npr.org
This drug is a true gamechanger
In the SURMOUNT-1 study, people who took the highest dose of tirzepatide, most of whom had a BMI of about 30 or higher but did not have diabetes, lost about 21% of their body weight during the 72 week study. As researchers point out, for people who have bariatric surgery, typical weight loss is about 25% to 30% of their weight, one or two years after the surgery. In the tirzepatide study, 36% of people taking the highest dose lost 25% or more of their body weight.
this is comparable to bariatric surgery
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Notes -
I am sorry if I gave the impression that I believed there was an evolutionary selection pressure to lower BEE. However, now might be a good time to point out that the earliest mammals had ways to store fat and enter a state called Torpor - low body temperature, high fat storage, low energy expenditure, higher hunger levels. Echidnas are one of the older branches from the mammal family tree - they lay eggs and exude milk from their skin instead of concentrating it in a nipple. They enter a state of torpor. Bears famously enter a state of torpor. It seems to be common to mammalian metabolism and remnants of it remain in most mammals. It is almost universally useful, for humans included, to lower metabolism during famine, dry periods, winters, etc.
When mammals are not in torpor, they store body fat in a specific ratio: Saturated, Mono Unsaturated, and Poly Unsaturated fats are 4:5:1. When it is time to enter into torpor, mono-unsaturated foods become more available and body fat becomes more unsaturated, closer to 2:7:1
There are a lot of mechanisms that go on inside a cell that can cause a metabolism bottleneck. Once the bottleneck occurs, they body can no longer expend the calories as energy and instead has to store them as fat. I'm not going to go into it here and now. When I get around to it, I will write an effort post on this and will tag you.
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