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ForumsTirzepatide (Mounjaro / Zepbound)Tirzepatide dual agonism: GIP + GLP-1 synergistic mechanism — 6 month update Page 2

Tirzepatide dual agonism: GIP + GLP-1 synergistic mechanism — 6 month update

MASHdoc_SA Wed, Mar 19, 2025 at 9:25 AM 11 replies 1,365 viewsPage 2 of 3
Dr.LeslieOBGYN
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Dallas, TX
Mar 19, 2025 at 12:15 PM#6

Honestly Joe that's a pretty solid analogy. I'd add that one of the interesting things is that turning the GIP key really hard and constantly might actually be similar to breaking the GIP lock in certain tissues — which is the paradox Maria was asking about. But for a quick-and-dirty explanation, your version works great.

42 6Dr.BariatricHTX, LindaRN_retired, tommy_boulder and 39 others
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Dr.EndoIndy
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Oct 2024
Indianapolis, IN
Mar 19, 2025 at 12:32 PM#7

Saving this entire thread for my pharmacology seminar presentation next month. This forum is better than half my textbooks tbh.

Thanks for that insight and everyone! 🧬

Last edited: Mar 19, 2025 at 3:32 PM
22 2LeilaHI, marcus_mpls, DeniseRN_TPA and 19 others
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ingrid_STO
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Stockholm, SE
Mar 19, 2025 at 12:49 PM#8

One additional point worth mentioning: tirzepatide isn't a 1:1 balanced agonist. It has approximately 5x greater affinity for GIPR vs GLP-1R. It's fundamentally a GIP agonist with meaningful GLP-1 activity, not the other way around. This was a deliberate design choice by Lilly's team based on the Finan et al. structure-activity relationship data.

The imbalanced agonism ratio is probably critical to the pharmacology — a perfectly balanced dual agonist might not produce the same results. Biology is about ratios, not just presence/absence.

This kind of rational drug design is what makes tirzepatide such a landmark molecule, regardless of how it compares to future drugs.

15 23MikeFit_NJ, InsuranceTom, WendyG_ATL and 12 others
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