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Evidence-based GLP-1 & peptide discussion since 2023
ForumsTirzepatide (Mounjaro / Zepbound)Switching from sema to tirz and WOW the difference Page 2

Switching from sema to tirz and WOW the difference

KarenAZ_mom Sun, Jan 4, 2026 at 8:41 AM 27 replies 1,036 viewsPage 2 of 6
mel_PDX
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Jan 4, 2026 at 11:31 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: Jan 4, 2026 at 5:31 PM
30 0Dr.NateNeph, PharmD_Rodriguez, julia.endo and 27 others
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JessicaM_2024
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Jan 4, 2026 at 11:48 AM#7

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

19 1NicoleRaleigh, james_edin, FranDenver and 16 others
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Dr.DermMIA
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Jan 4, 2026 at 12:05 PM#8
mel_PDX 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?

32 0A1cHero_PHX, Dr.RenalNash, LipidDoc_ATL and 29 others
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Dr.EndoEP
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Jan 4, 2026 at 12:22 PM#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

27 11Dr.BariatricHTX, LindaRN_retired, tommy_boulder and 24 others
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Dr.LipidDallas
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Jan 4, 2026 at 12:39 PM#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! 🙌

45 18Dr.PulmRoch, maya_sedona, stefan_berlin and 42 others
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