Treatment of obesity in spinal cord injury with tirzepatide: a case report

Spinal Cord Series and Cases, 2025 · DOI: https://doi.org/10.1038/s41394-025-00699-w · Published: February 21, 2025

Spinal Cord Injury Pharmacology Endocrinology

Simple Explanation

People with spinal cord injuries often struggle with weight gain and related health problems due to metabolic changes and difficulty exercising. This study explores a medication called tirzepatide to potentially help with weight loss. A man with a spinal cord injury who had trouble losing weight through diet and exercise was treated with tirzepatide. Over a year, he lost weight and improved his cholesterol levels. Tirzepatide may be a helpful addition to diet and exercise for people with spinal cord injuries who are struggling to lose weight and avoid heart problems. More research is needed to confirm these benefits.

Study Duration

1 Year

Participants

1 Male with C6 AIS B SCI

Evidence Level

Level 4: Case Report

Key Findings

1
The patient lost 31 pounds after 3 months of tirzepatide treatment and saw improvements in his lipid profile.
2
After one year of treatment with tirzepatide his weight was recorded as 100.7 kg (222 lbs) at a follow-up appointment with his PCP. In total, he lost 14.9 kg (33 lbs) after one year of treatment.
3
The only adverse effect reported throughout his treatment was mild heartburn.

Research Summary

Individuals with SCI experience alterations in metabolism that result in increased central obesity, insulin resistance, and dyslipidemia placing them at elevated risk for developing cardiometabolic disease (CMD). Tirzepatide may be an effective adjunct therapy to lifestyle interventions to help prevent CMD in those with SCI. The metabolic dysfunction associated with SCI and barriers to adequate exercise for weight loss place individuals with SCI at increased risk for obesity and CMD.

Practical Implications

Treatment of Neurogenic Obesity

Tirzepatide may be a practical, safe, and effective adjunct therapy to exercise and dietary intervention to help facilitate weight loss in SCI patients.

Prevention of Cardiometabolic Disease

The study suggests tirzepatide may help prevent CMD in individuals with SCI by improving lipid profiles and facilitating weight loss.

Future Research Directions

The study highlights the need for larger-scale studies to examine the long-term efficacy, benefits, and adverse effects of tirzepatide in SCI patients.

Study Limitations

1
Lack of appropriate pre and post treatment laboratory studies.
2
Patient did not receive treatment for one month while hospitalized for a thermal injury; however, it is unclear if that impacted weight loss results.
3
Patient’s dietary and exercise program adherence is based upon self-report and may be subject to self-report bias.

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