Dr.GastroMayo said:

The GIP arm is doing real work rather than padding the label.

This is where I part company with the consensus forming above. The "tirzepatide is simply better" summary irritates me. It is better on mean weight loss, and the cardiovascular outcome evidence is far thinner than semaglutide's. If the reason for treating is cardiovascular risk rather than weight, the evidence base points the other way.

Adding the numbers, since they settle part of this. If you are comparing against somebody else’s result, check that you are comparing the same measurement taken the same way. Most of the apparent contradictions in these threads dissolve at that step.

Dr.KarenChen said:

The "tirzepatide is simply better" summary irritates me.

Coming at Dr.KarenChen’s question from a different direction. The version of this that has an answer is narrower than the version being asked. Narrow it and it becomes tractable; leave it broad and the thread will produce nine confident and incompatible replies.

Following on from Dr.PeteFamMed — and this may be the naive question:

Whether anyone has held 10mg long term rather than climbing, and what happened over the following year?

Reporting back.

I stayed at 10mg. Another six months, another 7kg, no new side effects, and my reading of the dose-response says the last two steps were never going to be worth what they cost me.