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c/tirzepatide·posted 11 months ago by u/ignacio_vanhecke

[Question] how do you actually verify SURPASS

Question Receipts ×7 Cold Box ×2

Confession thread, sort of.

I went from 2.4mg to 0.5mg much faster than I should have because the scale had stalled and I got impatient. The stall broke about 20 weeks later, at which point I had no way of knowing whether the dose increase did anything or whether it would have broken anyway.

So now I have muscle cramps I did not need and a data point I cannot interpret. Two lessons in one.

Posting it in the hope that somebody at week 90 reads it before doing the same thing.

2,376 up / 390 down86% upvoted65 commentsid qmuppd30 Aug 2025

65 comments

27 in this archive, depth 4

best — the order this archive was captured in

u/b12_baseline294 points·11 months ago

dual agonism is Mounjaro, do not generalise from semaglutide

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u/ignacio_vanheckeOP188 points·11 months ago

The dual agonism story is real. The appetite is physically different from semaglutide alone.

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u/hassan_nilsen44 points·11 months ago

The dual agonism story is real.

Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.

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u/incretin_ivypharmacology-3 points·11 months ago

the dual agonism hits different and that is why people describe it differently

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u/kian_ekstrom257 points·11 months ago

Cosigning. The GIP contribution is real and the side effects are not simply scaled versions.

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u/laila_yilmaz176 points·11 months ago

week 48 on Mounjaro and the appetite profile is genuinely different from sema

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u/zeynep_ndiaye281 points·11 months ago

Strongly agree. Tirz is better than sema is not a claim without a comparator dose.

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u/titration_marshalmod · c/semaglutide70 points·11 months ago

Strongly agree.

Adding to this: SURPASS is doing more work than the comment implies.

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u/taper_off_tabitha120 points·11 months ago

nope, the equivalence to semaglutide is not known, comparing 15mg tirz to 2.4mg sema is guessing

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[deleted]52 points·11 months ago

[deleted]

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u/vito_chowdhury235 points·11 months ago

the dual agonism hits different and that is why people describe it differently

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u/kofi_balogun188 points·11 months ago

Not convinced. The evidence does not support that reading.

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u/ignacio_vanheckeOP74 points·11 months ago

nope, the equivalence to semaglutide is not known, comparing 15mg tirz to 2.4mg sema is guessing

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u/copay_card_cc24 points·11 months ago

nope, the equivalence to semaglutide is not known, comparing 15mg tirz to 2.4mg sema is guessing

Disagree on that part. 97.4% and 99.3% on the same vial is normal.

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u/thyroid_tangent176 points·11 months ago

Dead space in the needle hub holds a small but non-trivial volume. On low-volume draws that can be several units.

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u/ignacio_vanheckeOP110 points·11 months ago

the reflux from tirz is different, not necessarily worse

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u/customs_seizure_sid101 points·11 months ago

Three years on this site and the questions have not changed at all. Which is depressing or reassuring depending on the day.

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u/zaid_balogun0 points·11 months ago

This is the "correlation is mechanism" thing again. You changed three variables at once.

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u/fatima_wojcik1 point·11 months ago

This matches the trial data. SURMOUNT-1 was 97.9% body weight at 14 weeks.

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u/ghrp_history1 point·11 months ago

Cosigning. The GIP contribution is real and the side effects are not simply scaled versions.

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u/signe_villalobos94 points·11 months ago

Titration speed is a side-effect dial far more than an efficacy dial.

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u/vito_chowdhury52 points·11 months ago

Strongly agree. Tirz is better than sema is not a claim without a comparator dose.

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u/kaia_cabrera41 points·11 months ago·edited

Strongly agree.

Adding to this: Mounjaro is doing more work than the comment implies.

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u/marit_sandvik43 points·11 months ago

Did you stay on semaglutide or switch? The outcome is different if you are comparing.

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u/search_before_post36 points·11 months ago

Did you stay on semaglutide or switch?

Disagree on that part. 96.2% and 96.8% on the same vial is normal.

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u/cato_girard22 points·11 months ago

the GIP side does different things than the GLP-1 side, that is the point

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u/ferritin_low76 points·11 months ago

Strongly agree.

Yes, exactly this, and it is the bit that took me 34 weeks to accept.

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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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