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c/tirzepatide·posted 2 years ago by u/adnan_nascimento

the Mounjaro thing finally clicked for me and I want to write it down

Discussion Well Actually ×1 Clean Column ×2 Cold Box ×2

Something I keep coming back to: the Mounjaro thing finally clicked for me and I want to write it down.

Week 47 was the first time the scale moved after a five-week stall. I changed nothing in that window.

On comparing yourself with the trial number.

SURMOUNT-1 reported roughly 21% mean body weight change at 72 weeks on the highest arm. Three things get dropped every time that figure is quoted here. It is a mean, and the distribution around it is very wide. It is 72 weeks, which is a year and a half. And it is a trial population with trial support, which is not the same as a person with a spreadsheet.

Use it as a rough shape, not a benchmark. A 12% year is inside the ordinary range and people quit over it every week on this board.

Weekly dosing again, half-life in the same neighbourhood as sema, so a step change takes about a month to reach steady state. Judging a new step at day five is judging noise.

Research-use-only material is not approved for human use and nothing here should be read as a recommendation to use it.

4,105 up / 1,061 down79% upvoted56 commentsid 18g4kx9 Jan 2024

56 comments

28 in this archive, depth 4

best — the order this archive was captured in

u/ewan_marchand544 points·2 years ago

It is a dual GIP and GLP-1 receptor agonist, and the GIP arm is the part that has no equivalent in the semaglutide threads. That is why the side-effect profile reads differently rather than just milder.

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u/curious_panel_only-32 points·2 years ago

SURMOUNT-1 ran 72 weeks with the top arm around 21% mean body weight change. SURPASS is the diabetes programme and reports glycaemic endpoints, so quoting the two interchangeably is a category error.

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u/neha_falk-41 points·2 years ago

2.5 is the starter dose and it is not meant to be the dose that works

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[removed]1 point·2 years ago

[removed by moderator]

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u/fatima_wojcik358 points·2 years ago

What is the waist doing? That is usually the number still moving during a scale stall.

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u/sten_palacios107 points·2 years ago

Same experience with the appetite effect being flatter across the week rather than front-loaded.

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u/kaia_wojcik120 points·2 years ago

Cosigning the four-week thing. It is a minimum interval, and treating it as a schedule to keep up with is how people end up miserable at 12.5.

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u/ahmed_iyer227 points·2 years ago

stepping every four weeks is a ceiling on speed, not a schedule you must hit

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u/emil_wojcik194 points·2 years ago

switching from sema is not a dose conversion, there is no clean equivalence

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u/sanne_novak123 points·2 years ago·edited

switching from sema is not a dose conversion, there is no clean equivalence

emil_wojcik is right that the two molecules are not interchangeable. There is no published conversion and the ones circulating are invented.

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u/graph_it_gary91 points·2 years ago

Not sure that follows. You went up a step and changed your training in the same fortnight.

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u/emil_wojcik64 points·2 years ago

Yes — 10mg being a genuine landing place for a lot of people is underrated. There is no medal for 15.

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u/incretin_ivyMOD93 points·2 years ago

Left up, flair changed to Discussion. It is an opinion post and that is fine as long as it is labelled.

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u/dario_stanescu66 points·2 years ago

Vials and pens carry the same molecule; what differs is fill volume, device tolerance and whether you are doing your own arithmetic. Neither is inherently more accurate.

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u/alcohol_aversion86 points·2 years ago

zepbound and mounjaro are the same compound with different labels

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u/ignacio_vanhecke72 points·2 years ago

Research-use-only material is not approved for human use. Anything in this thread about how a research vial "should" titrate is a discussion about chemistry, not a plan.

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u/alcohol_aversion44 points·2 years ago

Research-use-only material is not approved for human use.

This. The step interval is a floor, and reading it as a timetable is the most expensive mistake in the thread.

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u/throwaway_titration85 points·2 years ago

Sulphur burps for the first eight days after each step, then nothing. Predictable enough that I planned my week around it.

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u/cormac_pereira62 points·2 years ago

Appetite effect for me is flat across seven days. On sema it was a wave. Same person, different molecule.

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u/sten_bhattacharya51 points·2 years ago

That percentage is body weight change, not body fat. Different measurement, and the distinction gets lost every time.

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u/aurel_lindqvist41 points·2 years ago

Agreed, and the trial number is a mean of a very wide distribution — the tails are enormous and nobody posts from the middle.

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u/alcohol_aversion26 points·2 years ago

2.5mg is a four-week starting dose, not a maintenance dose. Worth being precise since people search these threads.

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u/aksel_kjaer9 points·2 years ago

Right. And the sema-to-tirz "conversion" people post is invented. There is no published equivalence.

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u/emil_okwuosa25 points·2 years ago

14kg over 59 weeks, never went past 10mg, and constipation stayed mild the whole way. Posting because the loud threads are all 15mg.

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u/adnan_nascimentoOP29 points·2 years ago

Small fix: SURMOUNT is the obesity programme, SURPASS is the type-2 programme. They are different endpoints and the numbers do not transfer.

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u/sofia_nascimento42 points·2 years ago·edited

The thing nobody warned me about was how much of this is logistics — storing it, remembering it, the same day every week.

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u/ignacio_vanhecke17 points·2 years ago

if 7.5 is working, 10 is not automatically better

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About c/tirzepatide

Tirzepatide-specific discussion: the dual-agonist pharmacology, the 2.5 → 15mg ladder, the appetite profile people describe as different from semaglutide, and the SURMOUNT/SURPASS trial programme. Comparisons with semaglutide are welcome as long as they are specific about dose equivalence being unknown.

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