Mounjaro, Zepbound Lowers Diabetes Risk By 94%, Eli Lilly Trial Shows

• In a new clinical trial, the GLP-1 drug tirzepatide was effective in helping people maintain weight loss over a 3-year period.
• Researchers reported the resulting weight loss also lowered participants’ risk of progressing from prediabetes to type 2 diabetes.
• Experts agree these medications are effective, but encourage a long-term commitment to weight loss through a healthy diet and regular exercise.

A new clinical trial presents more evidence showing the GLP-1 drug tirzepatide can help people lose weight over a long period of time as well as reduce their risk of developing type 2 diabetes.

Officials at Eli Lilly made that announcement while unveiling the latest results of their 3-year SURMOUNT 1 clinical trial.

Company officials reported that people in the study who received weekly injections of tirzepatide, which is sold under the brand names Mounjaro and Zepbound, reduced the risk of progression from prediabetes to type 2 diabetes by 94% when compared to study participants who were given a placebo.

They also said that tirzepatide treatments led to sustained weight loss during the 3-year period. They noted that study participants who stopped receiving tirzepatide after 176 weeks began to regain weight. These participants also had signs of progression to type 2 diabetes during a 17-week follow-up period.

The company plans to submit the clinical trial results to a medical journal and present the findings at the Obesity Week 2024 conference sessions in November.

“These data reinforce the potential clinical benefits of long-term therapy for people living with obesityand prediabetes,” said Jeff Emmick, MD, senior vice president of product development at Eli Lilly, in a
statement.

Tirzepatide led to long-term weight loss, lowered diabetes risk

In the clinical trial, researchers studied 1,032 adults who had prediabetes as well as obesity or other weight management issues.

The study was a multi-center, randomized, double-blind, parallel, placebo-controlled trial. Participants were put on a reduced-calorie diet and asked to follow a regular physical activity routine.

Participants who received trizepatide were given weekly injections of 5 milligrams (mg), 10mg, or 15mg. The other participants received a placebo. Results from the clinical trial results showed:

• Participants who received tirzepatide for the 176-week period had an overall reduction in risk of
  progression to type 2 diabetes of 94%.
• Those who were given the 15mg dose experienced a nearly 23% decrease in body weight compared to
  about 2% for people who were given a placebo.
• People who received the 10mg dose had an average weight loss of nearly 20%.
• Those on the 5mg dose experienced an average weight loss of about 15%.

Researchers reported that during the 17-week off-treatment follow-up period, the participants who stopped taking tirzepatide began to regain weight and saw their risk reduction to type 2 diabetes fall to 88% compared to the placebo group.

Weight management is a long-term commitment

Experts said the post-treatment data in Eli Lilly’s trial reinforces the notion that weight loss is a long-term commitment.

“The study showed that weight regain is common after stopping these medications,” said Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California. Ali is not affiliated with the study.

“Many doctors are starting to think of obesity as a long-term chronic condition such as diabetes or hypertension; therefore, long term treatment may be required to maintain the weight loss,” Ali told Healthline.

Robert Gabbay, MD, PhD, the chief scientific and medical officer at the American Diabetes Association, agreed with the need for long-term commitment. Gabbay is likewise not affiliated with the study.

“These medications, like most all medications, tend to only be effective when being used. Therefore, it’s not surprising that there is weight regain with cessation of therapy.  We have seen this in other studies with this class of drug,” Gabbay told Healthline.

“Overall, as the full results become available and published, this becomes another consideration for high-risk individuals with prediabetes to help bend the curve on the number of people developing diabetes,” he added.

Health risks of obesity

The Centers for Disease Control and Prevention (CDC) estimates that about 40% of U.S. adults have obesity.

Experts say the weight gain that results from obesity can cost a wide array of health issues, including:

• type 2 diabetes
• high blood pressure
• high cholesterol
• heart disease
• fatty liver disease
• certain cancers
• stroke

In addition, the CDC estimates that obesity accounts for more than $170 million in annual medical expenditures.

GLP-1 drugs successfully aid weight loss

The first GLP-1 drug that received approval from the Food and Drug Administration (FDA) was exenatide. It was given the greenlight in 2005 as a treatment for type 2 diabetes.

The first GLP-1 drug that was approved specifically for weight loss was Saxenda (liraglutide) in 2014.

Wegovy, a semaglutide drug, received FDA approval for weight loss in 2021. Since then, other GLP-1 drugs, including Ozempic as well as the medications containing tirzepatide, have been spotlighted for their ability to suppress appetite and help people lose weight.

In the past two years, there are have been numerous studies lauding the weight-loss benefits of GLP-1 drugs. In addition, researchers have reported that GLP-1 drugs can help:

• reduce the risk of some cancers
• reduce the risk of a heart attack
• curb addictive behaviors such as smoking and alcoholism
• reduce rheumatoid arthritis flare-ups

“The trial results will likely increase the number of people seeking these medications,” Ali said. “Surgical weight loss still has the best long-term results for those who qualify. These medications are currently the most effective alternative to surgery.”

What to know before taking weight-loss drugs

There are side effects to taking weight loss medications. The researchers noted that some participants in the SURMOUNT 1 trial developed gastrointestinal-related symptoms that were mild to moderate in severity.

Specific side effects of GLP-1 drugs may include:

• nausea and vomiting
• diarrhea
• constipation
• abdominal pain
• indigestion

The researchers also pointed out that Zepbound may cause tumors in the thyroid and potentially result in thyroid cancer.

They noted that people should consult with their healthcare provider before taking medications such as Zepbound. They added the people who take medications such as insulin to treat diabetes should monitor their blood sugar levels while taking Zepbound.

They also said that the effectiveness of birth control pills could be diminished while taking Zepbound.

“I advise patients starting these medications to use them as a tool to help change to a healthier diet and lifestyle,” Ali said. “Also, depending on the degree of obesity, the patient may require long-term treatment for
sustained results.”

Takeaway

The latest results from GLP-1 drugmaker Eli Lilly’s clinical trial show that tirzepatide helped people maintain weight loss after 3 years. This resulting weight loss also helped significantly lower participants’ risk of developing type 2 diabetes.

Experts agree GLP-1 medications are effective, and encourage people need to make a long-term commitment to weight loss by following a healthy diet and exercising regularly.