Can people who do not have diabetes use Zepbound® for weight loss?

GLP1-antagonists were initially developed as treatments for diabetes in the early 2000s, but their significant weight-loss benefits quickly became evident. By 2013, Saxenda became the first GLP-1-based drug approved for weight loss, even in non-diabetic individuals. Since then, newer drugs like Wegovy and Zepbound® have emerged, demonstrating even greater efficacy in appetite suppression and weight loss management. 

Tirzepatide does much more than help control blood sugar levels. Hormones in our body called GLP-1 and GIP are naturally produced in our GI tract as we eat, signaling to the brain that we’re getting full. They increase insulin production (to store blood sugar), slow down digestion, and help us realize we no longer crave more food. Tirzepatide puts these hormones in overdrive, turning those natural signals into ones that show up more quickly and more strongly. So, Zepbound® helps it feel easy to avoid over-eating and over-craving. Zepbound® helps people make healthier food choices and by most accounts, simply feel better.²  

As opposed to long-standing weight-reduction methods that rely temporary treatment courses, such as stimulants like phentermine, or on sheer willpower of calorie restriction without assistance, Zepbound® offers an approach that works within the body, making it easier for patients to adopt and stick with healthier eating habits. This twin benefit of blood sugar control and appetite suppression sparked interest in Zepbound®’s possibility as an obesity treatment – even for people without diabetes.³ 

Compared to weight-loss medications such as phentermine or orlistat, Zepbound^®s long-term use potential sets it apart. Phentermine, for instance, is a stimulant that suppresses appetite by affecting the central nervous system. Although it can lead to rapid weight loss, it is suggested only for temporary because of hazards such as rapid heart rate, elevated blood pressure and potential drug dependency. 

In contrast, Zepbound® works by elevating natural body processes that are driven by GLP-1 & GIP hormones. This helps regulate your appetite without the unpleasant side effects of stimulants or fat blockers. Because of this, Zepbound® can provide steady, long-term weight loss that is easier to maintain – especially if combined with exercise and dietary changes. There is no time limit when you must stop Zepbound®, making it a fantastic long-term weight loss management tool. Obesity is a chronic disease, just like diabetes, high cholesterol or high blood pressure. Adoption of the lifestyle changes that Zepbound® allows and weaning down or weaning off is a great goal, but that timeline is unique from person to person.  

In late 2023, the federal food and Drug Administration (FDA) approved tirzepatide for treatment of obesity under the Zepbound® brand name. This was a significant step, as globally over one billion people are living with obesity, which brings a higher risk for many diseases such as diabetes and heart disease.⁴ 

However, this does not mean that concerns over “off label” use – a term used when a drug is prescribed for treating a condition it was not intended to treat – have ended. Many healthcare providers prescribe medications for purposes beyond their approved use when they believe the benefits outweigh the risks.  

In fact, after the FDA’s announcement, Eli Lilly (the maker of Zepbound®) came out with a strong statement opposing use for what it described as “cosmetic use” of Zepbound®.⁵ Upholding guidelines on safe and proper use is, indeed, important. PlushCare follows FDA guidelines that allow prescription of Zepbound® (and Wegovy, for that matter) to those with a BMI greater than or equal to 27 if other qualifying conditions (like high blood pressure) exist. It may also be prescribed to anyone over the age of 18 with a BMI of 30 or greater. In their letter, Eli Lilly warned about the prevalence of illegal online pharmacies, misleading advertisements, and even copycats of Zepbound®⁶, called compounded medication.

Eli Lilly warned about these copycats, which are drugs compounded in pharmacies from ingredients listed by the drugmaker as used in Zepound. It said that products made by pharmacies “may expose patients to potentially serious health risks.” The drugmaker said it “is extremely concerned” that its tests have shown some compounded tirzepatide contained “high amounts of impurities, and, in at least one instance, was actually nothing more than sugar alcohol.”⁷  

That said, there are compounding pharmacies that are FDA regulated to manufacture exact, third-party tested, copies of medications during times of national drug shortages. These pharmacies do exist and are a viable option when that’s the case.  

On the other hand, some online pharmacies also advertise compounded pill or other oral versions of tirzepatide. FDA has only approved administration of tirzepatide via under-the-skin injection. No regulator has evaluated the safety or effectiveness of pill or oral versions of tirzepatide.⁸ 

When prescribed for weight loss and long-term weight management in adults with either a body mass index (BMI) of 30 or higher (classified as obese), or a BMI of 27 or higher (overweight) and a weight-related health condition, such as  high blood pressure, heart disease, high cholesterol, or obstructive sleep apnea, Zepbound® proves to be one of the most effective weight loss medications available 

Clinical trials showed that Zepbound®’s active ingredient, tirzepatide, yields clinically significant improvements in glycemic control and weight loss when compared with other GLP-1 receptor agonists, such as semaglutide (Wegovy).  

Because of this, the American Diabetes Association (ADA) categorized tirzepatide as a highly effective therapy for achieving glycemic control and weight loss. 

Still, while Zepbound® has been effective for weight loss, it is important that non-diabetic users understand the risks associated with using a medication outside of its primary indication. These may include: 

Zepbound® has become a valuable tool for weight loss because of its capacity to manage appetite and improve metabolism. When compared with other weight-loss medications, Zepbound® often provides much more effective long-term results. Although it does not cause permanent changes if stopped, Zepbound® is used as a maintenance medication, with slow and individualized weaning, and is a fantastic weight management tool. This holds especially true when patients adopt slow and steady changes to their lifestyle of dietary choices and consistent exercise. As research continues, Zepbound® will likely show continued promise as a leading option for those seeking long-term weight management.