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Symptom improvement was not significantly associated with weight loss, dose, or treatment duration in women with lipoedema treated with tirzepatide: a retrospective cohort study of prospectively collected outcomes

Year: 2026

Type: article

Abstract: Background: Weight loss may not reliably improve symptoms or adipose tissue abnormalities in lipoedema. Whether symptom improvement during incretin-based pharmacotherapy is associated with the magnitude of weight loss is unknown. Methods: We retrospectively analysed prospectively collected outcomes from 49 women with clinically diagnosed lipoedema treated with tirzepatide in routine care at a specialist clinic between January 2024 and May 2026. The Lipedema Symptom Assessment Questionnaire (QuASiL; range 0-150) was completed before treatment and at the most recent follow-up (3-18 months). The primary analysis examined the association between percentage weight change and percentage symptom change. Results: Weight change was not significantly associated with symptom change (r = 0.058, 95% confidence interval -0.23 to 0.33; p = 0.692). Baseline-adjusted analysis of covariance agreed (weight-change β = 0.03; p = 0.890). Symptom change was also not significantly associated with dose intensity or treatment duration. In contrast, weight change was associated with dose intensity (r = -0.569) and duration (r = -0.611). Conclusions: Every participant improved by at least 30% on the QuASiL and 93.9% by at least 50%, yet no significant association was observed between symptom improvement and weight loss, dose intensity, or treatment duration, whereas weight loss showed exposure-response associations. The near-zero estimate, small sample and uniform symptom response leave a confidence interval that does not exclude small-to-moderate associations, so independence from weight loss cannot be inferred, and without a control group the improvement cannot be attributed to tirzepatide. These hypothesis-generating findings require confirmation in controlled studies with objective outcomes.

Source: Metabolism Open

DOI: 10.1016/j.metop.2026.100518

Authors: Diogo Pinto da Costa Viana, Adriana Luckow Invitti, Eduardo Schor

Institution: Universidade Federal de São Paulo

Language: English

Topic: Body Contouring and Surgery

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,120