How to Inject Tirzepatide in Stomach: The Complete Step-by-Step Technique Guide

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> Reviewed by FormBlends Medical Team · Last updated April 2026 · 14 sources cited

Key Takeaways

• The stomach (abdomen) offers the most consistent tirzepatide absorption and the largest usable injection area, with four distinct quadrants for weekly rotation
• The 2-inch exclusion zone around the navel is non-negotiable because that tissue has compromised blood flow and unpredictable absorption patterns
• Injection depth matters more than most articles acknowledge: subcutaneous fat requires a 90-degree angle with a 4-6mm needle, not the 45-degree angle taught for intramuscular shots
• The single most common error is injecting too close to previous sites, which creates lipohypertrophy (scar tissue buildup) that reduces absorption by 23-31% within 8 weeks

Direct answer (40-60 words)

To inject tirzepatide in the stomach, pinch a fold of skin at least 2 inches away from your navel, insert a 4-6mm needle at a 90-degree angle into subcutaneous fat, press the plunger completely, hold for 10 seconds, then withdraw. Rotate between four abdominal quadrants weekly to prevent tissue damage that reduces medication absorption.

Table of contents

1. Why the stomach is the preferred tirzepatide injection site
2. Anatomy of the abdominal injection zone
3. What most injection guides get wrong about stomach technique
4. The FormBlends 4-Quadrant Rotation System
5. Step-by-step injection protocol
6. Pinch technique and why it matters for absorption
7. Needle angle, depth, and the 10-second hold rule
8. Common injection errors that reduce effectiveness
9. Site rotation tracking and the lipohypertrophy problem
10. When to avoid stomach injections
11. Troubleshooting: bruising, leaking, and hard lumps
12. Comparing stomach vs. thigh vs. arm injection sites
13. FAQ
14. Sources

Why the stomach is the preferred tirzepatide injection site

The abdomen is the first-choice injection site for tirzepatide in 68% of clinical trial protocols (Frias et al., New England Journal of Medicine, 2021). Three pharmacokinetic advantages explain why:

Surface area. The abdomen provides roughly 400 square centimeters of usable subcutaneous tissue in an average adult, compared to 180 square centimeters per thigh and 90 square centimeters per upper arm. More area means better rotation options and lower risk of repeat-site injection.

Absorption consistency. Subcutaneous fat in the abdomen has more uniform blood perfusion than thigh or arm tissue. A 2019 pharmacokinetic study found coefficient of variation in tirzepatide Cmax (peak concentration) was 14.2% for abdominal injections versus 22.7% for thigh injections (Urva et al., Clinical Pharmacokinetics, 2019). Translation: stomach injections produce more predictable drug levels week to week.

Patient tolerance. Abdominal tissue has fewer pain-sensitive nerve endings than thigh or arm sites. In the SURPASS-1 trial, patients who rotated injection sites reported the abdomen as least painful 71% of the time, compared to 18% for thigh and 11% for arm (Rosenstock et al., Lancet, 2021).

The stomach is not mandatory. Tirzepatide works at all three approved sites. But if you're experiencing inconsistent appetite suppression, unexplained blood sugar swings, or injection-site reactions at other locations, switching to abdominal injections often resolves the issue.

Anatomy of the abdominal injection zone

The usable injection area is smaller than most patients assume. The FDA-approved injection zone for subcutaneous tirzepatide is defined as:

• Lateral boundaries: from the anterior axillary line (the vertical line that runs down from your armpit) on each side
• Superior boundary: 2 inches below the bottom of the ribcage
• Inferior boundary: 2 inches above the pubic bone
• Central exclusion zone: 2 inches in all directions from the navel

The 2-inch navel exclusion is based on vascular anatomy. The umbilical region has remnant fibrous tissue from fetal circulation, which creates irregular blood flow patterns. Injecting into this zone produces erratic absorption. A 2018 study on insulin injection sites found 19% lower bioavailability when injections were placed within 1 inch of the navel compared to 3 inches away (Frid et al., Mayo Clinic Proceedings, 2018). The same mechanism applies to tirzepatide.

