What to know about Zepbound side effects

The U.S. Food and Drug Administration (FDA) recently approved Zepbound® (tirzepatide), the newest medication geared specifically toward weight loss. With the same active ingredient as Mounjaro®—another brand name tirzepatide drug approved for type 2 diabetes—both work through multiple mechanisms, including increased energy expenditure, better-regulated blood glucose levels, and decreased appetite.

As is typical with any medication, Zepbound is a good fit for some people but not others—which is why Found helps people with personalized plans and prescriptions tailored for weight loss so you can find the right fit.

Like all drugs, Zepbound may have side effects, so it's helpful to know in advance what these might be (even if you don't end up experiencing any of them).

Here's a look at what to expect and how to deal with any Zepbound side effects if you take this medication as part of your journey to a healthier body weight.

What to expect with Zepbound

As with any weight-loss strategy, including medication, results can vary. That said, assessing the research used in gaining FDA approval can help you understand how much some people have lost on the drug, so you can set your expectations accordingly.

In November 2023, Zepbound’s manufacturer, Eli Lilly, noted that FDA approval was based on “results from the phase 3 SURMOUNT-1 and SURMOUNT-2 clinical trials. In SURMOUNT-1, a study of 2,539 adults with obesity, or excess weight and weight-related medical problems, not including diabetes, people taking Zepbound as an adjunct to diet and exercise experienced substantial weight loss compared to a placebo at 72 weeks.”

People taking the highest dose of Zepbound (15 mg) lost an average of 48 pounds, while those on the lowest dose in this trial (5 mg) lost 34 pounds. (The placebo group lost an average of 7 pounds.) The average starting weight was 231 pounds.

What can you expect when starting Zepbound for weight loss? Typically, your provider will start you on the lowest prescribed dose (2.5 mg) so your body can gradually get used to the medication. To lower the risk of developing sudden side effects, your provider may increase the dose over time until you reach a maintenance dose between 5 mg-15 mg. It can take several months to reach the maintenance dose that’s right for you.

Found members have the advantage of having a provider trained in obesity medicine who can help them develop a plan pairing medication for sustainable weight loss and access to a doctor-designed lifestyle change program tailored to each person’s unique needs.

Potential Zepbound side effects

According to Eli Lilly, the most common side effects of Zepbound (tirzepatide) are:

•  Constipation
•  Diarrhea
•  Fatigue
•  Gastroesophageal reflux disease
•  Hair loss
•  Indigestion
•  Injection-site reactions
•  Nausea
•  Stomach pain
•  Vomiting

The company noted that in studies, most reactions like nausea and diarrhea occurred when people increased their dose—but these possible side effects generally decreased over time.

Potential Zepbound risks 

Like GLP-1 receptor agonists (or glucagon-like peptide-1 agonists), tirzepatide, a dual agonist, carries an FDA-mandated boxed—or “black box”—warning for patients with a personal or family history of medullary thyroid cancer (MTC) or who have multiple endocrine neoplasia syndrome type 2 (MEN 2). Those with a history of MTC or MEN 2 shouldn’t take tirzepatide for weight loss or to treat type 2 diabetes. While rare, there are also risks of pancreatitis, gallbladder disease, kidney disease, severe allergic reactions and depression/behavior change/suicidality. Read more about risks and warnings on our dedicated Zepbound page.

Do not take Zepbound if you have ever had thyroid cancer. Please notify your doctor ASAP for medical advice if you develop trouble swallowing, hoarseness, a lump or swelling in your neck, or shortness of breath.

Avoid alcohol while taking Zepbound, and don’t use Zepbound if you are planning to become pregnant, pregnant, or nursing. People of childbearing age should use reliable birth control while taking this medication.

If you are going under general anesthesia or deep sedation, GLP-1s may make you accidentally breathe food or liquid into your lungs (pulmonary aspiration). Zepbound contains GLP-1. Tell the providers who will be performing the procedure that you’re taking Zepbound so they can give you instructions to avoid this.

Mounjaro, approved for treating type 2 diabetes, has the same boxed warning as Zepbound, which you can find on our dedicated Mounjaro page. 

What to do if you're experiencing Zepbound side effects

Found offers the benefit of having a weight care specialist to monitor your progress on any medication for weight loss, including Zepbound. Discussing your Zepbound side effects, even seemingly minor ones like passing bouts of nausea, can help track whether your side effects improve or worsen over time.

While taking Zepbound, watch for signs of diabetic retinopathy problems, such as changes in vision among those with type 2 diabetes. If you experience signs of low blood sugar, such as dizziness, weakness, shakiness, jitteriness, headache, anxiety/mood changes, rapid heartbeat, confusion, slurred speech, sweating, or lightheadedness, seek medical help immediately. (This is rare.)

If you use Zepbound and you're having more debilitating side effects, such as vomiting, hair loss, acid reflux, abdominal pain, or other gastrointestinal issues and stomach problems, speak to your provider as soon as possible. This doesn't mean you automatically need to switch to a different medication. However, you may need a change in dosage or a review of your medication schedule.

Switching to other medication

If the side effects of Zepbound are significant enough that you want to try different weight loss drugs, you have options with Found.

Found-affiliated providers prescribe treatment from a portfolio of weight loss medications—including some prescribed off-label—that can be combined in over 70 ways to personalize an obesity treatment plan that meets your needs. (The number of prescriptions available to you depends on your medical history, any other medications you’re taking, your preferences, and other factors.)

Keep in mind that all prescription drugs have potential side effects, but you may tolerate one medication better than another. That's part of the conversation with a Found-affiliated obesity-trained health care provider: understanding your experience with previous drugs and supplements to figure out what might work best for you—and what to do if you experience side effects.

Found also offers a virtual community for support, an app-based behavior change program, health coaching to help you with lifestyle changes that support your goals, such as physical activity and healthy eating if it’s appropriate.

To determine if Zepbound or another medication is right for your weight-loss journey, Found's doctor-designed weight-loss program leverages MetabolicPrint™, a proprietary metabolic health assessment engine, and clinicians specializing in obesity medicine to find the right medication for you. 

About Found

To discover your MetabolicPrint and start your journey with Found, take our quiz. Found is among the largest medically supported weight care clinics in the country, having served more than 200,000 members to date.

GLP-1/ GIP

GLP-1 and tirzepatide prescriptions, filled through your local pharmacy, are now available as part of Found's weight-loss toolkit. While these medications can be effective for weight loss, they are not clinically appropriate for everyone. Eligibility for these drugs is based on a thorough evaluation of your medical history and lab work. If GLP-1s or tirzepatide are not appropriate for you, our providers will work with you to determine an effective medication for your health profile.