Objective:  A male health outcomes researcher, age 55 – 65, with BMI ≥ 27 kg/m², but without type 2 diabetes, took compounded tirzepatide 7.5 mg/week therapy with a goal of losing 10% of body weight over approximately four weeks and restoring BMI ≤ 25 kg/m².  This study was also intended to offer a more sophisticated perspective of what compounded tirzepatide therapy entails and dispel some of the hype and myths currently circulating in popular media about tirzepatide and the glucagon-like peptide 1 (GLP-1) class of injectable drugs. All previous medical journals articles that mention tirzepatide have referred to the branded product, while this article is the first one focused solely on compounded tirzepatide.

Methods: The patient received subcutaneous injections of 7.5 mg compounded tirzepatide over four and a half weeks.  In the first, third, and fourth weeks, the patient received 7.5 mg of compounded tirzepatide as a bolus injection.  In week 2, the 7.5 mg dose was distributed over two injections of approximately 3.75 mg each given two days apart.  The primary end point in the trial was the percentage change in body weight from initiation to end of treatment.

Results: With a little over four weeks of compounded tirzepatide therapy, the patient achieved a 5% reduction in body weight and a BMI = 25.8. Despite having a healthy vegan diet and supplementing with many vitamins, minerals, electrolytes, and nutrients, the patient experienced most of the adverse events associated with the branded tirzepatide drug and the GLP-1 receptor agonist class of injectable drugs. However, the study revealed an undulating pattern  in which the compounded tirzepatide lost efficacy—or the patient built up resistance/tolerance for the drug—and also produced desirable side effects, both of which were findings not previously reported in the literature. 

Conclusions: Although compounded tirzepatide represents a welcome addition to the glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist class of drugs in chronic weight management, a 7.5 mg weekly dose of compounded tirzepatide over four weeks is unlikely to produce a lasting 10% reduction in body weight over the course of a month even for average-weight (male) patients, even for those patients practicing intermittent fasting and choosing a vegan diet, let alone those patients with the typical American eating habits and diet. Neither the Center for Medicare and Medicaid Services (CMS) nor other payers should cover the ten times more expensive branded version of these drugs for weight loss until the manufacturers can prove with real-world evidence (RWE) that the patients’ weight losses are permanent as desired. In contrast, the compounded versions of these peptide drugs are affordable and reasonable tools for continued clinical study.  

Conflict of interest statement

The author has no affiliation with any pharmaceutical firm or compounding pharmacy and no financial or ownership interest in any pharmaceutical firm or compounding pharmacy.  He has no conflicts of interests that in any way affected the research or analysis reported in this article.