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c/tirzepatide·posted 3 months ago by u/throwaway_titration

[PSA] SURPASS is not what most of this community thinks it is

Question

SURPASS is not what most of this community thinks it is. Two minutes of reading now saves an argument later.

Came off sema and onto tirz with a two-week gap. The first month was flat and I assumed I had made a mistake. Month two it moved.

Went 10 to 12.5 on the calendar and had the worst fortnight of the whole run. Dropped back to 10 and everything settled.

24kg over 50 weeks, never went past 10mg, and nausea stayed mild the whole way. Posting because the loud threads are all 15mg.

Please do not ask me what dose you should be on. I genuinely do not know and neither does anyone else here.

198 up / 7 down97% upvoted22 commentsid 1t6zt022 Apr 2026

22 comments

14 in this archive, depth 4

best — the order this archive was captured in

u/ahmed_fonseca15 points·3 months ago

The four-week interval in the label is a minimum. Nothing about the pharmacology requires you to step on schedule, and the trials stepped on a calendar because trials have to.

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u/hub_opssite staff9 points·3 months ago

It is a dual GIP and GLP-1 receptor agonist, and the GIP arm is the part that has no equivalent in the semaglutide threads. That is why the side-effect profile reads differently rather than just milder.

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u/gentle_correctionnice about it6 points·3 months ago

Does fatigue follow the day after the shot, or is it spread across the week?

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[deleted]3 points·3 months ago

[deleted]

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u/ahmed_fonseca1 point·3 months ago·edited

dual agonist, so the GIP arm is doing something the sema threads will not tell you about

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u/tarek_lokken1 point·3 months ago

if 7.5 is working, 10 is not automatically better

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u/quiet_moderatormod1 point·3 months ago

switching from sema is not a dose conversion, there is no clean equivalence

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u/dario_vermeulen1 point·3 months ago

Disagree with the conversion table. There is no validated equivalence between the two molecules and posting one as though there is does real damage.

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u/signe_villalobos2 points·3 months ago

This matches mine. Milder fatigue than I expected, and what there was settled inside a fortnight of each step.

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u/throwaway_titrationOP-26 points·3 months ago

It is a dual GIP and GLP-1 receptor agonist, and the GIP arm is the part that has no equivalent in the semaglutide threads.

Not sure about this bit. The GIP arm being real does not tell you that it is what caused your particular week.

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u/zeynep_zielinski8 points·3 months ago

the appetite effect is blunter than sema, in a good way, most weeks

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u/zaid_balogun0 points·3 months ago

SURMOUNT-1 ran 72 weeks with the top arm around 21% mean body weight change. SURPASS is the diabetes programme and reports glycaemic endpoints, so quoting the two interchangeably is a category error.

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u/sanne_novak1 point·3 months ago

That percentage is body weight change, not body fat. Different measurement, and the distinction gets lost every time.

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u/forest_plot_fionastats1 point·3 months ago

Sulphur burps for the first eight days after each step, then nothing. Predictable enough that I planned my week around it.

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About c/tirzepatide

Tirzepatide-specific discussion: the dual-agonist pharmacology, the 2.5 → 15mg ladder, the appetite profile people describe as different from semaglutide, and the SURMOUNT/SURPASS trial programme. Comparisons with semaglutide are welcome as long as they are specific about dose equivalence being unknown.

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