The short answer
In SURMOUNT-4, people switched to placebo regained weight on average, while those continuing tirzepatide lost more. Maintenance was a separate challenge.
A trial in two stages
First, 783 adults without diabetes entered a 36-week tirzepatide phase. The 670 who reached randomization had lost an average of 20.9% of their starting weight. They then continued tirzepatide or switched to placebo for 52 weeks.
From that second starting point, average weight changed by −5.5% with continued treatment and +14.0% after switching. These percentages use weight at randomization, not the original starting weight.
Percent of weight at randomization
Original chart based on the study. Values are reported group averages.
| Group or measure | Average result |
|---|---|
| Continued tirzepatide | −5.5% |
| Switched to placebo | +14.0% |
The takeaway
By week 88, average weight remained below the original baseline in both groups: 25.3% lower with continued tirzepatide and 9.9% lower with placebo.
This selected group had already completed the initial treatment phase; it does not represent everyone who starts. Digestive adverse events were more common with continued tirzepatide. The trial does not tell us which alternative maintenance plan would work best.
Sources
Aronne and colleagues, JAMA, 2024. Sponsored by Eli Lilly. Study abstract · Paper.