Episode Details

#Mounjaro #Tirzepatide #GLP1 #WeightLoss #obesitymedicine 

Why do two people on the same Mounjaro dose get completely different results? In this video, I break down a study of more than 3,000 people with type 2 diabetes from the SURPASS 1–4 trials. It looked at who is most likely to lose 15% or more of their body weight on tirzepatide (Mounjaro / Zepbound), and why.

You'll learn the 7 factors that predicted the biggest weight loss. Several of them are things you can change, sometimes before your first injection. I also cover what newer research says about Ozempic and Wegovy, why real-world results are lower than trial results, and the 6-month check-in that tells you whether you're on track.

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TIMESTAMPS
0:00 Same drug, very different results
1:15 Mounjaro vs Zepbound vs Ozempic explained
2:19 What the SURPASS study measured
3:32 Factor 1: Sex
4:36 Factor 2: Age (and muscle loss)
6:32 Factor 3: Your starting blood sugar
8:36 Factor 4: Your cholesterol
9:32 GLP-1 Masterclass
10:12 Factor 5: Your other medications
11:41 Factor 6: Dose
12:34 Factor 7: Race and ethnicity
13:29 Surprise: starting weight didn't matter
13:58 Does this apply to Ozempic and Wegovy?
15:26 The limits of this research
16:36 7 steps to improve your odds
19:52 Free GLP-1 Diet Cookbook + what's next

REFERENCES

Małecki MT, Batterham RL, Sattar N, et al. Predictors of ≥15% weight reduction and associated changes in cardiometabolic risk factors with tirzepatide in adults with type 2 diabetes in SURPASS 1–4. Diabetes Care. 2023;46(12):2292-2299. doi:10.2337/dc23-1135
Aronne LJ, Horn DB, le Roux CW, et al. Tirzepatide as compared with semaglutide for the treatment of obesity (SURMOUNT-5). N Engl J Med. 2025;393(1):26-36.
Aronne LJ, Horn DB, Kokkinos AD, et al. Relationship of early rapid weight loss to efficacy and safety of tirzepatide and semaglutide for obesity: SURMOUNT-5 post hoc analysis. Am J Med. 2026;139(7):913-921. doi:10.1016/j.amjmed.2026.03.010
Powell W, Song X, Mohamed Y, et al. Medications and conditions associated with weight loss in patients prescribed semaglutide based on real-world data. Obesity (Silver Spring). 2023;31(10):2482-2492. doi:10.1002/oby.23859
Look M, Dunn JP, Kushner RF, et al. Body composition changes during weight reduction with tirzepatide in the SURMOUNT-1 study of adults with obesity or overweight. Diabetes Obes Metab. 2025;27(5):2720-2729.
Sattar N, Frühbeck G, Andreelli F, et al. Weight reduction with tirzepatide varied meaningfully by baseline HbA1c category in adults with overweight or obesity and type 2 diabetes in SURMOUNT-2. Diabetes Care. 2025;48(11):e136-e137. doi:10.2337/dc25-1442
Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.
UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131):837-853.
Rodriguez PJ, Goodwin Cartwright BM, Gratzl S, et al. Semaglutide vs tirzepatide for weight loss in adults with overweight or obesity. JAMA Intern Med. 2024.
Leidy HJ, Clifton PM, Astrup A, et al. The role of protein in weight loss and maintenance. Am J Clin Nutr. 2015;101(6):1320S-