In short
- Two hormones, not one. Tirzepatide acts on GIP and GLP-1. Semaglutide acts on GLP-1 alone.
- The strongest results so far. In its main obesity trial the highest dose gave about 21 percent average weight loss over 72 weeks.
- Weekly injection. Built up in 2.5 mg steps, at least four weeks apart.
- The licence varies by country. Which one applies in the UAE is checked before anything is prescribed.
- Prescription only. Examination, blood work and a medication review come first.
Treatment Overview
What is Mounjaro?
Mounjaro is tirzepatide, given as a once weekly injection.
It activates two receptors: GLP-1, the same one semaglutide uses, and GIP, a second gut hormone involved in how your body handles food and stores energy.
That dual action is the main clinical difference, and it is why some patients respond to tirzepatide after a GLP-1 only medicine gave a limited result.
How much weight do people lose?
In SURMOUNT-1, more than 2500 adults with obesity and without diabetes were treated for 72 weeks.
| Group | Average weight change |
|---|---|
| Tirzepatide 5 mg | -15 percent |
| Tirzepatide 10 mg | -19.5 percent |
| Tirzepatide 15 mg | -20.9 percent |
| Placebo | -3.1 percent |
On the 15 mg dose, 91 in 100 lost at least 5 percent of their body weight and 57 in 100 lost at least 20 percent. Results held at three years.
Those are trial averages. They are not a prediction for you, and nobody here will give you a number to expect.
How is the dose built up?
| Step | Dose once a week |
|---|---|
| Weeks 1 to 4 | 2.5 mg |
| Then, at least four weeks apart | Increases of 2.5 mg at a time |
| Maximum | 15 mg |
The aim is the lowest dose that gets the result, not the highest you can tolerate. Many patients settle well below 15 mg.
Each increase is a decision. If a step causes real nausea, you stay where you are or step back down.
Mounjaro or Wegovy?
| Mounjaro | Wegovy | |
|---|---|---|
| Ingredient | Tirzepatide | Semaglutide |
| Acts on | GIP and GLP-1 | GLP-1 |
| Average loss in trials | About 21 percent at the top dose | About 15 percent |
| Proven heart benefit without diabetes | Not confirmed | Yes |
More weight loss is not automatically the better choice. If you have heart disease and no diabetes, semaglutide is the only one of the two with proven cardiovascular benefit in that group.
That trade off is exactly what the consultation is for.
What about the licence?
Tirzepatide is licensed for type 2 diabetes, and in a number of countries it is also approved for weight management, sometimes under a different brand name. In the United States it is additionally approved for moderate to severe obstructive sleep apnoea in adults with obesity.
Which licence applies here is checked before anything is prescribed, and if the use is off label you are told so and given the reason.
Who Is a Good Candidate?
- Your body mass index is 30 or above, or 27 and above with a weight related condition such as type 2 diabetes, high blood pressure or sleep apnoea.
- A GLP-1 only medicine gave you a limited result, or did not suit you.
- You have type 2 diabetes and want blood sugar and weight treated together.
- You accept a slow build up over months and regular review.
- You are ready to keep eating and training changes going alongside the medicine.
- You or a close relative have had medullary thyroid cancer, or you have multiple endocrine neoplasia type 2.
- You are pregnant, trying to conceive or breastfeeding.
- You have had pancreatitis, severe inflammatory bowel disease or gastroparesis.
- You have diabetic eye disease that is not stable. Titration must be slower and monitored, and sometimes another route is safer.
- You are looking for a prescription without an examination, or for a pen from an unregulated source.
What Happens During the Consultation
-
1
Goals and history
What you want to change and why, what you have already tried, including any previous GLP-1 medicine and what happened on it. Pregnancy plans and contraception are covered, because this medicine is not used in pregnancy.
-
2
Medical review
Examination, weight and body composition, blood pressure, blood work. Full review of every medicine and supplement you take, and of your personal and family history of thyroid cancer, pancreatitis and gallbladder disease.
-
3
Suitability decision
A clear answer, including no. If tirzepatide is not the right route you hear what is, whether that is semaglutide, another medicine or a structured metabolic programme.
-
4
Personal plan
Starting dose, the escalation plan, a protein and training target to protect muscle, what to do if you feel sick, the number to call and the review dates.
Program Structure & Follow-Up
What does follow up look like?
- Every four to six weeks while the dose climbs. A short review before each step, in person or by phone.
- Every two to three months once you are stable. Weight, body composition, blood pressure and blood work at agreed points.
- Between appointments. You can reach the practice when something is wrong. Continuous access is part of the membership programmes.
The dose you stay on matters
Once you reach your result, the maintenance dose is normally kept where it is rather than reduced.
In a trial of reduced maintenance dosing, patients kept on their maximum tolerated dose held a 22 percent reduction at 52 weeks. Those dropped to 5 mg held 17 percent, and those switched to placebo held 10 percent. Regaining half of what they had lost happened in 11 in 100 on the full dose, 25 in 100 on the reduced dose and 67 in 100 on placebo.
So stepping down is not a free saving. If there is a reason to do it, it is planned and monitored.
