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Zepbound for weight loss

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 7 minutes read

Zepbound is a weight loss drug used to treat people who are obese or are overweight with other medical conditions. In this article we explain what Zepbound is, who it is suitable for, how it works and possible side effects.

What is Zepbound?

Zepbound is the brand name for a drug called tirzepatide. It is a new class of drug called a GIP and GLP-1 receptor agonist. GIP is short for glucose-dependent insulinotropic polypeptide, and GLP-1 stands for glucagon-like peptide-1, both of which belong to a type of body hormone known as incretins which help to regulate blood sugar.

Zepbound can also slow down digestion so that sugar (glucose) from food takes longer to be absorbed into the body, and so it can reduce appetite, which in turn can cause weight loss.

How Zepbound works

Zepbound works by utilizing the hormones GIP and GLP-1, which play a crucial role in regulating blood sugar levels and appetite. When you inject Zepbound, it introduces tirzepatide, a synthetic version of GIP and GLP-1, into your system.

Once in your body, Zepbound has several key effects:

  • Increased insulin production: It prompts your pancreas to produce more insulin when needed. Insulin is crucial for regulating blood sugar levels.

  • Reduced liver glucose production: Zepbound helps reduce the excessive production of glucose by your liver, especially when your body doesn't require it.

  • Slower digestion: This medication slows down the digestion process, causing sugar (glucose) from the food you eat to be absorbed more slowly into your bloodstream.

  • Appetite suppression: One of the significant effects of Zepbound is its ability to curb your appetite. This can lead to reduced food intake and, consequently, weight loss.

Overall, Zepbound combines these effects to help manage blood sugar levels and promote weight loss in individuals who are obese or are overweight with other medical conditions.

How long does Zepbound take to work?

The effectiveness of Zepbound can vary from person to person. However, most individuals notice changes in their weight within the first few months of use.

It's important to follow your prescribed dosing schedule and maintain a healthy lifestyle with a balanced diet and regular physical activity to maximize the benefits of Zepbound. Your healthcare provider can provide personalized guidance on the expected timeline for your specific situation.

Doctors' advice

Who is Zepbound recommended for?

Zepbound is recommended for weight management in people who are obese, or in overweight people who have other medical conditions. The United States Food and Drug Administration (FDA) recommends that it can be used as an adjunct to a reduced calorie diet and increased physical activity for chronic weight management in:

  • adults with an initial body mass index (BMI) of ≥30 kg/m2 (obesity) OR

  • adults with a BMI ≥27 kg/m2 (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, type 2 diabetes mellitus, or dyslipidemia)

How is Zepbound used?

Zepbound is an injection that you give yourself once a week and is injected under the skin (subcutaneously) of your stomach (abdomen), thigh, or upper arm. 

It is important that you do not inject it into a muscle (intramuscularly) or vein (intravenously), and you should change the site where you give the injection every week - do not use the same site for each injection.

Zepbound dosages

Use Zepbound once a week, on the same day each week, at any time of the day. Standard dosing starts 2.5 mg per week in your first month, then 5 mg in your second month, then 7.5 mg in the third month, then 10 mg in the fourth month, then 12.5 mg in the fifth month, and 15 mg each week by the sixth month. From the seventh month onwards, your doctor may either keep you on the 15 mg dose weekly or decrease it to a lower strength if you don’t tolerate the highest dose. Please note this dosing may be different from person to person.

If you need to change the day of the week that you inject yourself for any reason, you may do so if your last dose of Zepbound was given 3 or more days before.

What if I miss a dose?

If you miss a dose and it’s within 4 days of the missed dose, give the injection. If it is longer than 4 days, skip the missed dose and continue with your regular dosing schedule. It's crucial not to double the dose to make up for a missed injection if it has been more than 4 days. If you're unsure about what to do, consult your healthcare provider for guidance.

Skipping a dose may result in increased hunger, potentially causing overeating and reducing the medication's effectiveness. When you miss a dose of Zepbound, it lowers the presence of tirzepatide in your system. This decrease can diminish the medication's ability to suppress appetite and delay the desired weight loss outcomes. Maintaining a consistent medication schedule as prescribed is crucial to achieve optimal results.

