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c/tirzepatide·posted 9 months ago by u/line_petrov

someone explain Zepbound to me like I have not read a paper in years

Titration Long Haul ×8 Sourced ×1 Well Actually ×3

someone explain Zepbound to me like I have not read a paper in years. I would rather ask a basic question now than get this wrong quietly for two months.

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.

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.

The four-week interval in the label is a minimum. Nothing about the pharmacology requires you to step on schedule, and the trials stepped on a calendar because trials have to.

That is everything I have. The rest is opinion and I have tried to keep it out.

4,970 up / 414 down92% upvoted37 commentsid p8wp8i14 Oct 2025

37 comments

14 in this archive, depth 3

best — the order this archive was captured in

u/ignacio_vanhecke976 points·9 months ago

The distribution matters more than the mean. In the trial population the interquartile spread was wide enough that two honest people can have completely different runs on the same arm.

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u/line_petrovOP384 points·9 months ago

the appetite effect is blunter than sema, in a good way, most weeks

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u/teodor_szabo467 points·9 months ago

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

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u/incretin_ivyMOD256 points·9 months 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/fatima_wojcik0 points·9 months ago

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

Not sure about this bit. The GIP arm being real does not tell you that it is what caused your particular week.

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[removed]1 point·9 months ago

[removed by moderator]

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u/certified_referenceQC359 points·9 months 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/emil_wojcik519 points·9 months ago·edited

Went 10 to 12.5 on the calendar and had the worst fortnight of the whole run. Dropped back to 10 and everything settled.

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u/blunt_coldbox29288 points·9 months ago

SURMOUNT-1 landed around 21% at 72 weeks on the top arm

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u/ewan_marchand237 points·9 months ago

Came off sema and onto tirz with a two-week gap. The first month was flat and I assumed I had made a mistake. Month two it moved.

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u/curious_panel_only168 points·9 months 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/yusuf_ramos109 points·9 months ago

This matches mine. Milder reflux than I expected, and what there was settled inside a fortnight of each step.

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u/amara_halonen67 points·9 months ago·edited

Yes. I stepped to 12.5 because the calendar said so, not because anything needed fixing, and I regretted it for a fortnight.

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u/halima_boateng200 points·9 months ago

Disagree with the conversion table. There is no validated equivalence between the two molecules and posting one as though there is does real damage.

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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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