Tirzepatide Reduces Appetite, Energy Intake, and Fat Mass in People With Type 2 Diabetes
Open accessAbstract
OBJECTIVE: To evaluate the effects of tirzepatide on body composition, appetite, and energy intake to address the potential mechanisms involved in body weight loss with tirzepatide. RESEARCH DESIGN AND METHODS: In a secondary analysis of a randomized, double-blind, parallel-arm study, the effects of tirzepatide 15 mg (N = 45), semaglutide 1 mg (N = 44), and placebo (N = 28) on body weight and composition, appetite, and energy intake were assessed at baseline and week 28. RESULTS: Tirzepatide treatment demonstrated significant reductions in body weight compared with placebo and semaglutide, resulting in greater fat mass reduction. Tirzepatide and semaglutide significantly reduced appetite versus placebo. Appetite scores and energy intake reductions did not differ between tirzepatide and semaglutide. CONCLUSIONS: Differences in energy intake during ad libitum lunch were not sufficient to explain the different weight outcomes. Further evaluation is needed to assess mechanistic differences related to tirzepatide actions on 24-h energy intake, substrate utilization, and energy expenditure.
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GLP-1s reduce energy intake by 16%-39% compared with placebo, related to changes in cravings, hunger, and fullness.
“GLP‐1s reduce energy intake by 16%–39% compared with placebo, related to changes in cravings, hunger, and fullness [56, 147, 148].”
From Nutritional priorities to support <scp>GLP</scp> ‐1 therapy for obesity: A joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society (2025) · cites this paper as [148]
The Results sections on energy intake and fasting appetite report lower lunch energy intake versus placebo and changes in hunger and fullness with tirzepatide and semaglutide. They do not give a 16%–39% reduction or measure cravings, and the study's energy-intake assessment was limited to lunch rather than total daily intake. (LLM, conf=0.88)
Experimental — accuracy not yet measuredTirzepatide is a single molecule that combines glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonism, resulting in synergistic effects on appetite, food intake, and metabolic function.
“Tirzepatide is a single molecule that combines glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonism13 resulting in synergistic effects on appetite, food intake, and metabolic function.14,15,16”
From Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial (2024) · cites this paper as [16]
The Introduction identifies tirzepatide as a GIP and GLP-1 receptor agonist, and the Abstract Results report reduced appetite, energy intake, and fat mass in people with type 2 diabetes. The paper does not establish that the two receptor actions are synergistic: the Conclusions say their mechanistic contribution needs further study, while appetite and energy-intake reductions did not differ from semaglutide. (LLM, conf=0.89)
Experimental — accuracy not yet measuredWith tirzepatide 15 mg, 70.6% of participants achieved ≥15% weight reduction and 56.7% achieved ≥20% weight reduction at 72 weeks.
“With the 15 mg dose, 70.6% of participants achieved ≥15% weight reduction, and 56.7% of participants achieved ≥20% weight reduction at 72 weeks [25].”
From Nutritional considerations with antiobesity medications (2024) · cites this paper as [25]
The Results (Body Weight Assessment; page unavailable) report weight reduction with tirzepatide 15 mg at week 28. The study does not report outcomes at 72 weeks or the claimed proportions achieving ≥15% and ≥20% weight reduction, so those figures are not supported by this source. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIn SURMOUNT-1, mean change in body weight was -15.0% (5 mg), -19.5% (10 mg), and -20.9% (15 mg) with tirzepatide versus -3.1% with placebo at 72 weeks.
“In the SURMOUNT-1 randomized controlled trial (NCT04184622) of tirzepatide for obesity, mean change in body weight was À15.0% (5 mg), À19.5% (10 mg), and À20.9% (15 mg) in tirzepatide-treated patients relative to À3.1% in placebo-treated control individuals at 72 weeks of treatment.”
From Nutritional considerations with antiobesity medications (2024) · cites this paper as [25]
The Results > Body Weight Assessment section reports greater weight loss with tirzepatide than with placebo, but in a different study measured at 28 weeks. It does not report SURMOUNT-1 results, the 72-week endpoint, or the claimed dose-specific percentages. (LLM, conf=0.87)
Experimental — accuracy not yet measuredA study comparing semaglutide 1 mg and tirzepatide with placebo in patients with type 2 diabetes showed lean mass reductions of approximately 15% or less of total weight loss across all groups.
