How Many Americans Take Zepbound? What the Published Numbers Show
No official count of US Zepbound users has been published. What exists is Lilly's audited revenue: Zepbound made $13,542 million in 2025, up 175%, and Lilly says it was the most prescribed weight management medication that year.
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There is no published number for how many Americans take Zepbound. No US government statistic, national poll, or prescription audit identified for this page gives a Zepbound-only user count for the United States, and Lilly’s quarterly financial releases report revenue by brand, not patient counts [4][5]. What has been published is different: audited revenue by brand, FDA approvals, and Lilly’s own claims about prescription rank and patient access [3][4][5]. Those numbers show rapid growth, but they measure dollars, not people.
Lilly said on February 23, 2026 that Zepbound was “the most prescribed weight management medication in 2025” and “the #1 prescribed injectable obesity-management medication” [3].
Are Mounjaro and Zepbound the same drug?
Both contain the same active ingredient, tirzepatide, and both are made by Eli Lilly [1][3][4]. The difference is the approved use and the brand name on the label. Zepbound is approved for adults with obesity, or overweight plus at least one weight-related medical problem, to be used with a reduced-calorie diet and increased physical activity [1][3]. On December 20, 2024, the FDA also approved Zepbound for moderate-to-severe obstructive sleep apnea in adults with obesity, making it the first drug approved for that condition [1].
Zepbound is a dual GIP and GLP-1 receptor agonist, meaning it activates receptors for two gut hormones, GLP-1 and GIP, to reduce appetite and food intake [1][3]. Lilly notes that Zepbound is not for cosmetic weight loss, and that its safety and effectiveness in children have not been established [3].
One more wrinkle: Lilly’s revenue tables state that tirzepatide is marketed for obesity under the Zepbound name in only three countries — the United States, Canada, and Japan [4][5]. So even Zepbound’s revenue line is not a pure US figure.
Why does the UK say Mounjaro for weight loss when the US says Zepbound?
In the UK, tirzepatide prescribed for weight loss carries the Mounjaro name [2]. NHS England began allowing GPs to prescribe Mounjaro for weight loss in June 2025, with about 220,000 patients expected to receive it over three years [2]. In the first year, eligibility was limited to people with a BMI over 40 plus at least four obesity-linked conditions such as type 2 diabetes, high blood pressure, heart disease, or obstructive sleep apnea [2]. Estimates cited at the time suggested about 1.5 million people in the UK were already taking weight-loss drugs through specialist services or private prescription [2].
What does Zepbound’s revenue say about its scale?
Revenue is the closest audited proxy for demand, and it is growing fast. Zepbound brought in $13,542 million for full-year 2025, up 175% from $4,926 million in 2024 [4]. Every figure in the table below is the brand-level Zepbound line from Lilly’s revenue tables, which the same tables footnote as covering the United States, Canada, and Japan [4][5].
| Period | Scope | Zepbound revenue | Change vs. prior year |
|---|---|---|---|
| Full-year 2024 | US, Canada, Japan | $4,926 million | — |
| Full-year 2025 | US, Canada, Japan | $13,542 million | +175% [4] |
| Q4 2025 | US, Canada, Japan | $4,261 million | +123% [4] |
| Q2 2025 | US, Canada, Japan | $3,381 million | — |
| Q2 2026 | US, Canada, Japan | $4,928 million | +46% [5] |
| H1 2026 (year-to-date) | US, Canada, Japan | $9,088 million | +60% [5] |
Lilly’s Q4 2025 release also states, in its narrative, that US Zepbound revenue increased 122% to $4.2 billion in Q4 2025, compared with $1.9 billion in Q4 2024, driven by demand and partly offset by lower realized prices [4].
In Q2 2026, the narrative figure for US Zepbound revenue was $4.9 billion, up 44%, driven by demand but offset by lower realized prices, including previously announced cuts to cash-pay prices [5]. That last point matters: revenue reflects dollars, not patients, and the realized price per patient varies widely depending on rebates, discounts, and whether someone pays cash [4][5].
What about Mounjaro’s numbers?
Mounjaro’s revenue is larger, but it is worldwide and increasingly driven by markets outside the US. Mounjaro made $22,965 million in full-year 2025, up 99% from $11,540 million in 2024 [4]. In Q4 2025, worldwide Mounjaro revenue was $7,409 million, up 110%, with US revenue of $4.1 billion (up 57%) and revenue outside the US of $3.3 billion, versus $899 million a year earlier [4].
By Q2 2026, worldwide Mounjaro revenue reached $9,943 million, up 91%, with US revenue of $4.8 billion (up 45%) and ex-US revenue of $5.2 billion, up 172% [5]. Lilly attributed the falling ex-US prices largely to Mounjaro being added to China’s National Reimbursement Drug List in Q1 2026 [5]. So Mounjaro’s headline growth is not a measure of US demand.
