FDA-approved (as studied)
Tirzepatide
Compounded medicines are not FDA approved.
The larger effect of the two — shown head to head in a randomised trial — with more serious adverse events in the pooled comparisons and the same catch about stopping.
- Research evidence score
- 10/10 · EstablishedGood human evidence that it works for this.This score reflects the cited research on the studied medicine. It does not rate the compounded preparation shown on this site.
- Judged for
- Weight management in adults with obesity, or overweight with a weight-related condition
- Regulatory status
- Approved for this use, after review of safety and effectiveness.What we offer is compounded: Mixed by a pharmacy for one patient. Not FDA-reviewed for safety, effectiveness or manufacturing quality.
Tests a clinician may consider
Architek does not routinely require lab tests for GLP-1 care. A clinician may request them based on your history.
The same question as for any metabolic medicine: is this weight, or is this blood sugar. The answer changes the choice.
Claim by claim
Each claim carries what kind of study is behind it, what that study found, and how much it settles. Those are three different questions, and collapsing them is how a thin case is made to look strong.
“Tirzepatide produces weight loss far beyond diet and exercise alone.”
SURMOUNT-1 randomised 2,539 adults without diabetes and reported mean weight change of −15.0%, −19.5% and −20.9% at 5, 10 and 15mg against −3.1% on placebo at 72 weeks. Comparable in quality to the semaglutide trials and larger in effect; the head-to-head evidence is set out below.
Jastreboff et al., New England Journal of Medicine, 2022 (SURMOUNT-1), n=2,539
“In a randomised trial, tirzepatide produced more weight loss than semaglutide.”
SURMOUNT-5 randomised 751 adults with obesity and no diabetes to the highest tolerated weekly dose of tirzepatide (10 or 15 mg) or semaglutide (1.7 or 2.4 mg) for 72 weeks. Weight fell 20.2% on tirzepatide against 13.7% on semaglutide, and more people on tirzepatide reached 10, 15, 20 and 25% loss. Open-label, which matters less for a measured outcome like weight, and funded by tirzepatide's maker.
“The effect is consistent across the placebo-controlled trials, not one result.”
A systematic review pooled the three placebo-controlled trials of tirzepatide in adults without diabetes — SURMOUNT-1, -3 and -4, 3,901 participants — and found a pooled weight loss of 18.7% against placebo (95% CI 16.2 to 21.3) — that figure is in the full text; the abstract a reader lands on reports the same result as a standardised mean difference of −1.61 — with BMI, waist, blood pressure and HbA1c falling alongside. It pools tirzepatide alone, not the wider GLP-1 class, which matters: tirzepatide is a dual agonist and the class analyses mostly leave it out.
“Tirzepatide beats semaglutide head to head, not only against placebo.”
A meta-analysis of direct comparisons — ten studies, 41,381 participants, randomised and observational together — found tirzepatide produced 4.28 percentage points more weight loss than semaglutide (95% CI 3.28 to 5.28), about 4.4kg, and a higher chance of reaching 10%, 15% and 20% loss, with no difference at 5%. The weight is moderate rather than high because most of the pooled studies were observational. It is a real difference, and not on its own a reason to pick one over the other — the next claim is the other half of the same paper.
Harms and limits, checked
These do not move the score above, which is only about whether it works. They are about what it costs and where it stops — a “no effect” on a harm means it was looked for and not found, and a “negative” on a limit means the limit is real.
“The weight comes back when you stop.”
It does. In SURMOUNT-4, 670 adults (71% women) who had lost 20.9% on tirzepatide over 36 weeks were randomised to continue it or switch to placebo for a year. Those who continued lost a further 5.5%; those switched to placebo regained 14.0%. At the end, 89.5% on tirzepatide had kept at least 80% of their loss, against 16.6% on placebo. As with semaglutide, it is a treatment you stay on.
“Tirzepatide is as safe as semaglutide.”
The same head-to-head meta-analysis found serious adverse events more frequent with tirzepatide (risk ratio 1.83, p=0.007), while overall and gastrointestinal side effects, and stopping because of them, did not differ. A page that reports the extra weight loss from this paper and not the extra serious events from it is reading half of it. Which half matters more for you is a clinical conversation.
What is still missing
- As with semaglutide, women-specific outcomes — cycle, fertility, PCOS — are not what these trials measured.
Our verdict
Better numbers than semaglutide, including in a randomised head-to-head trial, and more serious adverse events in the pooled head-to-head studies. Stopping brings the weight back, as it does with semaglutide. Which of the two suits you is a clinical decision about tolerance, cost and supply, not a decision the evidence makes for you.
Do we sell this?
Yes, as a compounded medication. It is one of our medication pathways, where online enrollment opens soon. Compounded medicines are not FDA approved.
See what a request involves →This is education, not a recommendation for you. A licensed clinician decides what is appropriate, may suggest something different, and may decide no prescription treatment is right. Medical disclaimer.