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c/tirzepatide·posted 17 days ago by u/titration_marshal

SURMOUNT-1 was -20.9% at 72 weeks. that is the number, not -30%

Discussion Receipts ×7 Long Haul ×2

Right: SURMOUNT-1 was -20.9% at 72 weeks. that is the number, not -30%. I paid for this one myself, nobody sent me anything, and the receipts are in the comments.

Hard numbers: 20.9%, 72 weeks and 30%. Anything softer than that is flagged as an impression.

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.

Switching from semaglutide, since three people asked in this thread alone.

There is no published dose equivalence between the two. The conversion tables that circulate are somebody’s arithmetic, not data. What people report here is that the first month after a switch is often flat, that the appetite effect feels differently shaped rather than simply stronger, and that starting at the bottom of the ladder again is the common approach.

None of that is a recommendation. It is what the threads say, and the threads are not a clinic.

Sceptical readings welcome. The confident ones are the ones I distrust.

1,578 up / 211 down88% upvoted59 commentsid nugpo012 Jul 2026

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u/adnan_nascimento208 points·17 days 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_marshalOPmod · c/semaglutide155 points·16 days ago

week 10 is early to draw any conclusion at all

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u/neha_falk116 points·16 days ago

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

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[removed]101 points·16 days ago

[removed by moderator]

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u/tidy_vialdrawer_pls137 points·16 days ago

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/quiet_moderatormod201 points·16 days ago

Sorting this by controversial is genuinely worth it today. The best answer in here is not the top one.

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u/certified_referenceQC83 points·16 days ago

sulphur burps are the signature complaint and they are not dangerous

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u/dexa_twice_yearlybody comp86 points·16 days ago

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.

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u/cato_girard23 points·16 days ago·edited

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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u/titration_marshalOPmod · c/semaglutide0 points·16 days ago

Correction to my own post above — I said 5mg and I have been on 7.5mg since the spring. Same argument, wrong number.

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u/sten_bhattacharya1 point·16 days ago·edited

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

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u/zeynep_zielinski1 point·15 days ago·edited

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/titration_marshalOPmod · c/semaglutide49 points·16 days ago

Which week did the appetite change actually land for you?

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u/georgi_chowdhury32 points·16 days 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/mod_cold_roommod · c/coldchain74 points·15 days ago

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.

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u/hub_opssite staff23 points·15 days ago

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

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u/throwaway_titration31 points·15 days 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/tarek_lokken14 points·14 days ago

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

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u/quiet_moderatormod10 points·15 days ago

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

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u/aurel_lindqvist42 points·15 days ago

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.

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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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