Tirzepatide Persistence and Associated Changes in Clinical Outcomes in US Adults With Obesity or Overweight: A 6-Month Claims Database Analysis

In this 6-month claims analysis of US adults with obesity or overweight, 55% were adherent to tirzepatide and 68% remained persistent on therapy. Among persistent users with available measurements, average weight loss was 10.5% (12.0% in GLP-1 naive users), alongside numerical reductions in most cardiometabolic risk factors.

Journal article — Retrospective observational claims database analysis. Population: US commercially insured adults with obesity or overweight without type 2 diabetes who initiated tirzepatide. Sample size: 22 512 individuals. Follow-up: 6 months. Interventions: Tirzepatide.

Of 22 512 adults who initiated tirzepatide, 55% (n = 12 292) were adherent (PDC ≥ 80%) and 68% (n = 15 208) were persistent over 6 months. At baseline, 91% (n = 20 554) had at least one obesity-related complication. Among persistent individuals with pre- and post-index measurements (n = 808), mean weight reduction was 10.5%, with a 12.0% reduction in the GLP-1-naive subgroup. Most cardiometabolic risk factors showed numerical reductions.

This paper provides real-world benchmarks for adherence, persistence and short-term weight and cardiometabolic changes with tirzepatide in an obesity/overweight population without type 2 diabetes. It does not establish long-term effectiveness, safety, or comparative benefit versus other anti-obesity medications, and because it is observational it cannot prove causation.

Key findings

• 55% (n = 12 292) of tirzepatide initiators were adherent (PDC ≥ 80%) during 6-month follow-up.
• 68% (n = 15 208) of tirzepatide initiators were persistent during 6-month follow-up.
• 91% (n = 20 554) had at least one obesity-related complication at baseline.
• Persistent individuals with pre- and post-index measurements had a mean weight reduction of 10.5% (n = 808).
• The GLP-1 RA-naive subgroup achieved a 12.0% body weight reduction.
• Most cardiometabolic risk factors showed numerical reductions among persistent users.

Limitations

• Observational design without a control arm cannot establish causation.
• Only 808 of 22 512 initiators had available weight measurements, so effectiveness estimates may not generalize to all initiators.
• Claims data may contain coding or misclassification errors.
• Follow-up was limited to 6 months; longer-term persistence and outcomes are unknown.

The record

• Journal: Diabetes, obesity & metabolism
• Published: 2026-08-10
• PMID: 42575714 — DOI: 10.1111/dom.71064
• Funding: Eli Lilly and Company
• Author countries: USA

Peptide profiles: Tirzepatide.

All indexed evidence: Tirzepatide trials & papers.

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