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c/tirzepatide·posted 1 months ago by u/cato_girard

why does nobody talk about SURPASS

Trial Data Receipts ×7 Clean Column ×2 Cold Box ×2

Slightly embarrassed to be asking this, but: why does nobody talk about SURPASS.

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.

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

38kg over 96 weeks, never went past 10mg, and constipation stayed mild the whole way. Posting because the loud threads are all 15mg.

If two or three other people have done the same thing we might actually learn something. Alone it is an anecdote.

3,787 up / 188 down95% upvoted50 commentsid pihhbt8 Jun 2026

50 comments

20 in this archive, depth 4

best — the order this archive was captured in

u/graph_it_gary812 points·1 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/endpoint_creep284 points·1 months ago

Sulphur burps for the first eight days after each step, then nothing. Predictable enough that I planned my week around it.

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u/matias_salgado188 points·1 months ago

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

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u/certified_referenceQC141 points·1 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/hana_pereira563 points·1 months ago

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

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u/cato_girardOP296 points·1 months ago·edited

Appetite effect for me is flat across seven days. On sema it was a wave. Same person, different molecule.

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u/bastian_eriksen954 points·1 months ago

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

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u/sanne_novak221 points·1 months ago

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

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u/quiet_moderatormod320 points·1 months ago

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

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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u/fatima_wojcik-16 points·1 months ago

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/cato_girardOP1 point·1 months ago

Have you held a step for longer than the four-week minimum at any point?

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u/cato_girardOP1 point·1 months ago

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

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u/emil_okwuosa1 point·1 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/search_before_post1 point·1 months ago

Held 7.5 for five months. Everyone kept asking when I was going to 10. The answer was never, because 7.5 was working.

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u/graph_it_gary1 point·1 months 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/dexa_twice_yearlyMOD310 points·1 months ago

This is the fifth "should I go up" post today and they are all welcome — but no member here can answer it for you.

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u/graph_it_gary250 points·1 months ago

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

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u/piotr_nascimento114 points·1 months ago

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

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u/neha_falk80 points·1 months ago

Week 16 was the first time the scale moved after a five-week stall. I changed nothing in that window.

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u/sten_palacios235 points·1 months ago

The thing nobody warned me about was how much of this is logistics — storing it, remembering it, the same day every week.

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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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