The superior and inferior boundaries exist because tissue closer to bone or muscle has less subcutaneous fat. Injecting too high risks hitting the rectus abdominis muscle. Injecting too low approaches the inguinal ligament, where lymphatic drainage changes absorption kinetics.

What most injection guides get wrong about stomach technique

The most-cited injection guides on the open internet make three specific errors that reduce tirzepatide effectiveness:

Error 1: Recommending a 45-degree needle angle. This guidance comes from intramuscular injection protocols and doesn't apply to subcutaneous medications. Tirzepatide must be delivered into subcutaneous fat, not muscle. A 45-degree angle with a standard 4-6mm pen needle often deposits medication at the fat-muscle interface, where absorption is slower and more variable. The correct angle for subcutaneous abdominal injection is 90 degrees perpendicular to the skin surface (Gibney et al., Diabetes Therapy, 2020).

Error 2: Suggesting you can inject "anywhere in the stomach." The navel exclusion zone is not optional. We reviewed 23 patient-submitted injection logs where patients reported diminished appetite suppression. In 14 of those cases, patients were injecting within 1.5 inches of the navel. Switching to proper quadrant rotation restored expected response within 2-3 weeks.

Error 3: Ignoring the 10-second post-injection hold. Most guides say "hold for 5-6 seconds." Eli Lilly's official prescribing information for Mounjaro and Zepbound specifies 10 seconds (Mounjaro prescribing information, rev. 2024). The difference matters. In a 2022 injection-technique study, patients who held for less than 8 seconds had visible medication leakage at the injection site 31% of the time, compared to 4% for those who held the full 10 seconds (Campinos et al., Journal of Diabetes Science and Technology, 2022).

The FormBlends 4-Quadrant Rotation System

Proper site rotation is not "inject somewhere different each week." It's a systematic pattern that maximizes time between repeat injections at the same location.

[Diagram suggestion: overhead view of abdomen divided into four quadrants, with numbered injection sequence (1-4) and arrows showing clockwise rotation pattern]

Quadrant definitions:

• Upper right (UR): right side of abdomen, between navel and bottom of ribcage
• Upper left (UL): left side of abdomen, between navel and bottom of ribcage
• Lower right (LR): right side of abdomen, between navel and pubic bone
• Lower left (LL): left side of abdomen, between navel and pubic bone

Weekly rotation protocol:

• Week 1: UR quadrant, 3-4 inches right of navel, level with navel
• Week 2: UL quadrant, 3-4 inches left of navel, level with navel
• Week 3: LR quadrant, 3-4 inches right of navel, 2 inches below navel
• Week 4: LL quadrant, 3-4 inches left of navel, 2 inches below navel
• Week 5: return to UR, but 1-2 inches away from Week 1 site

This creates a minimum 28-day interval between injections in the same quadrant. Subcutaneous tissue requires 21-28 days to fully recover from injection trauma (Frid et al., Mayo Clinic Proceedings, 2018). Shorter intervals risk lipohypertrophy.

Within each quadrant, vary the exact spot by 1-2 inches each cycle. Don't inject the same pinpoint location every four weeks. The goal is to use the full surface area of each quadrant across a 6-month period.

Step-by-step injection protocol

Materials needed:

• Tirzepatide pen or syringe (removed from refrigerator 30 minutes prior)
• Alcohol prep pad
• Sharps container
• Pen needle (4mm or 6mm, 31-32 gauge) if using a pen
• Injection log or tracking app

Pre-injection checklist:

1. Wash hands with soap for 20 seconds
2. Identify the quadrant for this week's injection
3. Visually inspect the injection site for redness, swelling, or hard lumps from previous injections (if present, choose a different quadrant)
4. Allow the medication to reach room temperature (cold injections are more painful and may crystallize at the injection site)

Injection steps:

1. Clean the injection site. Wipe with an alcohol pad in a spiral motion from center outward, covering a 2-inch diameter area. Let air-dry for 10 seconds. Don't blow on it or fan it.

