in the placebo group experienced an average weight loss of 3.3%. 

SURMOUNT-3. The SURMOUNT-3 trial evaluated Zepbound’s safety and effectiveness for weight loss. It was similar to the SURMOUNT-2 trial, except participants took part in a 12-week intensive lifestyle intervention and achieved up to 5% weight reduction before beginning medication or the placebo. Participants weren’t required to have type 2 diabetes. Requirements included a BMI of 30 or higher, or a BMI of 27 or higher with at least one weight-related health condition (besides diabetes). 

This 72 week trial split 579 subjects into 2 groups — 1  received Zepbound (10 or 15 milligrams) and another received a placebo. 

Participants who took Zepbound lost 18.4% of their initial body weight on average. Those on the placebo lost an average of 2.5% body weight. This trial also looked at maintaining the weight loss achieved with Zepbound. After 72 weeks, 87.5% of participants who took Zepbound achieved an additional weight reduction of up to  5%. In the placebo group, only 16.5% of participants achieved the same result. 

SURMOUNT-4. The SURMOUNT-4 trial evaluated whether a once-weekly injection of Zepbound (10 or 15 milligrams) alongside diet and physical activity affects maintenance of body weight loss in people who are overweight or obese with a weight-related complication, excluding diabetes. 

This study tested the maximum tolerated dose, which is the dose that a person can comfortably take without experiencing significant side effects. 783 participants received the maximum tolerated dose of Zepbound for 36 weeks. At 36 weeks, 670 participants had lost at least 20.9% body weight. These participants were randomized to continue treatment with Zepbound or switch to a placebo for 52 weeks, totaling 88 weeks in the trial. 

From week 36 to week 88, those who remained in the Zepbound group lost 5.5% of their body weight on average. Those who switched to a placebo gained 14% of their body weight back during the same time. Likewise, 89.5% of participants who continued receiving Zepbound maintained at least 80% of their weight loss, compared to only 16.6% in the placebo group. 

Overall, those who took Zepbound throughout the entire 88 weeks experienced a 25.3% reduction in body weight. In comparison, those who switched to placebo in week 36 averaged 9.9% body weight loss. 

These and other trials support how effective Zepbound is for weight loss. Individual, real-world results can differ from what’s seen in studies. Some people taking Zepbound may lose less weight than the trial participants, while others may lose more. 

Who’s eligible to take Zepbound?

Zepbound’s FDA labeling indicates that it’s approved for chronic weight management in adults who meet certain BMI criteria. It should be used in addition to a reduced-calorie diet and increased physical activity for weight management. The CDC recommends 150 minutes of moderate-intensity physical activity per week. That’s a 30-minute workout 5 days a week.

Zepbound doses for weight loss and how to use it

Zepbound doses for weight loss vary, but it’s always given as a once-weekly injection. Zepbound’s available in 6 strengths — 2.5, 5, 7.5, 10, 12.5, and 15 milligrams. 

Treatment starts at the lowest dose, then increases every 4 weeks until you reach the maximum dose you can tolerate, which is your maintenance dose. The typical maintenance dose is 12.5 or 15 milligrams.  

Sticking to this titration schedule helps your body adjust to the medication, which can prevent or lessen side effects. Dose titration should be done under the guidance of a healthcare professional. The typical tirzepatide dosing schedule is shown in the chart below. 

If you don’t tolerate tirzepatide well, your healthcare provider may increase your dose more slowly, such as every 8 weeks. They may also have you step back to a smaller maintenance dose if you don’t tolerate a higher dose. For example, if you don’t tolerate 15 milligrams of tirzepatide, your provider may step you back to 12.5 milligrams as your maintenance dose.

Zepbound is a once-weekly subcutaneous injection that goes just beneath your skin, but not deep enough to reach your muscle.  It’s injected into the abdomen, outer thigh, or back of the arm. It’s important to rotate injection sites to avoid damaging the skin in one area of your body. Always wash your hands and clean the site with an alcohol swab before giving yourself the injection to avoid contamination or infection.

