Dr.NateNeph said:

SURMOUNT-1 landed around 20.9% mean weight loss at 15mg over 72 weeks, against roughly 15% for semaglutide 2.4mg in STEP 1.

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.

The figures, for anyone assembling their own picture. Keep the original post as written when you update it, and add the correction underneath. An edited-away mistake is invisible to the next person who makes it.

CarlaRPh_TPA said:

The "tirzepatide is simply better" summary irritates me.

Adding the part of the answer the thread has not reached. If two explanations both fit, the useful question is which one predicts something the other does not. That is answerable; arguing about which sounds more plausible is not.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

One thing that is still open after pam_columbus’s answer:

How much of the tirzepatide advantage is the GIP component and how much is simply that the dose ladder goes higher in receptor-occupancy terms?

Reporting back.

Update: the eight-week restart pattern people described is exactly what happened. I nearly abandoned it at week five.