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c/tirzepatide·posted 7 months ago by u/mikkel_ogunleye

[Question] Mounjaro — what am I missing here

Question Receipts ×1 Clean Column ×2 Cold Box ×2

Asking properly rather than in a comment on somebody else’s thread: Mounjaro — what am I missing here.

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.

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.

Screenshot none of this. Read the whole thread, including the parts where I am told I am wrong.

3,574 up / 181 down95% upvoted45 commentsid 1tr5be1 Jan 2026

45 comments

21 in this archive, depth 3

best — the order this archive was captured in

u/emil_okwuosa798 points·6 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/cormac_pereira257 points·6 months ago

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

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u/titration_marshalMOD528 points·7 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/line_petrov418 points·7 months 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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[removed]275 points·6 months ago

[removed by moderator]

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u/mikkel_ogunleyeOP223 points·7 months ago

sulphur burps are the signature complaint and they are not dangerous

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u/mikkel_ogunleyeOP0 points·6 months ago

What step are you on and how long have you been there?

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u/kaia_wojcik302 points·6 months 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/throwaway_titration96 points·6 months ago

SURMOUNT-1 ran 72 weeks with the top arm around 21% mean body weight change.

Agreed, with one qualifier: that is the mean of the top arm and the spread around it was enormous.

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u/priya_guerrero104 points·6 months ago

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.

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u/zeynep_ndiaye57 points·6 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/b12_baseline76 points·6 months ago

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

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u/sten_palacios199 points·6 months 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/titration_marshalmod · c/semaglutide101 points·6 months ago

if 7.5 is working, 10 is not automatically better

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u/elin_ferrari46 points·6 months ago

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

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u/sten_bhattacharya123 points·6 months 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/bastian_ekstrom76 points·6 months ago

Did you come to this from sema, and if so how long was the gap?

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u/elin_ferrari-31 points·6 months 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/tarek_lokken55 points·6 months ago

Are you comparing yourself with the trial mean or with the people who post the most?

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u/quiet_moderatormod36 points·6 months ago·edited

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

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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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