Zepbound is a single-dose pen, regardless of the strength. That means each pen can be discarded after one use. Don’t reuse Zepbound pens. Keep in mind that Zepbound pens have a built-in needle. Be sure to dispose of the pen safely using a sharps container.

Zepbound also comes in single-dose vials. If you use this form of Zepbound, you’ll also need syringes and needles. They’re dispensed or sold separately. Be sure to use each syringe and needle only one time, and dispose of them safely after use.

Side effects of Zepbound for weight loss

Like any medication, Zepbound has potential side effects. Common side effects with Zepbound use include:

• Nausea
• Diarrhea
• Vomiting
• Constipation
• Stomach pain 
• Indigestion
• Injection site reaction
• Feeling tired
• Belching
• Hair loss
• Heartburn

Zepbound side effects are more common when you begin treatment and after you increase your dose. They usually subside as your body adjusts to the medication. Follow the prescribed dosing schedule to minimize the risk of tirzepatide side effects. If side effects persist, consider diet or other lifestyle changes to help manage them and talk to your healthcare provider. 

Rare but serious side effects of Zepbound may include kidney injury, acute gallbladder disease, changes in heart rate, low blood sugar (if taken with insulin or certain diabetes medications), allergic reaction, and low mood or suicidal thoughts or behaviors.

If you have any of these side effects or associated symptoms, contact your healthcare provider or call 911 immediately. If you have low blood sugar, consume something like glucose tablets or fruit juice  before contacting your provider or 911.

Contraindications, precautions, and boxed warnings for Zepbound for weight loss

Zepbound carries a boxed warning because it may increase the risk of certain thyroid tumors and cancer. A boxed warning is the FDA’s strongest safety warning. Zepbound was shown to cause thyroid tumors in animal studies. Don’t use Zepbound if you or a family member have a history of thyroid tumors or cancer. 

There are other precautions to consider before taking Zepbound. It may not be right for you if you have gastrointestinal (GI) disease, such as severe gastroparesis (slowed stomach emptying). Other precautions include kidney problems, gallbladder disease, pancreatitis, and severe or uncontrolled hypoglycemia. 

Zepbound isn’t recommended for people with diabetic retinopathy, certain eye disorders, or suicidal thoughts or behavior. You shouldn’t take Zepbound if you’ve had an allergic reaction to tirzepatide or GLP-1 agonist medications.

Your healthcare provider can help determine if Zepbound is a safe option for you. If you don’t have a healthcare provider, you can find a provider on marketplace services like Klarity.

Where to find Zepbound

Zepbound is a prescription medication that you get from a pharmacy. Weight loss medications have been growing in popularity, creating a national shortage. Currently the FDA lists tirzepatide on their national drug shortages list. Zepbound’s availability may be impacted by this as manufacturers find it challenging to keep up with demand. The drug manufacturer, Eli Lilly, is actively working to increase production and supplies.

Some pharmacies are compounding tirzepatide injections. Compounded medications are pharmaceutical preparations custom-made by licensed pharmacies based on a prescription from a healthcare provider. Licensed pharmacies can offer compounded versions of medications for various reasons, such as a way to provide patients with medications that are currently in shortage or are no longer commercially available.

What does Zepbound cost?

While insurance coverage can vary from person to person, Zepbound can be purchased out-of-pocket without insurance coverage. Zepbound doses for weight loss vary, but the price is pretty consistent. Retail prices for Zepbound are around $1,126 for a 1-month supply.

So, will insurance cover Zepbound for weight loss? It depends. Verify your plan details to see if Zepbound’s covered by insurance in your case.

Sometimes prescription medications require a prior authorization for Zepbound to be covered.  This is a process insurance companies use to determine if they’ll cover a medication. The process typically requires your healthcare provider to submit documentation showing why the medication is medically necessary for you. Coverage decisions may depend on your health history and other factors.

You may be eligible for savings with the Zepbound Savings Card. Also check websites like GoodRx, SingleCareRx, Optum Perks, and drugs.com for coupons to lower your out-of-pocket cost for Zepbound.

