Weight Loss Outcomes with Tirzepatide in Women with and Without Self-Reported Polycystic Ovary Syndrome

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.