“a study comparing semaglutide 1 mg and tirzepatide with placebo in patients with type 2 diabetes showed lean mass reductions of approximately 15% or less of total weight loss across all groups.36”
From Changes in lean body mass with <scp>glucagon‐like peptide</scp> ‐1‐based therapies and mitigation strategies (2024) · cites this paper as [36]
The Study Design and Participants section identifies the three groups, and Results > Body Composition Assessment reports fat-free-mass reductions with tirzepatide and semaglutide. It does not report that lean mass was approximately 15% or less of total weight loss across all groups; the Results instead say fat-free mass did not significantly decrease with placebo, which had approximately no weight loss at week 28. (LLM, conf=0.85)
Experimental — accuracy not yet measured
A significant reduction in appetite and food intake was observed with tirzepatide compared to placebo in people with T2D.
“A significant reduction in appetite and food intake was also observed with tirzepatide compared to placebo in people with T2D [45].”
From What is the pipeline for future medications for obesity? (2025) · cites this paper as [45]
Other studies show lean mass reductions of approximately 15% or less of total weight lost.
“while other studies show lean mass reductions of approximately 15% or less of total weight lost”
From Changes in lean body mass with <scp>glucagon‐like peptide</scp> ‐1‐based therapies and mitigation strategies (2024) · cites this paper as [36]
In registration trials, most gastrointestinal events were mild or moderate and generally transient, infrequently leading to treatment discontinuation.
“In registration trials, most events were mild or moderate and generally transient, infrequently leading to treatment discontinuation [22,25].”
From Nutritional considerations with antiobesity medications (2024) · cites this paper as [25]
The Study Design and Participants section says this paper reports secondary assessments of body composition, appetite, and energy intake, while the study’s safety results were published separately. Our copy does not report whether gastrointestinal events were mild or moderate, transient, or infrequently led to discontinuation (searched: gastrointestinal adverse events, severity, and discontinuation). (LLM, conf=0.75)
Experimental — accuracy not yet measuredImprovements in cardiometabolic risk factors including waist circumference, systolic blood pressure, triglycerides, HDL and non-HDL cholesterol, and fasting insulin, and patient-reported physical function were demonstrated with tirzepatide treatment.
“Improvements in cardiometabolic risk factors, including waist circumference, systolic blood pressure, triglycerides, high-density lipoprotein and non-high-density lipoprotein cholesterol, and fasting insulin, and patient-reported physical function were also demonstrated with tirzepatide treatment [25].”
From Nutritional considerations with antiobesity medications (2024) · cites this paper as [25]
Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredThe most common adverse events associated with semaglutide and tirzepatide treatment include gastrointestinal events such as nausea, diarrhea, and constipation.
“The most common adverse events associated with semaglutide and tirzepatide treatment include gastrointestinal events such as nausea, diarrhea, and constipation [22,25].”
From Nutritional considerations with antiobesity medications (2024) · cites this paper as [25]
The Study Design and Participants section says the study’s safety results were published elsewhere. Our copy reports body composition, appetite, and energy intake, but the searches for adverse events, nausea, diarrhea, and constipation found no passage establishing which events were most common with either treatment. (LLM, conf=0.76)
Experimental — accuracy not yet measuredTherapy with AOMs that activate the GLP-1 receptor (such as liraglutide, semaglutide, and tirzepatide) is associated with an increased risk of gastrointestinal adverse events, including nausea, vomiting, diarrhea, dyspepsia, and constipation.
“Therapy with AOMs that activate the GLP-1 receptor (such as liraglutide, semaglutide, and tirzepatide) is associated with an increased risk of gastrointestinal adverse events, including nausea, vomiting, diarrhea, dyspepsia, and constipation.”
From Nutritional considerations with antiobesity medications (2024) · cites this paper as [25]
The Study Design and Participants section says the study’s safety results were published separately. This paper reports appetite, energy intake, and body composition, but the passages found when searching for gastrointestinal adverse events and the named symptoms do not address the claimed increased risk. (LLM, conf=0.75)
Experimental — accuracy not yet measuredMost gastrointestinal adverse events with GLP-1 receptor-activating AOMs are mild or moderate, dose-dependent, and transient.
“Most of these events are mild or moderate, dose-dependent, and transient in nature [22,25].”
