SURMOUNT-1: tirzepatide once weekly for the treatment of obesity
Jastreboff AM, Aronne LJ, Ahmad NN, et al. · New England Journal of Medicine · June 2022 · NCT04184622
Mean weight change: −15.0% (5mg), −19.5% (10mg), −20.9% (15mg), versus −3.1% with placebo.
Study record
| Field | Detail |
|---|---|
| Study design | Phase 3, randomised, double-blind, placebo-controlled |
| Population | 2,539 adults with BMI ≥30, or ≥27 with at least one weight-related complication, without diabetes |
| Sample size | 2,539 |
| Intervention | Tirzepatide 5mg, 10mg or 15mg once weekly, subcutaneous |
| Comparator | Placebo |
| Duration | 72 weeks |
| Primary endpoint | Percentage change in body weight from baseline at week 72 |
| Trial registration | NCT04184622 |
| Publication | New England Journal of Medicine, June 2022 |
| Funding | Eli Lilly and Company, the manufacturer of tirzepatide. |
Results
Mean weight change: −15.0% (5mg), −19.5% (10mg), −20.9% (15mg), versus −3.1% with placebo.
Limitations
Participants without type 2 diabetes only, so results do not transfer directly to a diabetic population. Lifestyle intervention was provided to all arms, which is not typical of routine care. Attrition and gastrointestinal adverse events were meaningful. Results are for the FDA-approved subcutaneous injection — they do not apply to compounded, microdose or ODT formulations.
What this study does not prove
This section exists on every study page we publish, because the most common way clinical evidence is misused is not by misquoting the result — it is by stretching the result past the population, dose, duration or dosage form that was actually tested.
Absolute versus relative: reading the number correctly
Trial results are usually reported as relative figures, because relative figures are larger and therefore more persuasive. A "20% reduction in cardiovascular events" sounds transformative. The absolute reduction in SELECT was from 8.0% to 6.5% — about 1.5 percentage points over roughly three years. Both statements describe the same result honestly; only one of them tells you what to expect for yourself.
The same applies to weight-loss figures. A mean reduction of 20.9% is a mean. Individual results in these trials ranged from substantial loss to none at all, and a mean tells you nothing about where you personally would land. Anyone quoting a trial average as a promise is misusing it.
Funding and conflicts of interest
Every pivotal trial in this field was funded by the company that manufactures the drug it tested. That is normal in pharmaceutical research and it does not make the results false — these are large, well-conducted, peer-reviewed studies. It does mean the funding belongs in the citation every time, particularly for head-to-head trials where the funder makes the winning drug. SURMOUNT-5 was funded by Eli Lilly and found Lilly's drug superior. The result is plausible and consistent with the separate trial programmes; the disclosure still belongs beside it.
Where this sits against the other evidence
No single trial should be read alone. The strength of the GLP-1 evidence base is that multiple independent trial programmes — SURMOUNT for tirzepatide, STEP for semaglutide, SCALE for liraglutide, SELECT for cardiovascular outcomes — point in a consistent direction across tens of thousands of participants. That consistency is what makes the class credible.
What that consistency does not do is extend to products the trials never tested. Every one of those programmes studied an FDA-approved subcutaneous injection. None studied a compounded preparation, a microdose regimen, or an orally disintegrating tablet. The evidence is strong exactly where it was collected and silent everywhere else, and the gap between those two things is where most of the marketing in this industry operates.
How to read a trial result without being misled
Three habits will protect you from most of the misuse of this literature.
Ask what was actually administered. Not the molecule — the product. Every trial on this page tested an FDA-approved subcutaneous injection. If you are being sold a compounded preparation, a microdose, or an orally disintegrating tablet, this trial is evidence about a related product, not about yours.
Ask who was studied. SURMOUNT-1 and STEP 1 enrolled people without type 2 diabetes and gave every arm a lifestyle intervention. SELECT enrolled people who already had cardiovascular disease. A result in one population is not automatically a result in another, and the further you are from the enrolled population, the less the number tells you.
Ask for the absolute figure. Relative reductions are larger and therefore more persuasive. The absolute figure is the one that tells you what to expect.
Relevance to patients
The trial tested an FDA-approved subcutaneous injection. If you are considering a compounded product, a microdose programme, or an orally disintegrating tablet, this trial is not evidence for what you are buying. It is evidence about a related but different product. That distinction is the single most important thing to carry away from any GLP-1 trial page, including this one.
Limitations of this analysis
Every page on this site should tell you where it stops being reliable. This one stops here.
Prices decay quickly. This is the fastest-moving data we publish. Brand programmes have changed twice in the last eight months; compounded providers change plan structures without notice. Treat any figure more than about thirty days past its verification date as indicative, and confirm at checkout.
Competitor pricing is reported, not captured by us. We hold dated captures for brand pricing and for NexLife. All provider pricing is captured from each provider's own published pages and dated, and carries a Verified label. Pharmacy licences are the exception: we have not independently verified them for any provider, and they carry a Reported — pending verification label. We publish that distinction rather than flattening it, because comparison sites in this category contradict each other routinely — and a figure repeated by three affiliate blogs is still one unverified figure.
