First, understand the name
Tirzepatide is the active medicine. It activates both GIP and GLP-1 receptors, so it is more accurately described as a dual GIP/GLP-1 receptor agonist—not simply as another GLP-1 medicine. Mounjaro is a tirzepatide brand used for type 2 diabetes in the United States; Zepbound is the U.S. tirzepatide brand for chronic weight management. Brand names, approved indications and available presentations can differ by country. The exact product and current DRAP status in Pakistan must be checked rather than assumed from a foreign website or social-media post.
Tirzepatide reduces appetite and energy intake and improves glucose regulation. Its effect can be substantial, but it is not a “fat-melting” product, a cosmetic shortcut or a guaranteed number of kilograms. It is a prescription treatment that belongs inside a monitored obesity-care pathway.
Key tirzepatide trials at a glance
The percentages below are average change from starting body weight in groups of trial participants. They are not the percentage of people who succeeded, they are not a promise for an individual patient, and they came from structured trials with defined eligibility, gradual treatment escalation and lifestyle support.
| Trial | Population and duration | Main weight result | What it means clinically |
|---|---|---|---|
| SURMOUNT-1 | 2,539 adults with obesity or overweight plus a complication, without diabetes; 72 weeks | Mean change: −15.0%, −19.5% and −20.9% across the three studied doses, versus −3.1% with placebo | Established the large average weight effect in selected adults without diabetes. |
| SURMOUNT-2 | 938 adults with obesity or overweight and type 2 diabetes; 72 weeks | Mean change: −12.8% and −14.7% with the two studied doses, versus −3.2% with placebo | Benefit remained important, but average weight loss was lower in the diabetes population. |
| SURMOUNT-5 | 751 adults with obesity, without diabetes; 72-week open-label head-to-head trial | Tirzepatide −20.2% versus semaglutide −13.7%; waist −18.4 cm versus −13.0 cm | Direct evidence favoured tirzepatide for average weight and waist reduction in this defined population. |
| SURMOUNT-4 | Randomized-withdrawal study after a 36-week tirzepatide lead-in | After an initial mean loss of 20.9%, continued treatment produced another −5.5%; switching to placebo led to +14.0% regain from week 36 to 88 | Obesity is chronic. Stopping effective treatment without a maintenance strategy often leads to regain. |
How many people achieved a clinically important result?
In SURMOUNT-1, at least 5% weight loss was reached by 85%, 89% and 91% of participants in the three tirzepatide groups, compared with 35% receiving placebo. At the two higher studied doses, at least 20% loss was reached by 50% and 57%, compared with 3% on placebo. Those are impressive responder rates, but they also show that response varies and that not every participant reached the highest thresholds.
Trials usually report more than one statistical approach, and real-world results can be affected by missed treatment, adverse effects, supply interruption, affordability and follow-up. An honest consultation uses the trials to set a range of expectations—not to sell the best-looking number.
Does SURMOUNT-5 prove tirzepatide is “better” than semaglutide?
It proves that tirzepatide produced greater average weight and waist reduction than semaglutide over 72 weeks in the adults studied, using each medicine’s maximum tolerated dose. It does not prove that tirzepatide is safer, more tolerable, more affordable or more suitable for every patient. SURMOUNT-5 was open-label and funded by the manufacturer of tirzepatide. Those limitations do not erase the result, but they belong in a balanced interpretation.
Semaglutide still has extensive obesity evidence and established cardiovascular-outcome evidence in a specific high-risk population. Prior response, gastrointestinal tolerance, glucose treatment, cardiovascular history, supply and patient preference can all change the right decision.
Why tirzepatide is often central to Dr. Fowad’s weight practice
Many patients seeking care have more than excess weight: they may also have type 2 diabetes or prediabetes, fatty liver risk, high triglycerides, hypertension, PCOS/PMOS, sleep-apnoea risk or a history of repeated regain. Tirzepatide can be a powerful option when the medical indication is sound because appetite, weight and glycaemic risk can be addressed together.
Dr. Fowad does not prescribe it simply because a patient requests “Mounjaro.” The assessment asks what is driving risk, whether another treatment is more appropriate, and whether the patient can safely sustain treatment and follow-up.
What is assessed before a prescription decision?
- weight history, waist, previous treatment, regain pattern and realistic health goals;
- diabetes or prediabetes, blood pressure, lipids, fatty liver and sleep-apnoea risk;
- current medicines, including insulin or sulfonylureas that can increase hypoglycaemia risk;
- gastrointestinal symptoms, hydration, gallbladder and pancreatic history where relevant;
- personal or family history relevant to thyroid C-cell tumour warnings and MEN2;
- pregnancy, breastfeeding and pregnancy plans;
- food intake, protein adequacy, resistance activity and risk of losing lean tissue;
- authentic product, licensed-pharmacy supply, cold-chain history, affordability and continuity.
