The first-in-class dual GIP and GLP-1 receptor agonist — shown in clinical trials to produce up to 22.5% body weight reduction. Prescribed after a board-certified internal medicine physician reviews your health screening in a free async consult. We prescribe brand tirzepatide (Zepbound®) only, filled through manufacturer-direct pharmacy programs. We do not prescribe compounded tirzepatide.
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Tirzepatide is a first-in-class injectable medication that activates two different gut hormone receptors: glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1). It is the active ingredient in the brand-name drugs Mounjaro® (type 2 diabetes) and Zepbound® (chronic weight management), both manufactured by Eli Lilly.
While semaglutide works on one appetite pathway (GLP-1), tirzepatide works on two simultaneously. This dual mechanism is why tirzepatide produces greater average weight loss than semaglutide in head-to-head trials. Patients often describe feeling not just less hungry, but having a fundamentally different relationship with food — the reward response to high-calorie foods is dampened, and meal satisfaction comes earlier.
The landmark SURMOUNT-1 trial, published in the New England Journal of Medicine (2022), followed 2,539 adults with obesity over 72 weeks. Average weight loss by dose:
Roughly 57% of patients on the 15 mg dose lost 20% or more of their starting weight — a result historically achievable only with bariatric surgery.
The SURMOUNT-5 head-to-head trial (2025) directly compared tirzepatide with semaglutide: tirzepatide produced 20.2% average weight loss versus semaglutide's 13.7% at 72 weeks. Long-term extension data from SURMOUNT-1 (3.4 years) showed that patients on the highest dose maintained 23% weight reduction over the entire follow-up period, and tirzepatide reduced the risk of progression from prediabetes to type 2 diabetes by 94%.
Tirzepatide is titrated gradually to minimize gastrointestinal side effects. The standard titration schedule is:
Each increase is 2.5 mg, no sooner than every 4 weeks; the maximum dose is 15 mg weekly. Some patients do well on an intermediate maintenance dose and never need 15 mg. YourMD physicians manage titration along the labeled dose ladder — slowing it for sensitive patients or holding steady at an intermediate dose for long-term maintenance.
Birth control note: tirzepatide can reduce the effect of oral contraceptives. Use a non-oral method or add a backup method for 4 weeks after starting and for 4 weeks after each dose increase.
This is the single most common question patients ask during consultations. The honest answer is that both are excellent medications, and the right choice depends on your specific situation.
Many patients start on semaglutide and switch to tirzepatide later if they plateau or want more aggressive results. We support both pathways. See our full semaglutide vs tirzepatide comparison for a deeper side-by-side breakdown.
Side effect profile is similar to semaglutide: nausea, constipation, diarrhea, vomiting, abdominal discomfort, and fatigue. Most side effects are mild to moderate, peak in the first 2–4 weeks after each dose increase, and improve as your body adapts. Clinical trial discontinuation rates for side effects were comparable to semaglutide.
Our physicians manage side effects through three levers: (1) slower titration or holding at a lower dose, (2) dietary adjustments (small frequent meals, avoiding high-fat and ultra-processed foods during titration weeks), and (3) adjunctive medications such as ondansetron (Zofran), prescribed when appropriate for patients who need short-term anti-nausea support.
Serious but rare adverse events include acute pancreatitis, gallbladder disease, and severe GI reactions. Tirzepatide carries a boxed warning for thyroid C-cell tumors (seen in rodent studies; human relevance has not been determined). Tirzepatide is contraindicated in patients with a personal or family history of medullary thyroid carcinoma or MEN 2 syndrome, and is not recommended during pregnancy.
FDA-approved indications for chronic weight management (Zepbound) are:
Your YourMD physician will review your medical history, current medications, and goals in your free async consult to confirm whether tirzepatide is appropriate for you, or whether semaglutide or a non-GLP-1 approach would be a better fit.
In the SURMOUNT-1 trial, adults on tirzepatide 15 mg weekly lost an average of 22.5% of body weight over 72 weeks. Participants on the 10 mg dose lost 19.5%, and those on 5 mg lost 15.0%. Real-world results vary based on adherence, diet, activity level, and individual response.
In the SURMOUNT-5 head-to-head trial, tirzepatide produced greater average weight loss (20.2% vs 13.7% at 72 weeks). However, "better" depends on your individual response, budget, and tolerance. Many patients achieve excellent results with semaglutide at a lower monthly cost.
Zepbound® is the Eli Lilly brand name approved by the FDA for chronic weight management. Mounjaro® is the same active ingredient approved for type 2 diabetes, not weight loss. For weight management YourMD prescribes Zepbound® through manufacturer-direct pharmacy programs. We do not prescribe compounded tirzepatide.
Yes. Patients who plateau on semaglutide or want more aggressive weight loss can transition to tirzepatide. Your physician will typically start tirzepatide at the 2.5 mg starter dose regardless of your previous semaglutide dose to minimize GI side effects during transition.
You pay YourMD for physician care with a GLP-1 Essential ($79/month) or GLP-1 Concierge ($149/month) membership, and the medication is billed separately by LillyDirect™ or your insurance — YourMD doesn’t set or collect medication prices. See the pricing page for current physician-visit and membership pricing.
Baseline labs are not always required, but your YourMD physician may order a metabolic panel, HbA1c, lipid panel, or thyroid studies based on your medical history. If needed, labs can be ordered through our partner network, including at-home collection kits; lab fees are separate.
Tirzepatide has been studied in large clinical trials (SURMOUNT and SURPASS programs) for up to 3+ years. Long-term safety data continues to accumulate. Like semaglutide, tirzepatide is contraindicated in patients with personal or family history of medullary thyroid carcinoma or MEN 2 syndrome.
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Medical disclaimer: This page is educational and is not medical advice. Tirzepatide is a prescription medication and must be prescribed after a physician evaluation. Individual results vary. Side effects and contraindications are described above. Always consult with a licensed physician before starting any medication. Page medically reviewed by Teja V. Surapaneni, MD, MS — Board-Certified Internal Medicine, licensed in Nevada, Washington, Oregon, and Wisconsin.
Last reviewed: July 25, 2026