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Constipation is less dose-dependent and can persist, making it a more durable reason for discontinuation in patient reports. Sulfur burps reflect food sitting longer in a slowed stomach. Fatigue ranks second only to nausea in patient forums, although much of it tracks the calorie deficit rather than tirzepatide itself. Fried or fatty foods, coffee, meat, and alcohol can also become less appealing
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In the SURPASS and SURMOUNT trials, nausea was reported in up to 32% of participants, diarrhea in 23%, vomiting in 12%, and constipation in 11%
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