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c/tirzepatide·posted 1 year ago by u/ignacio_vanhecke

[Discussion] we are measuring Mounjaro at the wrong time and calling it noise

Discussion Cold Box ×9 Long Haul ×1 Receipts ×1

we are measuring Mounjaro at the wrong time and calling it noise — a position I have arrived at slowly and would like tested.

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.

Happy to answer the boring questions. Those are usually the ones worth asking.

5,523 up / 715 down89% upvoted50 commentsid tex1n11 Mar 2025

50 comments

30 in this archive, depth 5

best — the order this archive was captured in

u/incretin_ivyMOD856 points·1 year ago

Trial identifiers corrected in the title. SURMOUNT and SURPASS are different programmes.

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[removed]401 points·1 year ago

[removed by moderator]

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u/taper_off_tabitha-34 points·1 year 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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u/mikkel_kimani1 point·1 year ago

What is the waist doing? That is usually the number still moving during a scale stall.

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u/forest_plot_fionastats-50 points·1 year ago

the trials titrated on a calendar, real people titrate on symptoms

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u/britt_okwuosa788 points·1 year 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/mod_cold_roommod · c/coldchain1.2k points·1 year ago

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.

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u/blunt_coldbox29590 points·1 year ago

Agree. The GIP component is the interesting half and it barely gets discussed outside c/glp1science.

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u/dexa_twice_yearlybody comp0 points·1 year ago·edited

The 21% figure is a 72-week mean on the highest arm. Quoting it as what someone should expect by week 51 is not a fair reading.

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u/incretin_ivypharmacology1 point·1 year ago

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

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u/copay_card_cc1 point·1 year ago·edited

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

This. The step interval is a floor, and reading it as a timetable is the most expensive mistake in the thread.

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u/marit_sandvik1 point·1 year ago·edited

This.

Saving this one. It is the clearest statement of the stall problem I have read here.

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u/dario_vermeulen1 point·1 year 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/nz_unfunded1 point·1 year 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/taper_off_tabitha1 point·1 year ago

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

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u/teodor_szabo1 point·1 year 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/ignacio_vanheckeOP622 points·1 year ago

34kg over 83 weeks, never went past 10mg, and injection-site soreness stayed mild the whole way. Posting because the loud threads are all 15mg.

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u/ignacio_vanheckeOP457 points·1 year ago

the four-week step schedule is the label, not folklore

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u/priya_guerrero253 points·1 year 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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u/throwaway_titration242 points·1 year ago·edited

the four-week step schedule is the label, not folklore

ignacio_vanhecke is right that the two molecules are not interchangeable. There is no published conversion and the ones circulating are invented.

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u/b12_baseline335 points·1 year ago

Does fatigue follow the day after the shot, or is it spread across the week?

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u/zeynep_ndiaye373 points·1 year 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_wl2026224 points·1 year ago

Which week did the appetite change actually land for you?

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u/ferritin_low55 points·1 year ago

a lot of people plateau nicely at 10mg and never need 15

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u/nabila_ogunleye290 points·1 year ago

the food noise profile is genuinely gentler than people expect coming from sema

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u/hair_shed_hannah226 points·1 year ago

Careful with "everyone tolerates it better". The people it did not suit stop posting, which makes this board look calmer than the drug is.

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u/halima_boateng99 points·1 year 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/gustav_vermeulen33 points·1 year ago

zepbound and mounjaro are the same compound with different labels

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u/georgi_chowdhury27 points·1 year ago

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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