Short answer
Yes, on the evidence so far. In a 2025 post hoc analysis of the SURMOUNT-1 trial, women on tirzepatide lost 26% of their body weight before menopause, 23% in perimenopause and 23% after menopause. The FDA label says no overall differences in effectiveness were seen between patients 65 and older and younger adults. Individual results vary.
What the menopause analysis found
The analysis, published in the journal Obesity in May 2025, took women from the SURMOUNT-1, -3 and -4 trials and sorted them into premenopause, perimenopause and postmenopause groups. In SURMOUNT-1, women on tirzepatide (15 mg or the maximum tolerated dose) lost 26%, 23% and 23% of their body weight in those three groups. Women on placebo lost 2% to 3%. Waist size fell by 22, 20 and 20 cm on tirzepatide. Across the three groups, 97% to 98% of women on the drug lost at least 5% of their weight. The authors report similar results in SURMOUNT-3 and -4.
What the label says about age
The Zepbound label, revised in August 2026, describes SURMOUNT-1 as a 72-week trial of 2,539 adults. Their mean age was 45, and they ranged from 18 to 84. In the two fixed-dose weight trials, 226 people on Zepbound (9%) were 65 or older and 13 (0.5%) were 75 or older.
The label’s geriatric section states that no overall differences in safety or effectiveness were observed between patients 65 and older and younger adults. It also says the sleep apnea studies did not include enough people 65 or older to tell whether they respond differently.
What happened outside the trials
A Mayo Clinic study published in Obesity in 2026 looked back at 1,039 adults who stayed on tirzepatide for at least 12 months. Their mean age was 56. At 15 months, people 45 or younger had lost 15.1% of their weight and people 60 or older had lost 12.3%. In the analysis that accounted for other factors, age was not an independent predictor. Female sex, no type 2 diabetes, no earlier obesity medication, no weight gain-promoting medications and a higher tirzepatide dose were each linked to greater loss.
The limits
The menopause analysis was post hoc, and women were assigned to a reproductive stage retrospectively. It covered women without type 2 diabetes. Most of its authors are employees and shareholders of Eli Lilly, which makes Zepbound. The Mayo study was retrospective and included only people who stayed on the drug for a year.
We could not open a published SURMOUNT-1 breakdown by age band, so this page does not quote one. None of these sources tested whether hormone therapy changes the result. Whether Zepbound is right for you is a decision for your prescriber.
Related questions
Were people over 65 in the Zepbound trials?
Yes, but not many. In the two fixed-dose weight trials, 9% of people on Zepbound were 65 or older and 0.5% were 75 or older.
Does age change how much of the weight lost is fat?
In a SURMOUNT-1 substudy of 160 people, about 75% of the weight lost was fat mass and 25% was lean mass. The authors report those proportions stayed consistent across most subgroups, which included age groups under 50, 50 to 64, and 65 and older.
Read next
Sources
- Obesity: Body weight reduction in women treated with tirzepatide by reproductive stage, Tchang (2025)
- Eli Lilly: Zepbound prescribing information (revised 08/2026)
- Obesity: Sex, Not Age, Predicts Weight Loss Outcomes With Tirzepatide, Castaneda (2026)
- Diabetes, Obesity and Metabolism: Body composition changes with tirzepatide in SURMOUNT-1, Look (2025)
Published 2026-10-04 · Last checked 2026-10-04
Educational content, not medical advice. Made for the United States.