What is the difference between semaglutide and tirzepatide?
Semaglutide (Wegovy) is a single GLP-1 receptor agonist: it slows gastric emptying, improves glucose control, and reduces appetite. Tirzepatide (Zepbound) is a dual GIP/GLP-1 receptor agonist — it activates a second pathway (GIP) that amplifies the weight-loss effect. Clinical trials show the dual agonist produces greater average weight loss, which is why it's often the first choice in Midland when cost allows.
Why is the 3-4 month evaluation the clinical standard?
Both medications must be assessed at 3 to 4 months to decide on dosage adjustments or a medication switch. Individual response varies widely — some patients need a higher dose, some respond better to the other agent. The evaluation is the checkpoint that keeps treatment on track.
Why must medication be paired with lifestyle intervention?
FDA guidelines require pairing pharmacotherapy with a comprehensive lifestyle intervention (CLI) to preserve skeletal muscle and support long-term metabolic health. The protein-mTOR cascade matters here: adequate protein (1.2-1.6 g/kg) plus resistance training signals muscle retention during the deficit — without it, a meaningful share of weight lost can be lean mass.
What happens when you stop?
Without maintenance planning, weight regain is common — studies of long-term maintainers show that sustained habits (daily weighing, high activity levels, structured meals) are what separate the 11% who keep it off. Programs in Midland build the maintenance protocol into the plan from day one.