Zepbound (tirzepatide) is a medication developed by Eli Lilly and initially approved for medical use in the United states in November of 2023. It was approved by the U.S. Food and Drug Administration (FDA) as an adjunct to diet and exercise for chronic weight management in adults with obesity.

Like other popular medications Ozempic, Wegovy, and Rybelsus, Zepbound works by mimicking GLP-1 (glucagon-like peptide-1) hormone receptors, receptors in the gut responsible for feelings of fullness. Unlike these other medications, however, Zepbound is a dual-acting medication, so it also activates GIP (glucose-dependent insulinotropic polypeptide) receptors. This dual-action is what truly sets Zepbound apart from the competition, and is part of the reason it is so much more effective than traditional options.

Clinical Trials

The SURMOUNT trials are a series of clinical trials funded by Eli Lilly and used in the approval process of Zepbound by the FDA. Most of the information on the Zepbound label came from data collected during these trials.

The SURMOUNT 1 trial consisted of 2539 adults with a BMI of 30+ or 27+ with another weight related complication. Individuals with diabetes were excluded and participants were treated for 72 weeks at 4 different doses, including placebo.

The most frequently reported side effects were related to the gastrointestinal system, which is in line with other medications that target the GLP receptor, such as Ozempic and Wegovy. These side effects were mostly mild to moderate in intensity and occurred mainly when the dose was increased. Treatment discontinuation due to adverse events was observed in 4.3%, 7.1%, 6.2%, and 2.6% of participants receiving tirzepatide doses of 5 mg, 10 mg, 15 mg, and placebo, respectively. Overall, between 78.9% and 81.8% of participants treated with tirzepatide reported experiencing at least one adverse event during the treatment period, compared to 72.0% of participants in the placebo group.

Common Side Effects

The most common observed side effects at the medium dose (10mg) are listed below. Note this is not a complete list of all side effects.

• Nausea - 33.3%
• Diarrhea - 21.2%
• Constipation - 11.7%
• Dyspepsia (indigestion) - 9.7%
• Vomiting - 10.7%
• Headache - 6.8%
• Abdominal pain - 5.3%

It is worth noting that a 15.4% of participants also contracted COVID during the course of the study, which could have had an affect on other side effect reports. Most of the side effects were mild in nature and subsided over time. 6% of participants reported serious side effects, but there were similar percentages of serious events in the tirzepatide and placebo groups.

What Can You Do At Home?

Some of the mild side effects of Zepbound can be mitigated with effort. A combination of slow dose escalation, diet changes, and other medications can help with healthy bowel movements. Here are some things to try:

• Drink more water! A general rule of thumb is 1 ounce of water per 2 pounds of weight. For someone weighing 200 pounds, this would mean 100 ounces of water per day. Exercising would require more.
• Get some exercise. Even as little as 10 minutes of exercise a day can be enough to help bowel movements.
• Eat more fiber with foods like fruits, vegetables, and whole grains.
• Try to go to the bathroom at the same time every day. Simple conditioning can help your gut get into a good rhythm.
• Use a toilet stool for your feet (also known as a squatty potty), which can make having a bowel movement easier.

When to Ask For Help

Never hesitate to ask your healthcare provider if you are having unwanted effects, even minor ones. If you are a patient of MD Exam, you can always reach out to your doctor with questions via our Portal. Though unlikely, there are serious side effects that can occur with Zepbound, so caution is always better than negligence.

At MD Exam, we have found that switching medications can be helpful for individuals experiencing side effects. Semaglutide, which we suggest as a starting point before tirzepatide, is often better tolerated while remaining effective.

Final Notes

Congratulations on taking the first step towards your weight loss journey with Zepbound! Being informed about medication options is essential for embarking on this path successfully. If you're considering beginning your journey with MD Exam, it's as simple as completing our brief 5-minute questionnaire, selecting a program, and awaiting communication from our medical team. We provide compounded equivalents at a fraction of the cost of brand-name medications, emphasizing accessibility and affordability. For further details, explore our available programs here.

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