MON-725 - Real-World Evidence of Efficacy of Low-Dose Tirzepatide on Weight Loss and Metabolic Parameters in Obese Adults with and without Diabetes: A Retrospective Study from Central India.

Background
Tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, has shown substantial weight-loss and metabolic benefits in randomized clinical trials. However, higher doses are frequently associated with gastrointestinal adverse effects that may compromise adherence and quality of life. There is limited real-world evidence evaluating the efficacy of minimum therapeutic dosing (2.5 mg once weekly), particularly across both diabetic and non-diabetic obese populations. This study aimed to assess the effectiveness and metabolic impact of low dose tirzepatide in routine clinical practice.
Methods
This retrospective observational study was conducted at a tertiary care centre in central India. Adult patients with obesity, with or without type 2 diabetes mellitus, who were initiated on tirzepatide 2.5 mg weekly were included. Baseline and 3-month follow-up data were collected for anthropometric parameters (body weight, body mass index [BMI], waist circumference [WC]) and metabolic variables including fasting plasma glucose, glycated haemoglobin (HbA1c), lipid profile, and organ function tests. Exclusion criteria included prior use of injectable anti-obesity or GLP-1 receptor agonist therapies, history of bariatric surgery, type 1 diabetes, secondary causes of obesity, severe renal or hepatic dysfunction, pregnancy, or lactation. Primary outcomes were changes in weight, BMI, and WC. Secondary outcomes included changes in glycemic and lipid parameters. Statistical analysis was performed using paired and unpaired t-tests, with significance set at p< 0.05.
Results
Data from 47 patients were analysed (mean age 46.0 years; 17 males, 30 females). Of these, 68.1% had type 2 diabetes and 31.9% were non-diabetic. Significant weight reduction was observed at 3 months in both diabetic (103.3±12.6 kg to 96.9±11.8 kg; p< 0.0001) and non-diabetic individuals (103.4±10.9 kg to 97.0±10.3 kg; p< 0.0001). BMI decreased significantly from 39.4±5.2 to 36.9±4.9 kg/m² (p < 0.0001), and WC from 115.2±9.4 to 111.3±8.7 cm (p < 0.0001). Metabolic improvements included significant reductions in total cholesterol (−25.5 mg/dL) and triglycerides (−47.0 mg/dL; both p< 0.0001). Fasting plasma glucose declined by 26.5 mg/dL (p=0.0033), and HbA1c decreased from 7.2% to 6.3% (p < 0.0001).
Conclusion
In real-world clinical practice, minimum-dose tirzepatide (2.5 mg weekly) produces significant weight loss and meaningful metabolic improvements in obese individuals, irrespective of diabetes status. These findings support low dose tirzepatide as an effective, tolerable, and pragmatic strategy for obesity and metabolic risk management.

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