Cited by 208Diabetes Treatment and ManagementPharmacology and Obesity TreatmentRegulation of Appetite and Obesity

Tirzepatide Reduces Appetite, Energy Intake, and Fat Mass in People With Type 2 Diabetes

Open access
Heise, Tim, DeVries, J. Hans, Urva, Shweta, Li, Jing, Pratt, Edward J., Thomas, Melissa K., Mather, Kieren J., Karanikas, Chrisanthi A. +4 more·2023·Diabetes Care

Abstract

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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Crossref · 10.2337/dc22-1710

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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 measured
  • Tirzepatide 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 measured
  • With 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 measured
  • In 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 measured
  • 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.

    “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

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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
Venue
Diabetes Care
Published
2023-03-01
Volume
46
Issue
5
Pages
998-1004
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
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
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

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