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[DOI] [PubMed] [Google Scholar] 5.Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: the STEP 4 randomized clinical trial

Obesity is associated with low-grade systemic inflammation, characterized by increased levels of inflammatory markers such as Toll-like receptor 4 (TLR4), tumor necrosis factor-alpha (TNF-), IL-6, IL-1 [36], IL 17, leptin [37], and resistin [38]

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This does not mean tirzepatide is "stronger." The two molecules have different potencies, receptor binding profiles, and pharmacokinetics

Yes, dose titration helps

Combining them wont improve results and could increase side effects like nausea, vomiting, diarrhea, or, in rare cases, pancreatitis