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The prevalent wisdom is that its not the medication itself, but rather the weight loss

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Tirzepatide patients lost an average of 20.2% of their body weight, while semaglutide patients lost 13.7%, a difference of 6.5 percentage points.[1] In practical terms, for someone starting at 250 pounds, that means losing roughly 50 pounds (22.8 kg) on tirzepatide versus 33 pounds (15.0 kg) on semaglutide.[1] Waist circumference shrank by an average of 7.2 inches (18.4 cm) with tirzepatide versus 5.1 inches (13.0 cm) with semaglutide, a difference with real implications for heart disease risk.[1] When researchers looked at more dramatic weight loss thresholds, tirzepatide pulled further ahead

Why Semaglutide Can Cause Muscle Loss Does semaglutide cause muscle loss