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For some patients, weight regain despite intensive lifestyle efforts may warrant consideration of resuming tirzepatide or transitioning to alternative anti-obesity medications, provided they meet FDA-indicated criteria (BMI 30 kg/m or 27 kg/m with weight-related comorbidity)

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Studies show that tirzepatide elicits a cyclic AMP response in human beta cells significantly higher than what either GIP or GLP-1 produces alone

However, if serum cobalamin concentration is within the normal range, treatment should be continued at least monthly (for parenteral supplementation) and the owner should be forewarned that clinical signs may recur sometime in the future

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