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Start your intake Why Some Patients Gain Weight on Tirzepatide Therapy Weight gain on GLP-1 receptor agonists and dual GIP/GLP-1 agents like tirzepatide typically stems from five mechanisms: inadequate dosing for your metabolic phenotype, insufficient time to reach therapeutic dose, lifestyle factors offsetting medication benefits, hormonal imbalances unrelated to the peptide pathway, and individual genetic variation in how your body processes these compounds