Safety deserves the same attention as weight loss
Nausea, vomiting, diarrhoea, constipation, reduced appetite and abdominal discomfort are among the common adverse effects. Clinically important concerns can include dehydration and kidney injury, gallbladder disease, pancreatitis, severe gastrointestinal problems, hypersensitivity and hypoglycaemia when combined with certain glucose-lowering medicines. Product labels also carry specific contraindications and warnings, including pregnancy considerations and the U.S. boxed warning concerning thyroid C-cell tumours observed in rodents, with contraindications for a personal or family history of medullary thyroid carcinoma or MEN2.
This summary is not a substitute for the complete information for the exact authorized product. A patient should not copy another person’s schedule, combine related injections, restart after an interruption without advice, or continue through significant symptoms merely to protect a target weight.
Protecting nutrition and muscle is part of good obesity care
A lower appetite can make it easier to reduce excess energy intake, but it can also make protein, fluids and micronutrients inadequate. Rapid weight reduction without a nutrition and resistance-activity plan can worsen loss of lean tissue. Follow-up therefore considers physical function, food tolerance, hydration, bowel symptoms, strength, waist and metabolic markers—not only the scale.
What happens if tirzepatide is stopped?
SURMOUNT-4 provides a clear warning against treating obesity as a short injection course. Participants who stopped after substantial initial loss regained considerable weight, while those continuing treatment maintained and extended their loss. This does not mean every patient must remain on the same medicine forever. It means the maintenance question—ongoing treatment, an alternative strategy, nutrition, activity, affordability and follow-up—should be discussed before starting.
Use only a genuine, verifiable product
DRAP has warned about falsified GLP-1 receptor agonist products. Medicine should come from an authorized licensed pharmacy with verifiable packaging, batch information and storage history. The clinic does not endorse anonymous social-media sellers, unlabelled syringes, repackaged or “research” vials, or a product whose cold chain cannot be confirmed. A low price is not a benefit if identity, sterility or potency is uncertain.
Dr. Fowad’s bottom line
Tirzepatide is one of the most effective established medical options for obesity and metabolic risk. In appropriate patients, it can produce clinically important weight and waist reduction and substantial glucose benefit. Its strength is precisely why it should be prescribed thoughtfully. The best outcome is not the fastest loss; it is meaningful health improvement that the patient can tolerate, afford and maintain without sacrificing nutrition, muscle or safety.
Frequently asked questions
Is Mounjaro the same as tirzepatide?
Tirzepatide is the active medicine. Mounjaro is a tirzepatide brand used for type 2 diabetes in the United States, while Zepbound is the U.S. brand for chronic weight management. Names, indications and availability differ by country, so the exact product and current Pakistani status must be verified.
How much weight did people lose with tirzepatide in trials?
In SURMOUNT-1, adults without diabetes had average losses of 15.0%, 19.5% and 20.9% across the three studied doses at 72 weeks, versus 3.1% with placebo. In SURMOUNT-2, adults with type 2 diabetes averaged 12.8% and 14.7% versus 3.2% with placebo. Individual results vary.
Is tirzepatide better than semaglutide?
In SURMOUNT-5, tirzepatide produced greater average weight loss than semaglutide in adults with obesity without diabetes: 20.2% versus 13.7% at 72 weeks. The right treatment still depends on indication, safety, tolerability, cost, availability and patient preference.
Will weight return if tirzepatide is stopped?
Weight regain is common after effective obesity medication is withdrawn. In SURMOUNT-4, participants switched to placebo after initial tirzepatide treatment regained substantial weight. A maintenance strategy should be discussed before starting.
Can I arrange a prescription by WhatsApp?
WhatsApp can be used to arrange an appointment, but a prescription decision requires an individual medical assessment. Product authenticity, contraindications and a follow-up plan cannot be established through a brief message.
Primary sources
- SURMOUNT-1: Tirzepatide Once Weekly for the Treatment of Obesity, New England Journal of Medicine, June 2022.
- SURMOUNT-2: Tirzepatide for obesity in people with type 2 diabetes, The Lancet, June 2023.
- SURMOUNT-4: Continued treatment and maintenance of weight reduction, JAMA, December 2023.
- SURMOUNT-5: Tirzepatide compared with semaglutide for obesity, New England Journal of Medicine, May 2025.
- U.S. FDA Drug Trials Snapshot: Mounjaro, accessed July 2026.
- DRAP safety alert concerning falsified GLP-1 receptor agonists, July 2023.
Medical and regulatory note: This is an independent educational review, not a product advertisement, prescription or dosing guide. Trial averages do not guarantee an individual result. Brand indications and regulatory status differ by country and can change. Suitability requires an individual consultation, review of the complete information for the exact authorized product and a verifiable legal supply.