Mounjaro generated $8.7 billion in Q1 2026, passing Merck’s Keytruda at $7.9 billion to become the world’s best-selling drug; Keytruda had held the top spot since Q1 2023, when it displaced Humira [6]. Counting both brands together, tirzepatide generated $36.5 billion in 2025 versus Keytruda’s $31.6 billion [6].
Has Lilly published anything about how many patients use its drugs?
Lilly has published a few uptake claims, though none is a Zepbound user count. The company said that in 2025, one out of every three new patients starting a branded weight management medication was prescribed Zepbound self-pay vials [3]. It also said more than 1 million patients accessed Lilly treatments through LillyDirect in 2025 — across all Lilly medicines, not just Zepbound — and that LillyDirect self-pay pricing is at a 50% or greater discount compared with the list price of other incretin (GLP-1) medicines for obesity, in Lilly’s framing [3]. Lilly also raised its full-year 2026 revenue guidance to $85.0 billion to $87.0 billion [5].
What does Zepbound cost without insurance?
The documented self-pay price through LillyDirect starts at $299 per month for the 2.5 mg dose, with all doses available in either a single-dose vial or the KwikPen at the same self-pay price [3]. The KwikPen is a four-dose, single-patient-use device that delivers a full month of treatment; the FDA-approved label expansion for it was announced on February 23, 2026 [3]. A prescription is required, and fulfillment runs through LillyDirect [3]. Lilly states that the 2.5 mg dose is a starting dose, not an approved maintenance dose [3].
What do national surveys say about GLP-1 use?
National polls exist, but they measure the whole GLP-1 class, not Zepbound alone. The KFF Health Tracking Poll / KFF Tracking Poll on Health Information and Trust was fielded February 24 through March 2, 2026 among 1,343 US adults — 1,268 in English and 75 in Spanish — with a margin of sampling error of plus or minus 3 percentage points [7]. The material available for this page covers that poll’s methodology and unrelated questions, so no specific GLP-1 use percentage from it can be stated here. No national survey identified for this page breaks out tirzepatide users separately from semaglutide users.
How much weight did people lose in the Zepbound trials?
These are trial averages, not individual promises. In SURMOUNT-1, a 72-week study of adults without diabetes, average weight loss was 15.0% (34 lbs) at 5 mg, 19.5% (44 lbs) at 10 mg, and 20.9% (48 lbs) at 15 mg, versus 3.1% (7 lbs) for placebo [3].
In SURMOUNT-5, a 72-week open-label study comparing Zepbound against injectable Wegovy (semaglutide) in adults with obesity or overweight plus a related condition, participants on Zepbound at the maximum tolerated dose lost an average of 20.2% of body weight (50 lbs), versus 13.7% (33 lbs) for Wegovy at its maximum tolerated dose [3]. Lilly itself notes this was a less rigorous, open-label study, so the findings are less certain [3].
The obstructive sleep apnea approval was based on two randomized, placebo-controlled studies of 469 adults without type 2 diabetes, who received 10 or 15 mg weekly for 52 weeks; the main endpoint was the change in the apnea hypopnea index [1].
What are the safety warnings for Zepbound?
Zepbound causes thyroid C-cell tumors in rats, and it is unknown whether it causes medullary thyroid carcinoma in humans [1][3]. It should not be used by people with a personal or family history of medullary thyroid carcinoma, or with Multiple Endocrine Neoplasia syndrome type 2, or by anyone who has had a serious allergic reaction to tirzepatide or any of its ingredients [1][3].
Warnings include pancreatitis, gallbladder problems, hypoglycemia, acute kidney injury from dehydration, diabetic retinopathy in people with type 2 diabetes, suicidal behavior or thinking, and pulmonary aspiration during general anesthesia or deep sedation [1][3]. Common side effects include nausea, diarrhea, vomiting, constipation, abdominal pain, injection site reactions, fatigue, hypersensitivity reactions, burping, hair loss, and gastroesophageal reflux disease [1].
Zepbound should not be used together with other tirzepatide-containing products or any GLP-1 receptor agonist [3]. A KwikPen should never be shared with another person, even with a new needle, because of infection risk [3].
How can you judge any “X million Americans take Zepbound” figure?
Rank the evidence you see. Audited, dated, brand-level revenue from Lilly’s quarterly reports is the most reliable category [4][5]. Prescription-rank claims from a company come next — ask whether they refer to new or total prescriptions, and as of what date [3]. National polls follow: check the field dates, sample size, and margin of error, and remember they cover the whole drug class [7]. Constructed market-share estimates are the weakest.
