Five Essential Things I Wish Patients Knew Before Starting Tirzepatide (Mounjaro)

Many people come to us excited about starting Mounjaro (tirzepatide). The headlines are impressive, and for many, it feels like the first real breakthrough after years of struggling with weight, appetite, insulin resistance or metabolic issues. But patients often tell us the same thing in hindsight:
“I wish I had known these things at the beginning.”

These five conversations help set realistic expectations, improve long-term outcomes, and prevent the most common challenges—especially when stopping the medication.

Stopping Tirzepatide Is Just as Important as Starting It

Most people focus on the early weeks and how quickly weight will come off. But the bigger challenge comes later, when tirzepatide is reduced or stopped.

Tirzepatide works by replacing hormonal signals that regulate appetite and metabolism. When the medication stops, those signals stop too. Without a plan, the body often reverts to its pre-treatment state.

What patients commonly report when stopping without support:

• Hunger returns rapidly
• Old eating patterns resurface
• Weight regain starts sooner than expected
• Improvements in blood sugar, blood pressure and cholesterol can fade

The data aligns with this: weight regain is common after discontinuation unless a transition plan is in place.

Three approaches to stopping:

Cold Turkey

Stopping abruptly often produces the steepest rebound. Many people regain half or more within a year if they discontinue without structured support.

Strategic Tapering

Gradually reducing the dose over several months while building lifestyle habits leads to gentler transitions and generally better outcomes.

Low-Dose Maintenance

Long-term doses of 2.5–5 mg provide ongoing hormonal support with fewer side effects and lower cost. For many, this is the most reliable way to maintain results.

Key insight:
The medication works brilliantly—but stopping without guidance is where things unravel.

Early Digestive Side Effects Are Normal and Temporary

Almost everyone experiences some gastrointestinal effects when starting or increasing tirzepatide.
Common symptoms include:

• Nausea
• Constipation
• Diarrhoea
• Bloating
• A feeling of fullness

This happens because tirzepatide slows gastric emptying—a normal part of its mechanism.

Most symptoms settle by weeks 6–8.

What helps

• Eat smaller meals
• Slow down while eating
• Avoid heavy or fatty meals
• Maintain hydration
• Increase doses gradually

Patients often say they wish they had known:
“These side effects are normal. They don’t mean the medication isn’t working.”

Safety Screening Matters Far More Than Most People Realise

Before prescribing tirzepatide, we perform a thorough clinical assessment. There are situations where it is not safe or appropriate.

Contraindications include:

• Personal or family history of medullary thyroid carcinoma
• MEN2 (Multiple Endocrine Neoplasia type 2)
• Previous pancreatitis
• Gallbladder disease
• Significant renal impairment
• Pregnancy or actively trying to conceive

Patients are often surprised by how essential this screening is. It prevents complications and ensures that your treatment is both safe and effective.

Tirzepatide Creates the Opportunity—You Shape the Outcome

Because tirzepatide reduces appetite, many people lose weight more easily than ever before. But this can create the illusion that diet and exercise matter less.

The opposite is true.

Once eating becomes effortless, food quality and muscle preservation become even more important.

Behaviours linked to the best long-term results:

• Prioritising protein intake
• Resistance training 2–4 times per week
• Choosing nutrient-dense foods
• Maintaining hydration
• Protecting muscle mass during weight loss

Patients often tell us:
“I thought the medication would replace healthy habits—but it really just makes them achievable.”

Everyone Responds Differently—and That’s Normal

Some patients experience rapid appetite suppression and steady weight loss.
Others:

• Plateau early
• Lose weight more slowly
• Experience more nausea
• Need dose adjustments
• Respond better to lower doses than expected

The most common feedback is that expectations matter. Understanding normal variability helps patients stay consistent and avoids unnecessary discouragement.

Why These Conversations Matter

After supporting many patients through their tirzepatide journey, one pattern is clear:
The prescription is the easy part. The support that follows determines long-term success.

Our medical approach includes:

• Detailed safety and suitability screening
• Personalised dose titration
• Regular monitoring
• Symptom management
• Nutrition and lifestyle support
• A structured strategy for safely tapering or maintaining treatment

Patients who attempt to navigate this alone often struggle—particularly when stopping the medication.

If you’re considering tirzepatide, we welcome a conversation. Not to persuade you, but to give you the guidance patients consistently tell us they wish they’d had from day one.

The goal isn’t just weight loss.
It’s long-term metabolic health and results that last long after the medication ends.

Read more and contact us here.