Tirzepatide (Zepbound)

Tirzepatide is injected subcutaneously — into the fatty tissue of your abdomen, thigh, or upper arm. **Rotate your injection site each week** to prevent skin irritation or lumps from building up in one spot. Keep a simple note or pattern (e.g., left abdomen → right abdomen → thigh) so you always know where you injected last. Follow your prescriber's instructions on technique if you're unsure.

Injecting medication that is straight from the fridge can sting more and feel uncomfortable. Remove your pen from the fridge **15–30 minutes before your scheduled injection time** and let it come to room temperature. Do not warm it under hot water or in a microwave — simply leaving it out is sufficient.

Tirzepatide has six dose steps before reaching 15 mg. Each step is held for 4 weeks to let your GI system adapt. Skipping steps significantly increases nausea and vomiting risk. Your prescriber may keep you at a lower dose if it achieves your goals — higher is not automatically better.

Tirzepatide is a **once-weekly injection**, so choosing a consistent day — such as Sunday morning or Wednesday evening — makes it much easier to remember and build into your routine. Setting a recurring phone reminder can help. Follow your prescriber's instructions if you ever need to adjust the timing of a dose.

SURMOUNT-1 participants losing 20%+ of body weight were also losing lean mass. Aim for 1.2–1.6 g protein per kg body weight daily. If appetite is very low, protein supplements (shakes, Greek yoghurt, cottage cheese) help hit the target without large portions.

Many people find that injecting **before bed** means that the peak of any nausea or fatigue happens overnight while they're asleep, making the next day easier to manage. This is a personal preference — experiment to find what works best for your body and lifestyle.

Before coffee, before breakfast — make **250–300 mL of still water** the very first thing you drink each day. This jumpstarts your hydration, supports digestion, and helps counteract the tendency to forget fluids when appetite and thirst cues are suppressed. Keep a full glass on your bedside table the night before as a visual reminder.

If you need to change your injection day, take the dose on the new day and continue from there — as long as the gap between doses is at least 3 days. Do not double-dose.

SURMOUNT trial data showed weight loss curves that had not fully flattened by 72 weeks at the highest doses. Sustained treatment produced continued, slower reduction for many participants.

Drinking large volumes of fluid during a meal can contribute to bloating and nausea, especially in the early weeks. Instead, **sip water or herbal tea slowly throughout the day** and take small sips with meals rather than drinking a full glass all at once. A 500 mL reusable water bottle carried with you is a practical way to stay on track.

When appetite is suppressed, it's easy to fill up on carbohydrates or skip meals altogether — both of which can reduce protein intake to an unhelpful level. Make it a habit to **eat your protein source first** at every meal — whether that's eggs, chicken, fish, legumes, or Greek yoghurt. This helps protect muscle mass and keeps you fuller for longer on smaller portions.

Reduced hunger is a feature of tirzepatide, but skipping meals entirely can lead to fatigue, muscle loss, and rebound overeating later. Aim for **3 small, structured meals per day** — even if portions feel tiny. Set a reminder if needed. Think of it as fuelling your body with intention, not eating by hunger alone.

In the early weeks, your body is adjusting and energy levels may be lower than usual — this is not the time to launch into a demanding gym program. Start with **20–30 minute walks** a few times per week, which support weight management, improve mood, and are easy to sustain. Gradually build intensity as you feel more settled, and aim for at least 150 minutes of moderate activity per week over time.

Weight loss on tirzepatide can include some muscle loss alongside fat loss if resistance exercise isn't part of your routine. **Bodyweight exercises, resistance bands, or light weights** 2–3 times per week can help preserve and build muscle. Even simple exercises at home — squats, wall push-ups, lunges — make a meaningful difference over time.

Poor sleep can increase hunger hormones, reduce motivation, and impair the body's ability to manage weight effectively — even while on medication. Aim for **7–9 hours** of consistent, quality sleep by keeping a regular bedtime, limiting screen time in the hour before bed, and keeping your bedroom cool and dark. Sleep is one of the most underrated tools in your toolkit.

The number on the scale is just one measure of progress — and it can fluctuate daily based on fluid, food, and other factors. Keep a simple journal or notes app entry each week to record **non-scale victories**: how your clothes fit, your energy levels, how many flights of stairs you can climb, your sleep quality, or how your relationship with food is shifting. These changes are real and meaningful.

It's important to be honest with yourself: **the first four to six weeks can be hard**. Nausea, fatigue, and the absence of visible results can make it tempting to feel discouraged. Having realistic expectations from the start — and reminding yourself that these early weeks are temporary — can make a significant difference to how you feel emotionally. Connecting with a supportive community or speaking to your prescriber when things feel tough is always a good idea.