Analysis of Adverse Reactions During Weight Loss with Tirzepatide: A Summary of 10 Cases and Exploration of Changes in Body Composition

Abstract

Background: Tirzepatide, as a dual GIP/GLP-1 receptor agonist, has demonstrated significant efficacy in weight-loss treatment;
however, gastrointestinal tolerability and changes in body composition during therapy remain key clinical concerns. Method: Adverse reactions occurring during 6 months of tirzepatide treatment for weight loss were retrospectively summarized in 10 patients with obesity.
Result: Gastrointestinal reactions were the main adverse events, including diarrhea in 7 cases (7/10), alternating diarrhea and constipation in
2 cases (2/10), and nausea accompanied by early satiety in 6 cases (6/10). Most adverse reactions occurred during the dose-escalation phase
from 5 mg/dose to 7.5 mg/dose, and symptoms improved after symptomatic treatment. One patient discontinued treatment because of severe
constipation. Body composition analysis showed that all patients experienced varying degrees of decline in skeletal muscle mass, and the
extent of this decline was associated with whether vitamin D was taken regularly. Conclusion: The dose-escalation phase is a high-incidence
period for gastrointestinal adverse reactions and requires enhanced management. Attention to nutritional status, especially vitamin D supplementation, may help reduce skeletal muscle loss during pharmacological weight reduction.