SAT-680 - BMI Category Shifts following Tirzepatide Persistent Use among Adults with Overweight or Obesity without Diabetes

Background: Zepbound® (tirzepatide), approved for adults with obesity, has demonstrated efficacy in achieving clinically meaningful weight loss in the SURMOUNT clinical program. Understanding its real-world impact on BMI classes—including changes and shifts to lower BMI classes—is important. The study objectives were to evaluate BMI category and absolute BMI changes among GLP-1–naïve adults with obesity or overweight without diabetes, who persistently used tirzepatide in real-world clinical practice.

Methods: These retrospective, observational, descriptive analyses used data from the Komodo Research Dataset (KRD) multipayer database and the Healthcare Integrated Research Database (HIRD®) among commercially insured US enrollees. Individuals were included if they: were adults (age ≥18 years); had no evidence of diabetes; met eligibility criteria for obesity management medications (OMM) (BMI ≥30 kg/m2 or BMI ≥27 kg/m2 with ≥1 obesity-related complication [ORC]); had ≥1 prescription claim for tirzepatide (Zepbound®); had continuous enrollment for ≥12 months before and after tirzepatide initiation; were persistent on tirzepatide for ≥12 months (allowable gap ≤45 days); and with available BMI records at baseline (from 90 days before to 3 days after initiation) and at 365 (±30) days after tirzepatide initiation. Individuals with prior claims for another GLP-1 receptor agonist or other OMMs were excluded in this analysis. Key outcomes were shift to ≥1 lower BMI class, ≥2 lower BMI classes, attainment of BMI < 25 kg/m2, and BMI change.

Results: Overall, 2,572 OMM-eligible adults were identified in the KRD database and 430 in the HIRD database. Mean (SD) BMI was 35.3 (3.7) kg/m2 in KRD and 38.4 (6.9) kg/m2 in HIRD. The baseline BMI class distribution in KRD and HIRD, respectively, was: Class I, 36% and 28%; Class II, 39% and 30%; and Class III, 39% and 35%. Mean age (SD) was 49.1 (10.4) years in KRD and 49.0 (10.4) years in HIRD; in both databases, >70% of individuals were female, and more than 80% of individuals had ≥1 ORC. After 12 months of persistent tirzepatide use, BMI was reduced by a mean of 14.3% ( -5.0 kg/m2) (KRD) and 18.7% (-7.1 kg/m2) (HIRD) from baseline. During 12-month follow-up, 71.5% (KRD) and 84.2% (HIRD) shifted to ≥1 lower BMI class, 29.9% (KRD) and 34.9% (HIRD) shifted to ≥2 lower BMI classes and 12.4% (KRD) and 16.3% (HIRD) attained BMI < 25 kg/m2.

Conclusion: This study provides real-world evidence of BMI reduction among GLP-1–naïve OMM-eligible adults who received tirzepatide for obesity. Findings suggest tirzepatide may help patients move to lower BMI categories linked to reduced health risks.

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