From Nutritional considerations with antiobesity medications (2024) · cites this paper as [25]
The Study Design and Participants section says this paper reports secondary assessments of body composition, appetite, and energy intake, while safety results were published separately. A search of our copy for gastrointestinal adverse events, their severity, dose dependence, and duration found no passage addressing the claim. (LLM, conf=0.76)
Experimental — accuracy not yet measuredA study evaluating semaglutide and tirzepatide demonstrated weight loss is predominantly driven by fat mass loss, but a small portion (1.4%, 2.6% respectively) due to loss of fat-free mass, primarily muscle.
“A study evaluating the effects of semaglutide and tirzepatide on energy intake and body composition, demonstrated weight loss is predominantly driven by fat mass loss, but a small portion (1.4 %, 2.6 % respectively) due to loss of fat-free mass, primarily muscle [25,30,32].”
From Nutritional deficiencies and muscle loss in adults with type 2 diabetes using GLP-1 receptor agonists: A retrospective observational study (2025) · cites this paper as [32]
GLP-1s reduce energy intake by 16-39 % compared to placebo.
“GLP-1s reduce energy intake by 16–39 % compared to placebo, related to changes in cravings, hunger, and fullness [52,138,139].”
Semaglutide and tirzepatide reduce energy intake by markedly enhancing satiation and decreasing hunger.
“Both medications reduce energy intake by markedly enhancing satiation and decreasing hunger, and they appear to lessen the need for traditional cognitive and behavioral strategies (e.g., monitoring food intake) to achieve calorie restriction.”
From The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities (2023) · cites this paper as [45]
The reduction in energy intake with tirzepatide did not differ significantly from that in participants who received semaglutide 1 mg (reduction of 284 kcal).
“The reduction in energy intake with tirzepatide did not differ significantly from that in participants who received semaglutide 1 mg (with a reduction of 284 kcal).”
From The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities (2023) · cites this paper as [45]
In adults with type 2 diabetes, tirzepatide 15 mg once weekly reduced energy intake from baseline to week 28 by 348 kcal compared to 39 kcal for placebo.
“In adults with type 2 diabetes, tirzepatide 15 mg once weekly reduced energy intake, during an ad libitum lunch, from baseline to week 28, by 348 kcal compared to 39 kcal for placebo [45].”
From The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities (2023) · cites this paper as [45]
Tirzepatide was associated with significant improvements in self-reported appetite control compared with placebo.
“Tirzepatide was associated with significant improvements in self-reported appetite control compared with placebo [45].”
From The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities (2023) · cites this paper as [45]
New-generation AOMs reduce patients' responsiveness-or vulnerability-to the toxic food environment.
“By consistently reducing hunger (which initiates eating), increasing satiation and satiety (which terminate meal intake and extend the inter-meal interval, respectively), and potentially decreasing hedonic eating [45–47], the authors view the new-generation AOMs as reducing patients’ responsiveness—or vulnerability—to the toxic food environment.”
From The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities (2023) · cites this paper as [45]
Data from ad libitum buffet lunch meals provide further evidence of the medications' efficacy in reducing energy intake.
“Data from the ad libitum buffet lunch meals, described earlier, provide further evidence of the medications’ efficacy in reducing energy intake [43, 45].”
From The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities (2023) · cites this paper as [45]
GLP-1s reduce energy intake by 16%-39% compared with placebo, related to changes in cravings, hunger, and fullness.
“GLP-1s reduce energy intake by 16%–39% compared with placebo, related to changes in cravings, hunger, and fullness [56,147,148].”
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- Authors
- Heise, T., DeVries, J. H., Urva, S., Li, J., Pratt, E. J., Thomas, M. K., Mather, K. J., Karanikas, C. A., Dunn, J., Haupt, A., Milicevic, Z., & Coskun, T.
- Affiliations
- 1Profil, Neuss, Germany
- Eli Lilly (United States) (US)
- 2Eli Lilly and Company, Indianapolis, IN
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2023-03-01
- Volume
- 46
- Issue
- 5
- Pages
- 998-1004
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC10154650
- OpenAlex
- W4322726790
- Cited by
- 208
- References
- 9
- Citations by year
- 2026: 50 · 2025: 79 · 2024: 58 · 2023: 20 · 2022: 1
- FWCI
- 42.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (acceptedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Keywords
- tirzepatide, type 2 diabetes, appetite, energy intake, fat mass, weight loss, body composition, semaglutide, GLP-1 receptor agonists, weight loss mechanisms
- MeSH terms
- Tirzepatide, Appetite, Body Weight, Energy Intake, Diabetes Mellitus, Type 2, Double-Blind Method, Humans, Obesity
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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