HealthlineHormone Therapy May Boost Weight Loss on Wegovy, But Not as Much on Zepbound

ℹ️ Observational Association Only Evidence

An observational study of 3,855 women examined weight loss with semaglutide or tirzepatide, comparing MHT users with nonusers within each cohort. Participants averaged 57 years of age and a BMI of 36 kg/m². Semaglutide users receiving MHT had greater weight loss from nine months onward; tirzepatide users showed no sustained statistically significant difference at later assessments. Presented at the 2026 Menopause Society meeting, the findings remain unpublished and do not establish a treatment-enhancing effect.

Clinical Considerations

• The semaglutide cohort included 2,379 women; the tirzepatide cohort included 1,476. Average follow-up differed between drug cohorts.
• Semaglutide-associated differences persisted at 12 and 15 months and final follow-up, but absolute between-group weight-loss differences were not supplied.
• Tirzepatide findings varied by endpoint: early weight-loss differences were modest, while achieving greater than 5% loss was more likely at final follow-up.
• Different significance patterns do not establish different MHT effects between drugs; no formal interaction analysis is reported.
• MHT formulation, route, exposure duration, medication doses, and adjustment methods are not described, limiting interpretation of confounding and applicability.
• The reported 30% threshold describes an attainment endpoint, not average weight loss or a 30% incremental benefit from MHT.

Practice Applications

• Clarify that MHT is not approved for weight loss; this association does not justify starting it solely to enhance medication response.
• Discuss menopause symptom treatment and obesity treatment as separate, individualized decisions when both concerns are present.
• Interpret the findings as hypothesis-generating, pending peer-reviewed methods, effect estimates, and prospective confirmation.