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ForumsTirzepatide (Mounjaro / Zepbound)Tirzepatide and muscle preservation — DEXA evidence vs semaglutide Page 2

Tirzepatide and muscle preservation — DEXA evidence vs semaglutide

MikeFit_NJ Sun, Feb 8, 2026 at 6:58 AM 13 replies 487 viewsPage 2 of 3
julia.endo
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Feb 8, 2026 at 9:48 AM#6

For what it's worth, there was a retrospective analysis (Rubino et al., presented at ObesityWeek 2024) looking at patients who switched from semaglutide to tirzepatide. The cohort that did accelerated titration (2wk/2wk through starter doses) had comparable GI adverse event rates to the standard titration group. N was small though (~180 patients).

The more interesting finding was that 73% of sema "plateau" patients resumed weight loss within 8 weeks of reaching tirz 7.5mg or higher.

Last edited: Feb 8, 2026 at 3:48 PM
17 5anna.melb_AU, mark_tokyo, hans_munich and 14 others
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PeptideSynthNJ
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Princeton, NJ
Feb 8, 2026 at 10:05 AM#7

following this thread! im in the exact same boat. stalled on wegovy 2.4 for almost 4 months now 😩

Last edited: Feb 8, 2026 at 2:05 PM
7 14NurseAsh_DET, BenResearch_OR, MikeKY_noInsulin and 4 others
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NurseKim_ATL
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Atlanta, GA
Feb 8, 2026 at 10:22 AM#8
julia.endo said:
For what it's worth, there was a retrospective analysis (Rubino et al., presented at ObesityWeek 2024) looking at patien...

73% resumed weight loss — that tracks with what I've seen anecdotally on here and on the Discord. The other 27% probably needed 10mg+. Have you seen any data on what happens to that remaining group at higher tirz doses?

45 21ingrid_STO, pete_nash, hank_denver and 42 others
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tom_AK
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Anchorage, AK
Feb 8, 2026 at 10:39 AM#9

UPDATE — Week 2:

Ok so I'm finishing my second week on 2.5mg and here's what I'm noticing:

  • Appetite suppression is milder than what I had on Wegovy, but it's... different? Hard to explain but food doesn't look as "exciting" if that makes sense
  • Zero nausea so far (I had horrible nausea on sema for the first 2 months)
  • Energy is UP. Like noticeably. I thought people were exaggerating about the tirz energy boost but no, it's real
  • Down 2.1 lbs already after 4 months of nothing on sema
  • No sulfur burps yet 🤞

Moving to 5mg next week per my endo's accelerated plan. Will keep updating!

SW: 247 | CW: 206.9 | GW: 165

Last edited: Feb 8, 2026 at 2:39 PM
44 24jennifer_SEA, tyler_CSCS, VanRx_Mike and 41 others
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A1cHero_PHX
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Feb 8, 2026 at 10:56 AM#10

The energy increase you're describing is something I hear from probably 60% of my patients who switch. There's some mechanistic basis for it — GIP receptor activation in the brain may have distinct effects on perceived energy vs pure GLP-1 agonism. It's not well studied yet but it's a very consistent patient-reported outcome.

Glad the transition is going smoothly! 🙌

35 20jason_sac26, chris_chi24, tampaLisa73 and 32 others
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