Two specific traps to avoid. First, back-calculating patient counts from revenue is unreliable, because realized prices are moving: Lilly reported a 13% company-wide decline in realized prices in Q2 2026, with Zepbound and Mounjaro cited as drivers [5]. Second, the Zepbound revenue line includes Canada and Japan, not just the US [4][5]. Any figure that divides US Zepbound revenue by a single assumed price and presents the result as a patient count is a guess, not data.
Sources
- US Food and Drug Administration. FDA Approves First Medication for Obstructive Sleep Apnea.
- The Guardian. NHS begins mass rollout of weight-loss jabs to patients in England. June 23, 2025.
- Eli Lilly and Company. Zepbound (tirzepatide), the most prescribed weight management medication in 2025, now available in multi-dose KwikPen. February 23, 2026.
- Eli Lilly and Company. Lilly reports fourth-quarter 2025 financial results and provides 2026 guidance. February 4, 2026.
- Eli Lilly and Company. Lilly reports second-quarter 2026 financial results, raises full-year guidance, and highlights continued growth and pipeline progress. August 5, 2026.
- The Boston Globe. Lilly’s Mounjaro overtakes Keytruda as world’s top-selling drug. May 6, 2026.
- KFF. KFF Health Tracking Poll on Health Information and Trust, March 2026. March 2026.
- Axios. Axios-Ipsos poll: Cost isn’t discouraging GLP-1 use. March 19, 2026.
- Investing.com. Eli Lilly Q1 2026 slides: incretin dominance drives 56% revenue surge. April 30, 2026.
- IQVIA. Obesity Deep Dive: The Unparalleled Launch Success of Mounjaro and Zepbound. September 23, 2025.
- Eli Lilly and Company. Lilly lowers the price of Zepbound (tirzepatide) single-dose vials. December 1, 2025.
- Walmart. LillyDirect and Walmart Pharmacy Launch First Retail Pick-Up Option With Direct-to-Consumer Pricing for Zepbound. October 29, 2025.
- Centers for Medicare & Medicaid Services. Medicare GLP-1 Bridge.
- Eli Lilly and Company. An open letter from Eli Lilly and Company warning of potential patient safety risks associated with tirzepatide compounded with vitamin B12. March 12, 2026.
- Reddit. Zepbound community discussion forum.
- Reddit. Mounjaro community discussion forum.
Frequently asked questions
Are Mounjaro and Zepbound the same drug?
Both contain tirzepatide and are made by Eli Lilly. Zepbound is the brand Lilly markets for obesity in the United States, Canada, and Japan. In the UK, tirzepatide for weight loss is prescribed under the Mounjaro name.
Is there an official count of US Zepbound users?
No. No US government figure, national poll, or prescription audit identified for this page gives a Zepbound-only user count, and Lilly's quarterly financial releases report revenue by brand, not patients. Lilly says Zepbound was the most prescribed weight management medication of 2025, but that is a rank claim, not a count.
How much money did Zepbound and Mounjaro make last year?
For full-year 2025, Zepbound revenue was $13,542 million, up 175% from 2024, and Mounjaro revenue was $22,965 million worldwide, up 99%. Mounjaro's figure is global and increasingly driven by markets outside the US, including China.
Is Mounjaro now the best-selling drug in the world?
Yes, by quarterly sales. Mounjaro generated $8.7 billion in Q1 2026, passing Merck's Keytruda at $7.9 billion. Keytruda had held the top spot since Q1 2023. Combined Mounjaro and Zepbound revenue was $36.5 billion in 2025.
What is the cheapest documented way to pay for Zepbound without insurance?
The documented self-pay option is LillyDirect, starting at $299 per month for the 2.5 mg dose, with all doses available in a vial or KwikPen at the same self-pay price. Lilly says that is a 50% or greater discount versus the list price of other incretin obesity medicines. A prescription is required.
What conditions is Zepbound FDA-approved for?
Zepbound is approved for weight loss in adults with obesity, or overweight plus at least one weight-related condition, used with diet and exercise. On December 20, 2024, the FDA approved it for moderate-to-severe obstructive sleep apnea in adults with obesity.
How much weight did people lose in the Zepbound trials?
In the 72-week SURMOUNT-1 study of adults without diabetes, average weight loss was 15.0% at 5 mg, 19.5% at 10 mg, and 20.9% at 15 mg, versus 3.1% for placebo. In the 72-week open-label SURMOUNT-5 study, Zepbound averaged 20.2% (50 lbs) versus 13.7% (33 lbs) for Wegovy.
This article summarizes FDA labeling, published research and company information current as of September 14, 2026. It is not medical advice and does not replace a conversation with your own healthcare provider. How we research and verify.