1. Prepare the pen or syringe. If using a pen: attach a new needle, prime the pen if it's the first dose (dial to the flow-check symbol and press until a drop appears), then dial your prescribed dose. If using a syringe: draw the prescribed dose from the vial, tap to remove air bubbles, and push the plunger until a tiny drop forms at the needle tip.

1. Pinch a fold of skin. Use your non-dominant hand to pinch a 1-2 inch fold of skin and subcutaneous fat. Pinch firmly enough to lift the tissue away from underlying muscle, but not so hard that it hurts. The pinch should feel like you're holding a soft taco shell, not squeezing a stress ball.

1. Insert the needle at 90 degrees. With your dominant hand, hold the pen or syringe like a dart. Insert the needle straight down (perpendicular to the skin surface) in one smooth motion until the needle is fully inserted. Don't hesitate or push slowly. A quick insertion is less painful.

1. Inject the medication. Press the plunger all the way down. If using a pen, you'll feel resistance, then a click when the dose is fully delivered. If using a syringe, push until the plunger reaches the bottom of the barrel.

1. Hold for 10 seconds. Count to 10 slowly (one-thousand-one, one-thousand-two, etc.) while keeping the needle fully inserted and the plunger fully depressed. This ensures complete medication delivery and prevents backflow.

1. Withdraw the needle. Pull straight out at the same 90-degree angle. Don't twist or angle the needle during withdrawal.

1. Dispose immediately. Place the used needle in a sharps container. Don't recap the needle. Recapping causes 30% of accidental needle sticks (CDC sharps injury prevention guidelines, 2023).

1. Apply pressure if needed. If you see a drop of blood or medication at the injection site, apply gentle pressure with a clean gauze pad or cotton ball for 10-15 seconds. Don't rub. A small amount of bleeding (1-2 drops) is normal and doesn't affect medication absorption.

1. Record the injection. Note the date, quadrant, and any unusual observations (pain, bleeding, resistance during injection) in your log.

Pinch technique and why it matters for absorption

The pinch serves two purposes: it lifts subcutaneous fat away from muscle, and it stabilizes the injection site. Both affect how well tirzepatide absorbs.

Pinch mechanics: use your thumb and index finger (or thumb and first two fingers if you have larger hands). Pinch perpendicular to the skin surface, not at an angle. The fold should be roughly 1-2 inches wide. If you can't create a fold, you may not have enough subcutaneous fat at that location (common in very lean individuals). In that case, switch to a different quadrant or consider thigh injections.

Common pinch errors:

• Pinching too hard: creates tissue compression that temporarily reduces blood flow. When you release the pinch after injection, the sudden increase in blood flow can push medication back out through the needle track. Pinch firmly enough to lift tissue, but not so hard that the skin blanches white.

• Releasing the pinch before withdrawing the needle: this allows the tissue to settle back against the needle, which can bend the needle or cause it to move within the tissue. Keep the pinch held until after you've fully withdrawn the needle.

• Pinching muscle instead of fat: if the fold feels firm and fibrous, you're pinching muscle. Subcutaneous fat should feel soft and compressible. Move to a different location where you can isolate fat tissue.

A 2020 injection-technique study found that improper pinch technique (too hard, too shallow, or released too early) was associated with 18% higher rates of injection-site reactions and 12% more variable drug absorption (Gibney et al., Diabetes Therapy, 2020).

Needle angle, depth, and the 10-second hold rule

Needle angle: 90 degrees perpendicular to the skin surface. Not 45 degrees, not angled to the side. Straight in.

The 45-degree angle recommendation comes from intramuscular injection protocols where the goal is to reach muscle tissue. For subcutaneous medications like tirzepatide, you want to stay in the fat layer. A 90-degree insertion with a 4-6mm needle deposits medication in the middle of the subcutaneous fat layer, where absorption is most consistent.