Key takeaways

Zepbound (tirzepatide) is a prescription drug that’s effective for weight loss.  It’s proven to help people lose weight as part of a medical weight loss program that includes diet and exercise. Data shows that patients maintain weight loss for as long as they take Zepbound. 

There is a national shortage of Zepbound due to its popularity and surging demand. It’s particularly difficult to find the lower doses of Zepbound in stock at pharmacies in the U.S. The drug’s manufacturer, Eli Lilly, is actively working to boost production, so keep checking back if your pharmacy was out. 

Common Zepbound side effects include stomach upset, nausea, vomiting, indigestion, diarrhea and constipation. To help lessen side effects, under the guidance of your healthcare provider, increase your dose every 4 weeks until you reach a target dose.

Zepbound’s out-of-pocket cost is more than $1,000 per month without insurance. Some insurance plans may cover the medication with a prior authorization. Your healthcare provider can help you navigate this process. To save on your prescription, you may be eligible to get Zepbound for $25 with the Zepbound Savings Card program or other discounts and coupons.

Talk with a healthcare provider to see if you’re a candidate for Zepbound or another prescription weight loss drug.

Make an appointment to talk to a provider about Zepbound today.

Klarity can connect you with a licensed healthcare provider who specializes in weight loss. Meet with your provider online from the comfort of your own home to discuss the possibility of getting a Zepbound prescription. Find a provider on Klarity to start your weight loss journey today.

Sources

Centers for Disease Control and Prevention, Adult Obesity Facts, May 2022, https://www.cdc.gov/obesity/data/adult.html.

Centers for Disease Control and Prevention, Physical Activity, Mar. 2023, https://www.cdc.gov/physicalactivity/basics/adults/index.htm

DailyMed. Zepbound-tirzepatide injection solution, Nov. 2023, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b

Diabetes, The Role of GIP in the Regulation of GLP-1 Satiety and Nausea, Matthew Hayes, Jun. 2021, https://diabetesjournals.org/diabetes/article/70/9/1956/137765/The-Role-of-GIP-in-the-Regulation-of-GLP-1-Satiety

Drugs.com, Zepbound Prices, Coupons and Patient Assistance Programs, Apr. 2024, https://www.drugs.com/price-guide/Zepbound

Eli Lilly Investors, FDA Approves Lilly’s Zepbound™ (tirzepatide) for Chronic Weight Management, a Powerful New Option for the Treatment of Obesity or Overweight with Weight-Related Medical Problems, Nov. 2023, https://investor.lilly.com/news-releases/news-release-details/fda-approves-lillys-Zepboundtm-tirzepatide-chronic-weight

Eli Lilly, Zepbound, 2024, https://Zepbound.lilly.com/how-to-use

JAMA, Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity, The SURMOUNT-4 Randomized Clinical Trial, Louis Aronne et al, Dec. 2023, https://jamanetwork.com/journals/jama/fullarticle/2812936

Lancet, Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. Timothy Garvey et al, Aug. 2023, https://pubmed.ncbi.nlm.nih.gov/37385275/

National Institute of Diabetes and Digestive and Kidney Diseases, Overweight & Obesity Statistics, Sept. 2021, https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity

Nature Medicine, Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-3 phase 3 trial, Thomas Wadden et al, Sept. 2023, https://www.nature.com/articles/s41591-023-02597-w

StatPearls, Glucagon-Like Peptide-1 Receptor Agonists, Logan Collins & Ryan A. Costello, Jan. 2023, https://www.ncbi.nlm.nih.gov/books/NBK551568/

StatPearls, Tirzepatide, Khashayar Farzam & Preeti Patel, Jul. 2023, https://www.ncbi.nlm.nih.gov/books/NBK585056/

U.S. Food and Drug Administration, FDA Approves New Medication for Chronic Weight Management, Nov. 2023, https://www.fda.gov/news-events/press-announcements/fda-approves-new-medication-chronic-weight-management

U.S. Food and Drug Administration, FDA Drug Shortages, Apr. 2024, https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Tirzepatide%20Injection&st=c&tab=tabs-1

The information provided in this article is for educational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health.

How we reviewed this article: This article goes through rigorous fact-checking by a team of medical reviewers. Reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the author.