[Meta] the tirzepatide rule is doing its job and people should stop complaining
the tirzepatide rule is doing its job and people should stop complaining, and it will stay as it is unless somebody makes the case to change it.
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.
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.
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.
Please do not ask me what dose you should be on. I genuinely do not know and neither does anyone else here.
best — the order this archive was captured in
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.
Trial identifiers corrected in the title. SURMOUNT and SURPASS are different programmes.
the appetite effect is blunter than sema, in a good way, most weeks
That percentage is body weight change, not body fat. Different measurement, and the distinction gets lost every time.
Disagree with the conversion table. There is no validated equivalence between the two molecules and posting one as though there is does real damage.
zepbound and mounjaro are the same compound with different labels
2.5 is the starter dose and it is not meant to be the dose that works
What step are you on and how long have you been there?
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.
the trials titrated on a calendar, real people titrate on symptoms
The step schedule question, answered properly, because it comes up weekly.
The label sets a minimum interval of four weeks between increases. That is a floor on how fast you may go, and it exists because tolerability, not efficacy, is what limits most people. There is nothing in the pharmacology that says you must increase at four weeks, or at eight, or ever.
What decides it in practice is whether the effect you want is still there. If appetite is quiet and the trend is going the right way, the dose is doing its job. If both have genuinely gone flat for six weeks or more, that is a conversation worth having with someone who knows your history.
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.
2.5mg is a four-week starting dose, not a maintenance dose. Worth being precise since people search these threads.
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.
Correction to my own post above — I said 2.5mg and I have been on 15mg since the spring. Same argument, wrong number.
if 7.5 is working, 10 is not automatically better
Right. And the sema-to-tirz "conversion" people post is invented. There is no published equivalence.
Right.
Not sure about this bit. The GIP arm being real does not tell you that it is what caused your particular week.
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.
Cosigning the four-week thing.
cormac_pereira is right that the two molecules are not interchangeable. There is no published conversion and the ones circulating are invented.
The thing nobody warned me about was how much of this is logistics — storing it, remembering it, the same day every week.
The thing nobody warned me about was how much of this is logistics — storing it, remembering it, the same day every week.
This. The step interval is a floor, and reading it as a timetable is the most expensive mistake in the thread.
Not sure that follows. You went up a step and changed your training in the same fortnight.
the constipation profile is genuinely gentler than people expect coming from sema
Push back: "gentler than sema" is a population statement. Plenty of people on this board have the opposite experience and they are not doing it wrong.
Yes — 10mg being a genuine landing place for a lot of people is underrated. There is no medal for 15.
switching from sema is not a dose conversion, there is no clean equivalence
SURMOUNT-1 landed around 21% at 72 weeks on the top arm
I would separate the two claims. That the GIP arm exists is uncontroversial; that it explains your food noise pattern is a guess.
- 1The distribution matters more than the mean. In the trial population the…10 comments in this branch · started by u/aksel_kjaer
- 2The step schedule question, answered properly, because it comes up weekly.…10 comments in this branch · started by u/certified_reference