How Starting Doses Compare to Higher Doses The starting dose of tirzepatide is usually low, around 2.5 mg or 5 mg per week, depending on the patients treatment plan
Choose Semaglutide (Wegovy) If: Best for people who: Want the longest safety track record (5 years) Have good insurance coverage for Wegovy specifically Prefer lowest discontinuation rate (6.9%) Are satisfied with 15% average weight loss Advantages: Most real-world data, proven track record since 2021 Disadvantages: Lowest efficacy (14.9%), highest cost ($1,349/month) Choose Tirzepatide (Zepbound) If: Best for people who: Want highest efficacy among available options (22.5%) Prefer best tolerability (31% nausea, lowest) Want better value (~$290/month cheaper) Want medication available today Advantages: Superior efficacy, best side effect profile, lower cost Disadvantages: Less long-term data than Semaglutide (3 years vs 5) Consider Waiting for Retatrutide If: Might make sense if you: Can wait until 2027-2028 without health consequences Want maximum weight loss (28.7%) Have tried both Semaglutide and Tirzepatide with insufficient results Have flexible health timeline Advantages: Highest efficacy (28.7%) Disadvantages: 2+ year wait, highest discontinuation (18.2%), no long-term data Realistic Recommendations For most people today: Choose Tirzepatide
Consultation with a cardiologist may be appropriate for patients with complex cardiac histories
J Clin Invest 38:1298-1313
6 MAR709 had finished its Phase 2a clinical trial in 2017, 51 and it is a balanced dual agonist for GLP-1R and GIPR