Protecting your muscle
Across studies of this class, close to a third of the weight lost came from muscle related measures. That is the part most weight clinics never mention.
- A daily protein target set to your body weight, not a vague instruction.
- Resistance training at least twice a week. Walking does not protect muscle.
- Body composition measured alongside the scale.
Stopping
Without a plan, most of the weight returns. Across studies people regain around 0.4 kg a month after stopping a medicine in this class.
Obesity behaves like a long term condition, so this is usually long term treatment. When there is a reason to come off, the exit is planned before it happens.
Benefits, Limits & Safety
What are the side effects?
- Common. Nausea in roughly a quarter to 40 in 100 patients, with vomiting, diarrhoea or constipation in around 10 to 20 in 100. Worst in the days after a dose increase, and usually settling.
- Uncommon but serious. Gallbladder disease, pancreatitis, bowel obstruction. Rare, and not proven to be caused by the medicine in every case, but the reason you are reviewed rather than left alone.
What helps with the nausea?
- Smaller meals, more often. Stop at the first sign of fullness.
- Eat slowly.
- Keep fat, grease and spice low in the days after your injection.
- Keep drinking.
- If a step is not tolerated, it is delayed or reversed. That is normal, not failure.
When should you call straight away?
- Severe stomach pain going through to your back, especially with vomiting.
- Vomiting that will not stop, or that stops you keeping fluids down.
- Pain under the right ribs, yellow skin or eyes.
- Any change in vision if you have diabetes.
Two things to tell other doctors
- Before an operation or sedation. Tell the anaesthetist. The medicine slows stomach emptying and they may want you to hold a dose.
- If you take diabetes medication. Insulin and some tablets may need reducing as your weight comes down, otherwise your sugar can drop too low.
Two things Dr. Felix will not do
- Compounded tirzepatide. Copies mixed outside a regulated manufacturer have not been through the safety, quality and effectiveness review the licensed product has, and harm has been reported.
- Microdosing. Deliberately staying on a tiny dose has not been studied, gives unpredictable results and invites dosing errors.
What the evidence shows
About 21 percent average weight loss on the top dose over 72 weeks in the main obesity trial, sustained at three years. Individual results vary widely and no number is promised to you.
How you are followed
Review every four to six weeks while the dose climbs, then every two to three months. Weight, body composition, blood pressure and blood work, plus a direct line between appointments.
When it is not used
Pregnancy, breastfeeding, personal or family history of medullary thyroid cancer, multiple endocrine neoplasia type 2. Caution or refusal with previous pancreatitis, severe inflammatory bowel disease, gastroparesis or unstable diabetic eye disease.
Cost & Program Investment
Cost depends on your dose and how long you stay on treatment, so a single number on a website would be misleading. You get the full figure in the consultation, before anything is prescribed, and there are no charges you have not been told about. What is included is the part that decides the outcome: the assessment, the escalation plan, the reviews, the protein and training structure, and access between appointments through the membership programmes.
Frequently Asked Questions
For weight loss alone, the trial numbers are higher for tirzepatide. That does not make it the better choice for everyone. If you have cardiovascular disease without diabetes, semaglutide is the only one of the two with proven heart benefit in that group. The right answer depends on your case.
Semaglutide acts on the GLP-1 receptor. Tirzepatide acts on GLP-1 and on GIP, a second gut hormone. The dual action is why some people respond to it after a GLP-1 only medicine did little.
Generally if your body mass index is 30 or above, or 27 and above with a weight related condition, and lifestyle changes have not held. The decision also takes your history, your other medicines and your goals into account.
Appetite usually changes in the first weeks, often before the scale does. Weight loss builds as the dose climbs. The meaningful assessment point is around three months on a proper dose.
The needle is short and fine and goes into the fat of the abdomen, thigh or upper arm. Most patients describe a pinch or nothing. You are shown how and do the first one under supervision.
If you remember within a few days you usually take it and stay on your normal weekly day. If more time has passed, skip it and take the next as planned. Never double up. After several missed weeks you may need to restart at a lower dose.
Not necessarily. The aim is the lowest dose that holds your result. What is not recommended is dropping the dose once you are stable, because regain is much more likely.
There is no absolute ban. Alcohol adds calories, can upset a stomach that is already sensitive on this medicine, and matters more if you have diabetes because of the risk of low blood sugar.
Yes, at the start and at agreed points afterwards. It sets a baseline, finds conditions that change the plan, and shows what is improving as the weight comes down.
No. It is not used in pregnancy or while breastfeeding, and it is stopped well before a planned pregnancy. If you could become pregnant, contraception is discussed before you start.
Appetite returns and, without something else in place, so does the weight. On average people regain around 0.4 kg a month after stopping. That is why the maintenance plan is agreed before you start.
It depends on your dose and how long you stay on it, so a single figure would be misleading. You get the full cost in the consultation before anything is prescribed, because you should be able to decide with the real number in front of you.
Evidence
Where this information comes from
Every figure on this page is taken from the sources below. All of them are free to read, so you can check them yourself.
- Mounjaro: European public assessment report
- Obesity and overweight
- Obesity: identification, assessment and management
This page is general medical information and does not replace a personal consultation. Trial results are averages across large groups, not a prediction for any one person.