Tirzepatide vs. semaglutide dosing: what TikTok gets right and wrong

What did @its.raychl actually say?

She laid out tirzepatide's titration schedule as 2.5, 5, 7.5, 10, 12.5, and 15 mg, and estimated semaglutide's as 0.25, 0.5, 1, and 2 mg. She was upfront that she was guessing on the semaglutide side: "I think I looked into it... I'm wrong because again, I'm not taking" it currently. She also explained the GLP-1 vs. GLP-1/GIP distinction as the key pharmacological difference between the two drugs, and shared her own cost and weight-loss experience on compounded tirzepatide.

She's describing herself as a real patient navigating real tradeoffs, not positioning herself as a clinical authority. That framing matters when evaluating what she gets right versus where she causes confusion.

Does the science back this up?

The tirzepatide dose schedule she described matches the FDA-approved titration for Zepbound and Mounjaro almost exactly. The semaglutide numbers are partially right but incomplete in ways that matter clinically.

Tirzepatide's approved starting dose is 2.5 mg weekly, titrating by 2.5 mg increments every four weeks, with a maximum of 15 mg. That matches what she said. The SURMOUNT-1 trial (Jastreboff et al., 2022, New England Journal of Medicine) used this same schedule and found a mean weight reduction of 20.9% at the 15 mg dose over 72 weeks, which is meaningfully larger than semaglutide's results in comparable trials.

For semaglutide, the Wegovy titration is 0.25, 0.5, 1, 1.7, and 2.4 mg, not stopping at 2 mg as she suggested. The STEP-1 trial (Wilding et al., 2021, NEJM) used 2.4 mg as the target dose, and that number is the clinically important one for weight loss. Missing the 1.7 mg step and especially the 2.4 mg ceiling dose is not a trivial omission if someone is using this video to understand their own treatment.

What did they get wrong (or right)?

She got the tirzepatide titration right. That's worth saying clearly. The 2.5-to-15 mg progression she described is accurate and consistent with both FDA labeling and what compounding pharmacies typically follow.

She got semaglutide's doses partially wrong. The approved weight-loss dose for Wegovy tops out at 2.4 mg, not 2 mg. She acknowledged uncertainty here, which is honest, but the missing 1.7 and 2.4 mg steps mean anyone relying on this for Wegovy guidance is working with an incomplete picture.

Her explanation of tirzepatide as a "GLP-1 GIP" dual agonist versus semaglutide as a GLP-1 agonist is accurate. Tirzepatide activates both GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 receptors, while semaglutide targets GLP-1 receptors only. That pharmacological difference is real and likely contributes to the greater average weight loss seen in head-to-head comparisons. A 2023 retrospective analysis (Frias et al., 2023, Nature Medicine) found tirzepatide produced greater weight loss than semaglutide in matched cohorts, though direct randomized head-to-head data is still limited.

One thing she did not say, and should have: compounded tirzepatide is not the same as Zepbound or Mounjaro. The FDA has not evaluated compounded versions for safety or efficacy.

What should you actually know?

Dosing schedules for GLP-1 and GLP-1/GIP medications are not interchangeable, and small numerical errors in a video like this can have real consequences for patients trying to self-navigate titration.

A few things to keep straight:

• Semaglutide's full approved weight-loss titration (Wegovy) goes 0.25, 0.5, 1, 1.7, and 2.4 mg weekly. The 2.4 mg maintenance dose is where the clinical evidence for weight loss lives.
• Tirzepatide's titration is 2.5, 5, 7.5, 10, 12.5, and 15 mg weekly. She described this correctly.
• Compounded versions of these drugs are not FDA-approved formulations. The active ingredient may be the same molecule, but potency, sterility, and excipients are not verified by the FDA the way brand-name products are. Do not assume a compounded version performs identically to a brand product.
• The GLP-1/GIP dual mechanism of tirzepatide does appear to produce greater average weight loss than GLP-1 monotherapy, based on current data, but individual responses vary significantly.
• Titration pace matters. Moving up doses faster than prescribed does not accelerate weight loss and substantially increases GI side effect risk.

Her personal experience losing 30 pounds is real and valid. But dosing information in a TikTok comment reply is not a substitute for guidance from a licensed prescriber who knows your full medical history.