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Forumsβ€ΊTirzepatide (Mounjaro / Zepbound)β€ΊTirzepatide body composition: SURMOUNT-1 DEXA substudy data

Tirzepatide body composition: SURMOUNT-1 DEXA substudy data

MikeFit_NJ Sun, Mar 8, 2026 at 6:53 AM 12 replies 270 viewsPage 1 of 3
MikeFit_NJ
Senior Member
1,567
6,543
Apr 2024
New Jersey
Mar 8, 2026 at 8:18 AM#1

Can we talk about the SURMOUNT-OSA results? Because they are genuinely life-changing for those of us with obstructive sleep apnea.

For those who haven't seen it:

SURMOUNT-OSA Trial Summary:

  • Population: Adults with moderate-to-severe OSA and obesity (BMI β‰₯30)
  • Two sub-studies: those not using CPAP/PAP at baseline (Study 1) and those using CPAP/PAP (Study 2)
  • Primary endpoint: Change in AHI (apnea-hypopnea index) from baseline

Key results (52 weeks):

EndpointTirz (max 15mg)Placebo
AHI reduction (Study 1)-25.3 events/hr-5.3 events/hr
AHI reduction (Study 2)-29.3 events/hr-5.5 events/hr
Patients achieving AHI <5 (mild/resolved)~42%~6%
Patients achieving AHI <15 (no longer moderate/severe)~62%~14%
Body weight reduction~18-20%~2%

42% of patients achieved AHI <5, which is essentially RESOLUTION of sleep apnea. I'm 54 years old and I've been on CPAP for 12 years. The idea that a weekly injection might let me ditch this machine is incredibly exciting.

Anyone else here with OSA on tirz? What's been your experience?

43 19LeilaHI, marcus_mpls, DeniseRN_TPA and 40 others
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CarlaRPh_TPA
Senior Member
1,890
8,234
Jan 2024
Tampa, FL
Mar 8, 2026 at 8:35 AM#2

Sleep medicine physician here. SURMOUNT-OSA is one of the most impactful obesity-related trials published in recent years, and I say that as someone who prescribes CPAP for a living.

Important clinical nuances:

  1. The AHI reductions are massive. A 25-point AHI reduction is the difference between severe OSA and normal. For context, CPAP typically reduces AHI to <5 when used properly, but adherence is terrible (~50% stop using it within a year). A medication-based approach that achieves this for 42% of patients is clinically transformative.
  2. This isn't just about the weight loss. The AHI improvements exceeded what would be predicted from weight loss alone, suggesting tirzepatide may have direct effects on upper airway physiology β€” possibly through reduction of pharyngeal fat deposition and/or anti-inflammatory effects on upper airway tissues.
  3. Quality of life metrics were also significantly improved β€” Epworth Sleepiness Scale, FOSQ (Functional Outcomes of Sleep Questionnaire), and patient-reported snoring all improved dramatically.
  4. Caveat: If you're on CPAP, do NOT stop it without a repeat sleep study and discussion with your sleep doc. Even if you feel better, untreated residual OSA can still increase cardiovascular risk.

I'm now having conversations with patients about tirzepatide as a potential CPAP exit strategy, which is something I never thought I'd say.

β€” Board-certified in sleep medicine and pulmonology

26 2ricardo_MIA, BrianDallas92, labquiet_amy and 23 others
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BenResearch_OR
Senior Member
2,456
11,234
Dec 2023
Oregon
Mar 8, 2026 at 8:52 AM#3

I am one of those success stories. Started tirz 8 months ago at BMI 38 with moderate OSA (AHI 22). Lost 52 lbs, did a repeat home sleep test last month β€” AHI is now 3.8. THREE POINT EIGHT. My sleep doctor said I can stop CPAP.

I cried in his office. I literally cried. I've hated that machine for 6 years. The mask marks, the dry mouth, the hose getting tangled, the noise, traveling with it... all gone.

I sleep better now without CPAP than I ever did with it. My husband says I don't snore anymore. I wake up feeling actually rested instead of just "less terrible."

This drug changed my life. I know that sounds dramatic but it's the truth.

Last edited: Mar 8, 2026 at 9:52 AM
50 11Dr.NateNeph, PharmD_Rodriguez, julia.endo and 47 others
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tommy_boulder
Member
234
1,123
Nov 2024
Boulder, CO
Mar 8, 2026 at 9:09 AM#4

Michelle that's incredible and exactly what I'm hoping for. Can I ask what dose you're on and how quickly the sleep improvements started?

Last edited: Mar 8, 2026 at 10:09 AM
1 5dan_philly
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Dr.GastroMayo
VIP Member
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Jan 2024
Mayo Clinic, MN
Mar 8, 2026 at 9:26 AM#5

I'm at 12.5mg. The sleep improvements were noticeable pretty early β€” probably by month 2-3, even before major weight loss. My husband noticed the snoring reduced first, then I started waking up feeling more refreshed. By month 4 I was "forgetting" to put on my CPAP because I was sleeping so well without it (I know, bad, don't do this before getting tested).

The home sleep test at month 7 confirmed what I was feeling. Went from AHI 22 to 3.8. Repeat oximetry was normal too β€” no desaturations below 90%.

15 19InsuranceTom, WendyG_ATL, SaraMom3 and 12 others
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