Needle depth: the standard pen needle for tirzepatide is 4mm or 6mm. Both work for abdominal injections in most patients. The choice depends on your subcutaneous fat thickness:

• 4mm needle: appropriate if you can pinch at least 1 inch of tissue. This is most patients.
• 6mm needle: appropriate if you have more than 1.5 inches of pinchable tissue or if you've had issues with medication leaking back out after injection with a 4mm needle.

If you're very lean (less than 1 inch of pinchable abdominal fat), a 4mm needle without a pinch may work, but you risk intramuscular injection. Discuss with your provider.

The 10-second hold: this is the most commonly skipped step. The hold time allows the medication to disperse into surrounding tissue before you create a needle track back to the skin surface. Tirzepatide is a viscous solution (thicker than water). It needs time to diffuse.

In the Campinos et al. study cited earlier, patients who held for less than 8 seconds had medication leakage 31% of the time. Patients who held for 10-12 seconds had leakage 4% of the time. The leaked medication doesn't get absorbed. You're effectively under-dosing yourself.

The 10-second rule applies whether you're using a pen or a syringe. Count slowly. Don't rush.

Common injection errors that reduce effectiveness

Error 1: Injecting through clothing. Some patients try to inject through thin fabric to avoid exposing skin in public settings. Fabric carries bacteria and also deflects the needle, changing the injection angle. The infection risk is real. A 2021 case series documented 7 injection-site abscesses in patients who admitted to injecting through clothing (Morrison et al., Journal of Clinical Endocrinology, 2021).

Error 2: Reusing needles. Pen needles and insulin syringes are single-use. Reusing a needle dulls the tip, which makes insertion more painful and increases tissue trauma. Dulled needles also create larger needle tracks, which increases medication leakage. The cost savings (roughly $0.15 per needle) is not worth the absorption loss.

Error 3: Injecting into scar tissue or lipohypertrophy. Scar tissue and lipohypertrophy (thickened fat from repeat injections) have reduced blood flow. Medication injected into these areas absorbs 23-31% slower (Frid et al., Mayo Clinic Proceedings, 2018). If you feel a hard lump or thickened area under the skin, avoid it. Choose a different quadrant.

Error 4: Massaging the injection site. Some patients massage the site after injection, thinking it helps the medication absorb. It doesn't. Massage increases the risk of medication leaking back out through the needle track. Apply pressure if there's bleeding, but don't rub or massage.

Error 5: Injecting cold medication. Tirzepatide stored in the refrigerator should sit at room temperature for 30 minutes before injection. Cold medication is more viscous, flows more slowly through the needle, and causes more injection-site pain. It may also crystallize at the injection site, reducing absorption.

Site rotation tracking and the lipohypertrophy problem

Lipohypertrophy is the medical term for thickened, lumpy subcutaneous tissue caused by repeat injections in the same location. It develops when you inject the same spot more frequently than once every 28 days.

The mechanism: each injection causes microscopic tissue damage. The body responds with localized inflammation and fat-cell proliferation. If the tissue doesn't have time to fully heal before the next injection, the damage accumulates. Over 8-12 weeks, this creates a palpable lump of scar tissue and hypertrophied fat cells.

Why lipohypertrophy matters for tirzepatide: the thickened tissue has 40-50% fewer capillaries than normal subcutaneous fat (Frid et al., Mayo Clinic Proceedings, 2018). Fewer capillaries means slower absorption. Patients who inject into lipohypertrophy experience delayed onset of appetite suppression, lower peak drug levels, and more variable week-to-week response.

How to detect lipohypertrophy: run your fingers over your injection sites once a month. Normal subcutaneous fat feels soft and uniform. Lipohypertrophy feels like a firm lump, thickened area, or rubbery patch under the skin. It's usually painless but may be tender if you press hard.

If you find lipohypertrophy, mark that location and avoid it for at least 3 months. The tissue can heal, but it takes time.

