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Patients often report increased energy within the first week due to L-carnitines mitochondrial effects, but weight loss velocity accelerates most significantly between weeks 4 and 8 as hepatic steatosis resolves and VLDL export normalizes

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Tirzepatide: A Novel, Once-weekly Dual GIP and GLP-1 Receptor Agonist for the Treatment of Type 2 Diabetes

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doi: 10.1016/j.cbpa.2018.11.002 59 GuLRobinsonRA

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The hormonal pattern often resembles PCOS even in women without PCOS, with elevated estrogen relative to progesterone

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She was initially started on liraglutide with limited weight response

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