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Tirzepatide response record: weight milestones and the checks that go with them
Track your own response every 4 weeks against the milestones the SURMOUNT trials reported, alongside protein, strength training and side effects. Fast loss brings its own checks, so the sheet keeps the gallbladder and pancreas warning signs and the questions to raise before deciding to stop.
Starting point
Start date and starting dose
Starting weight, height and BMI
Waist circumference
Type 2 diabetes?yes / no; latest HbA1c
Thyroid test (TSH) if checked, and date
Any history of gallstones or pancreatitis
Every 4 weeks
Work out the percent lost as (starting weight minus today's weight) divided by starting weight, times 100.
| Week | Dose | Weight | % lost since start | Waist | Protein on most days (g) | Strength sessions a week | Days with nausea | Notes |
|---|---|---|---|---|---|---|---|---|
What the SURMOUNT trials and the label report
- SURMOUNT-1, no diabetes, week 72: 85% to 91% on tirzepatide lost 5% or more, against 35% on placebo.[1]
- SURMOUNT-1: 50% on 10 mg and 57% on 15 mg lost 20% or more, against 3% on placebo.[1]
- Losing less than 5% by week 8 did not mean no response: in SURMOUNT-1 those participants averaged a 14.6% loss at week 72.[2]
- SURMOUNT-2, type 2 diabetes: 79% to 83% on tirzepatide lost 5% or more, against 32% on placebo.[3]
- SURMOUNT-1: side effects led 4.3% to 7.1% on tirzepatide to stop, against 2.6% on placebo.[1]
- Zepbound weight trials: gallstones in 1.1% on tirzepatide against 1% on placebo; gallbladder inflammation in 0.7% against 0.2%.[4]
- Hair loss on tirzepatide was associated with weight reduction.[4]
Call your prescriber right away
- Pain in the upper stomach with fever, yellowing of the skin or eyes, or clay-colored stools (possible gallbladder problem).[5]
- Severe stomach pain that will not go away, with or without nausea or vomiting (possible pancreatitis).[4]
Questions for the prescriber
- Is my rate of loss safe for my muscle and bones, or should we slow down?
- Would a body-composition or bone-density scan be useful for me?
- Is the dose I am on now the one to stay on long term?
- If I want to stop, what is the plan for keeping the weight off?
- Are my thyroid, glucose or hormone results affecting my response?
Sources for the facts on this sheet
- Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med 2022. PMID 35658024. https://pubmed.ncbi.nlm.nih.gov/35658024/
- Kokkinos A, Thethi T, Lee CJ, et al. Tirzepatide Efficacy and Tolerability According to Early Weight Response: A Post Hoc Analysis of the SURMOUNT-1 and SURMOUNT-2 Trials. Diabetes Obes Metab 2026. PMID 42348366. https://pubmed.ncbi.nlm.nih.gov/42348366/
- Garvey WT, Frias JP, Jastreboff AM, et al. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet 2023. PMID 37385275. https://pubmed.ncbi.nlm.nih.gov/37385275/
- Eli Lilly and Company, via DailyMed. Zepbound (tirzepatide) injection, for subcutaneous use: prescribing information and Medication Guide. Effective 2026-08-28. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b
- Eli Lilly and Company, via DailyMed. Mounjaro (tirzepatide) injection, for subcutaneous use: prescribing information and Medication Guide. Effective 2026-08-27. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2d7da5d-ad07-4228-955f-cf7e355c8cc0
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.