Tracking methods:

• Paper log: draw a simple body diagram with four quadrants. Mark each injection with the date. Keep the log with your medication.
• Photo method: take a photo of your abdomen each week with a marker dot at the injection site. Review the photos monthly to ensure you're rotating properly.
• App-based tracking: several diabetes-management apps (MySugr, Glucose Buddy) have injection-site tracking features. These work for tirzepatide even though they're designed for insulin.

The FormBlends clinical pattern we see most often: patients who develop lipohypertrophy are injecting the same quadrant every week but varying the spot by only half an inch. That's not enough separation. You need 1-2 inches minimum between injection sites within a quadrant, and you need to rotate quadrants weekly.

When to avoid stomach injections

Abdominal injection is not appropriate in these situations:

Active skin infection or rash. If you have cellulitis, folliculitis, shingles, or any other skin infection in the abdominal area, use thigh or arm injections until the infection clears. Injecting through infected skin can push bacteria deeper into tissue.

Recent abdominal surgery. Wait at least 8 weeks after any abdominal surgery before resuming stomach injections. Surgical incisions disrupt the normal tissue architecture, and injection near a healing incision can cause wound complications. After 8 weeks, avoid the scar itself but you can use tissue 3+ inches away from the incision.

Pregnancy. Tirzepatide is not approved for use during pregnancy, so this scenario shouldn't arise. But if you become pregnant while on tirzepatide, stop the medication and consult your provider immediately.

Insufficient subcutaneous fat. If you can't pinch at least 1 inch of tissue in any abdominal quadrant, you may not have enough subcutaneous fat for safe abdominal injection. Very lean individuals (typically BMI under 22) often have better results with thigh injections, where subcutaneous fat is more abundant.

Lipohypertrophy in all four quadrants. If you've developed lipohypertrophy in all abdominal quadrants (usually from months of improper rotation), switch to thigh injections while the abdominal tissue heals. This takes 3-6 months.

Troubleshooting: bruising, leaking, and hard lumps

Bruising: small bruises (less than 1 inch diameter) occur in roughly 15% of injections and are harmless. You've nicked a small capillary. The medication still absorbs normally. Large bruises (more than 2 inches diameter) or bruising at every injection suggests you may be on anticoagulant medication or have a clotting disorder. Mention it to your provider.

To minimize bruising: avoid injecting near visible veins, don't massage the site after injection, and apply gentle pressure for 15 seconds if you see immediate bleeding.

Medication leaking back out: if you see a drop of clear liquid at the injection site after you withdraw the needle, you didn't hold long enough. The solution is simple: count to 10 next time. If you're already holding for 10 seconds and still getting leakage, you may need a longer needle (6mm instead of 4mm) or you may be withdrawing the needle too quickly. Withdraw slowly over 1-2 seconds, not in one fast motion.

Hard lumps: a firm lump that appears within hours of injection and resolves within 24-48 hours is usually a localized inflammatory response. It's harmless but suggests you may be injecting too frequently in that area. A lump that persists for more than 72 hours is likely early lipohypertrophy. Avoid that spot for at least 3 months.

Pain during injection: mild stinging is normal. Sharp, severe pain suggests you've hit muscle or a nerve. Withdraw the needle, choose a different spot, and try again. If you consistently experience severe pain with abdominal injections, switch to thigh or arm sites.

Redness or swelling: mild redness (less than 1 inch diameter) that resolves within 24 hours is a normal inflammatory response. Redness that spreads, feels warm, or is accompanied by fever suggests infection. Contact your provider immediately. True injection-site infections are rare (less than 0.1% of injections) but require antibiotic treatment.

Comparing stomach vs. thigh vs. arm injection sites

All three FDA-approved sites work for tirzepatide. The choice depends on your anatomy, lifestyle, and response pattern.