Can anyone use Zepbound?

No. Zepbound is not suitable if:

  • you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)

  • you have had a serious allergic reaction to tirzepatide or any of the ingredients in Zepbound

Before using Zepbound for the first time you should also tell your doctor if you have any other medical conditions, including if you:

  • have or have had problems with your pancreas or kidneys

  • have type 2 diabetes and a history of diabetic retinopathy

  • have or have had depression, suicidal thoughts, or mental health issues

  • are pregnant or plan to become pregnant (you should stop using Zepbound 2 months before you plan to become pregnant)

  • are breastfeeding or plan to breastfeed; it is not known if Zepbound passes into your breast milk

  • if you are taking other medications, make sure your doctor is aware of this - because Zepbound slows stomach emptying it can affect medicines that need to pass through the stomach quickly

Does Zepbound have side effects?

All medicines have the potential to cause side effects and Zepbound is no different. The most common ones include:

  • nausea

  • stomach pain, heartburn, or belching

  • dizziness

  • diarrhea and vomiting

  • headache

  • tiredness

  • runny nose or sore throat

  • constipation

Other possible side effects include pancreatitis (inflammation of the pancreas gland), gallbladder problems, allergic reactions, and low mood. If you have diabetic eye disease (retinopathy) and are using insulin, then Zepbound may lead to a worsening of your vision, which may require treatment. If this occurs, inform your doctor.


Can I drink alcohol when taking Zepbound?

While taking Zepbound, it's advisable to avoid alcohol consumption. Alcohol can affect blood sugar levels and may interact with Zepbound. As a result, alcohol can worsen the side effects of Zepbound. It can also contribute to weight gain, which is counter to the intended effects of taking Zepbound.

It's best to consult with your healthcare provider regarding alcohol consumption and its potential impact on your treatment plan. They can provide personalized advice based on your medical history and individual circumstances.

What should I eat when taking Zepbound?

When taking Zepbound, it's important to maintain a balanced and nutritious diet. Focus on incorporating a variety of foods rich in nutrients, such as fruits, vegetables, lean proteins, and whole grains.

Avoid excessive consumption of high-calorie or sugary foods, as this can counteract the weight loss benefits of Zepbound. Your healthcare provider or a registered dietitian can help you create a personalized meal plan that aligns with your treatment goals.

Are Zepbound and Mounjaro the same?

Zepbound and Mounjaro are similar; they both contain tirzepatide as the active ingredient. Zepbound is specifically formulated and licensed for weight management, while Mounjaro is primarily used to treat type 2 diabetes. The dosages and administration schedules may differ between the two drugs. Always consult your healthcare provider for guidance on which medication is appropriate for your condition.

Are Zepbound and Mounjaro interchangeable?

Zepbound and Mounjaro should not be considered interchangeable without consulting your healthcare provider. They have different approved uses and dosing regimens. Your healthcare provider will determine which medication is suitable for your specific medical condition and needs.

Can Zepbound cause stomach upset?

Stomach upset is a possible side effect of Zepbound. Adults in clinical trials reported nausea, vomiting, abdominal pain, and dyspepsia. If you notice increased stomach upset or any other concerning stomach symptoms while taking Zepbound, it's crucial to discuss this with your healthcare provider. They can evaluate your symptoms and provide appropriate guidance or adjustments to your treatment if needed. It is common to be given an anti-sickness medication to counteract the side effects

Can Zepbound cause diarrhea?

Yes, diarrhea is one of the potential side effects of Zepbound. If you experience persistent or severe diarrhea while taking Zepbound, it's important to inform your healthcare provider. They can assess the severity of the side effects and determine whether any adjustments to your treatment plan are necessary.

Can Zepbound cause constipation?

Constipation is among the possible side effects of Zepbound. If you experience persistent constipation while on Zepbound, it's advisable to discuss this with your healthcare provider. They can offer recommendations to alleviate this side effect and ensure your overall well-being during treatment.

Can Zepbound make you tired?

Tiredness or fatigue can be a side effect of Zepbound. If you experience excessive tiredness while taking Zepbound, it's essential to discuss this with your healthcare provider. They can assess whether it may be related to the medication or another underlying factor and provide guidance accordingly.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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