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Identical in percent, six kilograms apart in fact

Two populations lost the same proportion of their weight and very different amounts of it. Trials report the first number.

Ruth Alvarez6 min read
Asian vs non-Asian trial populationsmeasured as a percentage−18.16% vs −17.92%p = 0.94no differencemeasured in kilograms−16.72 kg vs −23.46 kgp = 0.03a real differenceSame people, same trials, two units.

Trials of these drugs report percentage weight loss, which is convenient and quietly consequential. This meta-analysis shows what happens when the same comparison is expressed both ways [1]. The pooled figures across the whole literature are in the weight-loss averages.

Measured as a percentage, the Asian and non-Asian trial populations lost essentially the same amount: 18.16% against 17.92%, with a p value of 0.94. Measured in kilograms they did not: 16.72 kg against 23.46 kg, with a p value of 0.03. Both statements describe the same participants in the same trials.

The authors are unusually careful about what their own null means. Only 148 Asian participants received tirzepatide, across two trials, and they state plainly that the comparison is underpowered and cannot confirm equivalence. A p value of 0.94 on a sample that small is absence of evidence rather than evidence of sameness — the distinction that governs the frailty analysis, where the sample was large enough for a null to mean something.

The design carries a further limit. This compares across trials rather than within one, so the Asian and non-Asian groups differ in every way two separate trials differ — sites, era, baseline characteristics, background care — and ethnicity is only one of them. Heterogeneity on the headline effect was also substantial, at I² = 77%.

For a reader the transferable lesson is about units rather than ethnicity. Any comparison between populations with different baseline weights will look different depending on whether it is reported as a percentage or an absolute, and trials almost always choose the percentage. The same trap sits behind cross-trial comparisons like the ecnoglutide trial, where entry criteria set a lighter starting population, and behind the subgroup ranges in the sleep apnea subgroups.

Frequently asked

Does tirzepatide work equally well across ethnic groups?
Percentage weight loss was nearly identical, but only 148 Asian participants received the drug and the authors state the comparison is underpowered and cannot confirm equivalence.
Why did the kilogram figures differ?
Participants in the non-Asian trials weighed more at baseline, so the same proportional loss removes more kilograms — 23.46 kg against 16.72 kg.
Which measure matters more?
It depends on the question. A percentage describes drug performance; absolute mass is what joints, sleep apnea and cardiovascular risk actually respond to.

Sources

  1. [1] Kamrul-Hasan ABM, Khalil I, Dutta D, Mahajan K, Nagendra L, Pappachan JM (2026). Comparative Efficacy and Safety of Tirzepatide in Asian and Non-Asian Adults With Obesity Without Diabetes: A Systematic Review and Meta-Analysis Endocrinology, Diabetes & Metabolism. PMID 42487213

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