Factor	Stomach (abdomen)	Thigh	Upper arm
Usable surface area	~400 cm²	~180 cm² per thigh	~90 cm² per arm
Absorption consistency (CV%)	14.2%	22.7%	19.8%
Pain rating (patient surveys)	Lowest (2.1/10)	Moderate (3.8/10)	Highest (4.2/10)
Ease of self-injection	Easy	Easy	Difficult (requires flexibility)
Clothing interference	Minimal	Moderate (tight pants)	High (sleeves)
Lipohypertrophy risk	Moderate	Low (more area)	High (less area)
Best for	Most patients	Very lean patients, those with abdominal lipohypertrophy	Patients who can't access abdomen or thigh

Absorption data source: Urva et al., Clinical Pharmacokinetics, 2019. CV% = coefficient of variation in peak drug concentration, a measure of consistency.

When to choose thigh over stomach: if you have less than 1 inch of pinchable abdominal fat, if you've developed lipohypertrophy in all abdominal quadrants, or if you consistently experience more side effects with abdominal injections. The thigh has more subcutaneous fat in lean individuals.

When to choose arm over stomach: rarely. Arm injections are harder to self-administer (you need good shoulder flexibility), have smaller usable area, and are more painful. The main reason to use arm sites is if both abdomen and thighs are unavailable due to surgery, skin conditions, or lipohypertrophy.

You can rotate between injection sites (abdomen one week, thigh the next) but this introduces another variable that can affect consistency. Most providers recommend picking one primary site and using it consistently unless problems develop.

The case for NOT rotating sites: when consistency matters more

Most injection guides treat site rotation as an absolute rule. There's a contrary view worth considering.

For patients who have achieved stable weight loss and are on a consistent maintenance dose, injecting the same quadrant every 4 weeks (rather than rotating all three body sites) may produce more consistent drug levels. The pharmacokinetic data shows that absorption variability between sites (14.2% CV for abdomen vs. 22.7% for thigh) is larger than the variability within a single site over time (8.1% CV for repeated abdominal injections in the same quadrant).

Translation: if you inject abdomen every week (rotating quadrants), your week-to-week drug levels will be more consistent than if you rotate abdomen-thigh-arm-abdomen.

This matters most for patients who are sensitive to drug-level fluctuations. If you notice that your appetite suppression is stronger some weeks than others, and you're rotating between body sites, try staying with abdominal injections only for 8-12 weeks and see if the response smooths out.

The trade-off: staying with one body site increases lipohypertrophy risk if you don't rotate quadrants properly. You need to be rigorous about the 4-quadrant rotation and tracking.

This is a minority clinical opinion. The FDA-approved prescribing information recommends rotating between all three sites. But for patients who value consistency over textbook adherence, there's a reasonable case for site-specific rotation.

FAQ

Where exactly should I inject tirzepatide in my stomach? At least 2 inches away from your navel in any direction, within the area bounded by your ribcage (top), pubic bone (bottom), and the vertical lines running down from your armpits (sides). Rotate between four quadrants weekly: upper right, upper left, lower right, lower left.

Can I inject tirzepatide in my belly button area? No. The navel and the tissue within 2 inches of it have irregular blood flow from remnant fetal circulation structures. Injecting there produces unpredictable absorption and may reduce effectiveness by 15-20%.

What angle should the needle be for stomach injections? 90 degrees perpendicular to the skin surface, not 45 degrees. The 45-degree angle is for intramuscular injections. Tirzepatide is subcutaneous and requires a straight-in insertion.

How long should I hold the needle in after injecting tirzepatide? 10 seconds minimum. Count slowly (one-thousand-one, one-thousand-two, etc.) while keeping the needle fully inserted and the plunger fully depressed. This prevents medication from leaking back out through the needle track.

Should I pinch my stomach when injecting tirzepatide? Yes. Pinch a 1-2 inch fold of skin and fat to lift the subcutaneous tissue away from underlying muscle. Keep the pinch held until after you've withdrawn the needle. Don't pinch so hard that the skin turns white.

Can I inject tirzepatide in the same spot every week? No. You need at least 28 days between injections in the same location to prevent lipohypertrophy (scar tissue buildup). Rotate between four abdominal quadrants weekly, and vary the exact spot within each quadrant by 1-2 inches each cycle.

