at 0.25 my appetite went completely and i dropped back a step, eating nothing isnt a win
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#tirzepatide 2025-05-19
Monday34 messages11 participantstimes are UTC
Highlights from this day
- lean_mass_lex — the A1c results were genuinely striking though. all three tirz arms beat sema 1mg and a big fraction got under 5.7 20:10
- dexa_or_bia — which is the only sentence that actually matters for anyone reading this 20:33
- lean_mass_lex — side branch because we always end up here. the mechanism argument for why tirz is often easier on the stomach 21:23
- snac_and_water — good thread. back to the comparator thing — has anyone here actually swapped and compared on themselves 21:44
went back to semaglutide after 6 months because the cost difference mattered more than the GI
changed my mind about needing 15, i was chasing a number rather than an outcome
SURMOUNT was the weight programme and SURPASS was diabetes, thats the split people mix up
SURMOUNT-OSA was the sleep apnoea trial and it is not a weight headline however its quoted
GIP plus GLP-1
how did people handle the 2.5 to 5 jump
10 was enough
SURMOUNT was the weight programme and SURPASS was diabetes, thats the split people mix up
same plateau here
Reminder for stable_not_volatile: dose day is today. Set 7 days ago.
if SURPASS-2 already settled tirz vs sema why do people still argue
because the comparator was semaglutide 1mg
1mg was the highest approved diabetes dose at the time. it is not the 2.4 obesity dose
ah
and it was an A1c trial with weight as a secondary. people quote the secondary and ignore the design
the A1c results were genuinely striking though. all three tirz arms beat sema 1mg and a big fraction got under 5.7
yes. thats the result that changed diabetes practice, not the weight column
so what happens at 2.4 vs 15
closer, and tirz still ahead on the mean in the direct comparison programme
but closer by enough that individual variation swamps it for any one person
which is the only sentence that actually matters for anyone reading this
✅7
i dont understand why the comparator dose matters so much, its the same drug
because sema is dose responsive across that whole range. 1mg to 2.4mg is not a rounding difference
STEP 8 gives you a feel for it — 2.4 got around 16% in obesity, and nobody gets that from 1mg
ok that landed
💡5
side branch because we always end up here. the mechanism argument for why tirz is often easier on the stomach
good thread. back to the comparator thing — has anyone here actually swapped and compared on themselves
yes and thats in the switching conversation, its messier than you would hope
the GIP explanation for easier nausea is plausible and i still treat it as a story not a fact, i have it written down somewhere
i went to 15 and came back to 10, more suppression wasnt more useful for me, your mileage will differ
licensed top is 15 weekly, past that is not a licensed dose and nobody here can tell you what it does
coming off semaglutide, is there a conversion or do i restart at 2.5
wk 1-4 2.5mg
wk 5-8 5.0mg
wk 9-20 7.5mg <- stayed here
wk 21-24 10.0mg (no extra benefit for me)
wk 25+ 7.5mg (came back down)