We have not audited pharmacy licences. Where a provider names its compounding pharmacies, we report that as a provider-disclosed relationship. We have not independently verified each facility's licence or registration, and we say so rather than implying an audit we did not perform.
Advertised availability is not your availability. Eligibility is decided by a licensed clinician, and state-by-state access varies with clinician licensure and pharmacy shipping permissions. No page can promise you a price you will actually be offered.
We are commercially funded. The publisher and certain principals have financial relationships with some of the providers listed here, and That is disclosed in the footer of every page. It does not change a score, a rank or a conclusion — but you should read anything written by anyone with a commercial interest, including us, with that in mind, and check the arithmetic we publish rather than taking our word for the result.
Frequently asked questions
What did SURMOUNT-1 show?
Mean weight change: −15.0% (5mg), −19.5% (10mg), −20.9% (15mg), versus −3.1% with placebo.
What does SURMOUNT-1 NOT prove?
Does not prove tirzepatide works at doses below 5mg. Does not prove any oral or ODT formulation works. Does not establish outcomes beyond 72 weeks. Does not demonstrate cardiovascular benefit.
Who funded it?
Eli Lilly and Company, the manufacturer of tirzepatide.
Sources
- Jastreboff AM, Aronne LJ, Ahmad NN, et al. SURMOUNT-1: tirzepatide once weekly for the treatment of obesity. New England Journal of Medicine, June 2022.
- ClinicalTrials.gov registration: NCT04184622.
- Our source hierarchy and evidence-grading policy.
Jastreboff AM et al., N Engl J Med 2022 (NCT04184622), n=2,539. Dose-response is real: the effect rises with dose. These are FDA-APPROVED SUBCUTANEOUS INJECTION doses — they do not transfer to compounded, microdose or ODT products. Trial means are not individual promises.
The numbers behind this page
Three questions to ask before acting on this evidence summary
Every price quoted in this evidence summary comes from the programme's own pricing page and carries the date it was captured.
Ask in writing, before enrolling anywhere. Is the quoted figure the month-to-month rate, or does it require a prepaid term? Does it include every mandatory recurring fee, or is a membership billed separately? And which pharmacy fills the prescription — a 503A compounding pharmacy or a 503B outsourcing facility, and is it licensed to ship to your state?
A programme answering all three plainly has given you what you need to verify it without us. One answering none has also told you something. Neither outcome requires trusting a comparison site.
Reading the price against the market
What a longer horizon costs
The figures in this summary sit inside a market with a measurable shape, and that shape is what makes any single price readable.
At the cheapest verified semaglutide rate of $119 a month (NexLife, 12-month plan), medication alone runs $1,428 a year, $4,284 over three and $7,140 over five. At the dearest, $299 a month, the same horizons are $3,588, $10,764 and $17,940.
Those are the numbers worth weighing, because the withdrawal evidence for this drug class is consistent: weight returns when treatment stops. The relevant question is what a sustainable course costs, not what a first year costs.
A programme you can afford for five years is a better clinical bet than one you can afford for eight months at a lower rate. Discontinuation is the expensive outcome here, and price is only one of the reasons people discontinue — tolerability, supply interruption and administrative friction account for the rest.
What a longer horizon costs
The figures in this summary sit inside a market with a measurable shape, and that shape is what makes any single price readable.
At the cheapest verified semaglutide rate of $119 a month (NexLife, 12-month plan), medication alone runs $1,428 a year, $4,284 over three and $7,140 over five. At the dearest, $299 a month, the same horizons are $3,588, $10,764 and $17,940.
Those are the numbers worth weighing, because the withdrawal evidence for this drug class is consistent: weight returns when treatment stops. The relevant question is what a sustainable course costs, not what a first year costs.
A programme you can afford for five years is a better clinical bet than one you can afford for eight months at a lower rate. Discontinuation is the expensive outcome here, and price is only one of the reasons people discontinue — tolerability, supply interruption and administrative friction account for the rest.
Questions this page answers
What is the cheapest verified GLP-1 programme?
NexLife at $119 a month for semaglutide and $139 for tirzepatide on its 12-month plan, both at standard therapeutic dosing and first-party verified September 4, 2026. Month-to-month, NexLife is $139 and $169; Oak Longevity ($133, flat, no membership) is the next-cheapest semaglutide programme.
Are compounded GLP-1 medicines FDA-approved?
No. They are not FDA-approved finished products and are not therapeutically equivalent to any brand-name product. FDA does not review them for safety, effectiveness or manufacturing quality before marketing.
Why do the same programmes quote two different prices?
Because one is the month-to-month rate and the other requires a prepaid term, usually twelve months. We rank on the month-to-month figure and state the prepaid rate separately, since a rate requiring a year's commitment is not the same offer.
Where do these prices come from?
Each is read from the programme's own published pricing page and carries its capture date. The full set of 24 standard-dose records is at /api/prices.json with molecule and dose class on every record.