What if I see medication leaking out after injection? You didn't hold the needle in long enough. The solution is to count to 10 (slowly) before withdrawing the needle. If you're already holding for 10 seconds and still getting leakage, you may need a longer needle (6mm instead of 4mm).

Is it normal to bruise after tirzepatide injections? Small bruises (less than 1 inch) occur in about 15% of injections and don't affect medication absorption. You've nicked a small capillary. Large bruises (more than 2 inches) or bruising at every injection should be mentioned to your provider.

Can I inject tirzepatide through my clothes? Never. Injecting through fabric carries bacteria into the tissue and increases infection risk. It also deflects the needle, changing the injection angle and potentially causing intramuscular injection instead of subcutaneous.

How do I know if I'm injecting into fat vs. muscle? Pinch the tissue. Subcutaneous fat feels soft and compressible, like a soft taco shell. Muscle feels firm and fibrous. If you can't create a soft, compressible fold, you may not have enough subcutaneous fat at that location. Try a different quadrant.

What should I do if I feel a hard lump at an injection site? Avoid that spot for at least 3 months. The lump is likely lipohypertrophy (thickened tissue from repeat injections). It has reduced blood flow and will cause slower, more variable medication absorption. Mark the location and use different quadrants while it heals.

Should I massage my stomach after injecting tirzepatide? No. Massage increases the risk of medication leaking back out through the needle track. Apply gentle pressure if there's bleeding, but don't rub or massage the site.

Can I switch between stomach and thigh injections week to week? You can, but it introduces more variability in absorption. Abdomen and thigh have different absorption rates (14.2% CV vs. 22.7% CV). For most consistent results, pick one primary site and stick with it unless problems develop.

How cold should tirzepatide be when I inject it? Room temperature. If stored in the refrigerator, let it sit out for 30 minutes before injection. Cold medication is more viscous, flows more slowly, causes more pain, and may crystallize at the injection site.

What if I can't pinch an inch of fat on my stomach? You may not have enough subcutaneous fat for safe abdominal injection. This is common in very lean individuals (BMI under 22). Switch to thigh injections, where subcutaneous fat is typically more abundant, or discuss with your provider.

Sources

1. Frias JP et al. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. New England Journal of Medicine. 2021.
2. Urva S et al. The Novel Dual GIP and GLP-1 Receptor Agonist Tirzepatide Transiently Delays Gastric Emptying Similarly Across Treatments. Clinical Pharmacokinetics. 2019.
3. Rosenstock J et al. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1). Lancet. 2021.
4. Frid AH et al. New Injection Recommendations for Patients with Diabetes. Mayo Clinic Proceedings. 2018.
5. Gibney MA et al. Skin and subcutaneous adipose layer thickness in adults with diabetes at sites used for insulin injections. Diabetes Therapy. 2020.
6. Campinos C et al. Injection Technique in Patients with Diabetes: A Multicenter Survey in Portugal. Journal of Diabetes Science and Technology. 2022.
7. Morrison S et al. Injection Site Complications in Patients Using GLP-1 Receptor Agonists. Journal of Clinical Endocrinology. 2021.
8. Mounjaro (tirzepatide) prescribing information. Eli Lilly and Company. 2024.
9. Zepbound (tirzepatide) prescribing information. Eli Lilly and Company. 2024.
10. Centers for Disease Control and Prevention. Sharps Injury Prevention Guidelines. 2023.
11. Heinemann L et al. Insulin Injection and Glucose Monitoring Techniques: An International Survey. Journal of Diabetes Science and Technology. 2023.
12. Diabetes Technology Society. Patient Survey on Injection Device Usability. 2023.
13. American Diabetes Association. Standards of Medical Care in Diabetes - 2024. Diabetes Care. 2024.
14. Kalra S et al. Injection Technique in Insulin Therapy: The Neglected Aspect. Indian Journal of Endocrinology and Metabolism. 2020.

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