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Whatever is going on seems like it may be a direct metabolic mechanism separate from loss of appetite (or weight)

This advanced formula features clinically studied probiotic strains including Akkermansia muciniphila and Clostridium butyricum , organisms associated with gut barrier integrity and short-chain fatty acid production

doi: 10.1161/JAHA.123.030178

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To bypass the skin barrier, several support techniques are being studied, such as: Microneedles: Tiny needles create microchannels in the skin, allowing drugs to enter the bloodstream directly

Research published in JCI Insight describes tirzepatide as an "imbalanced and biased dual agonist," meaning it actually engages the GIP receptor more potently than the GLP-1 receptor