Weight loss outcomes with tirzepatide in women with and without self-reported polycystic ovary syndrome

Abstract Context Weight management is key to managing polycystic ovary syndrome (PCOS) and overweight/obesity but is challenging for many. Evidence regarding tirzepatide's efficacy in women with polycystic ovary syndrome is limited. Objectives To quantify the effectiveness of tirzepatide for weight loss in women with (self-reported) polycystic ovary syndrome and overweight/obesity compared with women not living with PCOS and to explore associations between engagement with nonpharmacological digital adjuncts and weight loss. Methods Retrospective open-cohort study in a digital weight management service in the United Kingdom. All women (aged 18+ years) with overweight/obesity prescribed tirzepatide for weight management between February 2024 and January 2025 were included. Percentage weight change from baseline was calculated in women reaching specific follow-up time points, stratified by PCOS status. Kaplan-Meier methods estimated cumulative probabilities of attaining total body weight loss thresholds. Results The cohort comprised 54 114 women of whom 4241 (7.84%) women had PCOS. At 10 months, the mean weight change in women with PCOS (n = 40) was −19.40% (95% confidence interval [CI], −22.38% to −16.42%); this was not significantly different from women without PCOS (n = 397; mean weight change, −18.74%; 95% CI, −19.67% to −17.81%). A total of 57.66% of women with PCOS lost ≥20% total body weight (95% CI, 47.44% to 68.29%) by 10 months. In women living with PCOS, digitally engaged women lost 3.42% more weight in absolute terms (95% CI, 1.71% to 5.12%; P < .001) by 10 months. Conclusion Tirzepatide may offer a highly effective therapeutic option for women with PCOS and overweight/obesity in whom weight loss is a key goal but a persistent challenge.