Rankings / Metabolic Health

Tirzepatide

Metabolic Health · GLP-1/GIP agonist (dual)

Also known as: Mounjaro ·Zepbound

Tier B

Reviewed by Read Off Label · Last reviewed · How we grade

glp-1gipprescription
6.8 / 10
Tier B
Ev 8 Bn 8 Sf 5

Bottom line

Read Off Label grades Tirzepatide as B (6.8/10) based on strong evidence, high benefit magnitude, and a med-risk safety profile.

SURMOUNT-1: ~22.

Studied, labeled, or reported-use context: Zepbound obesity label: titration to 10-15 mg SC weekly; Mounjaro (T2DM) — Rx; not individualized guidance.

If you were testing this on yourself

Two properties decide whether an n-of-1 experiment is readable and recoverable. These describe the experiment — they are not a judgment about whether to run it, and nothing here is a recommendation.

Can you undo it?

Reverses on stopping

As with semaglutide, the safety profile reverses on stopping and so does the weight loss. Regain is the expected default without a maintenance plan.

Can you tell if it worked?

Readable — Weeks

Body weight, waist, HbA1c.

What would fool you The lean-mass question is more pronounced here — comparative data suggest the greatest fat loss comes with the greatest lean loss. A scale alone will read that as unambiguous success.

What the evidence says

SURMOUNT-1: ~22.5% weight loss over 72 weeks at 15 mg — highest of any approved weight loss drug. SURMOUNT-5 (head-to-head 2025): tirzepatide -20.2% vs semaglutide -13.7% at 72 weeks. SURPASS-CVOT showed CV non-inferiority to dulaglutide. SURMOUNT-1 176-week extension (Heerspink 2026, Diabetes Obes Metab) confirmed sustained weight loss and renal-function preservation. Awaiting SURMOUNT-MMO for CV outcomes in obesity without diabetes. A Jul 2026 BMJ network meta-analysis (262 RCTs, n=99,791) found tirzepatide lost the most fat mass of the approved anti-obesity drugs (-25.7%) but also the most lean mass (-8.3%) -- a composition trade-off not captured by weight-loss percentage alone.

Mechanism

Dual GIP/GLP-1 receptor agonist; GIP component enhances weight loss and glycemic effects beyond GLP-1 alone; mechanisms similar to semaglutide but more potent

Studied, labeled, or reported dose & route

Zepbound obesity label: titration to 10-15 mg SC weekly; Mounjaro (T2DM)

This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.

Citations

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Common questions

What does the evidence show about Tirzepatide's effects?
Read Off Label rates the evidence for Tirzepatide as Strong and the benefit magnitude as high, producing an overall grade of B (6.8/10). SURMOUNT-1: ~22.
What safety findings are reported for Tirzepatide?
Tirzepatide has a med risk profile in the database. Med Legal status: Rx.
What doses or routes are reported for Tirzepatide?
Zepbound obesity label: titration to 10-15 mg SC weekly; Mounjaro (T2DM) This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
How does Tirzepatide work?
Dual GIP/GLP-1 receptor agonist; GIP component enhances weight loss and glycemic effects beyond GLP-1 alone; mechanisms similar to semaglutide but more potent

This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.