What you’ll learn:
- Zepbound® helps support lasting weight loss by targeting appetite, digestion, and insulin function through dual-action on GLP-1 and GIP hormones.
- Most side effects, like nausea, diarrhea, and fatigue, are temporary and can be managed with gradual dosing, smart meal choices, hydration, and other lifestyle adjustments.
- With the right care and support, Zepbound® can fit smoothly into your routine, helping you stay on track with weight loss while minimizing discomfort and managing risks effectively.
If you’re considering taking Zepbound®, you’ve likely heard about its potential to support significant weight loss. But you may also be wondering how it might affect how you feel day-to-day. Zepbound® can be a highly effective medication for weight loss, with people losing an average of 21% of body weight, but it also comes with some side effects.
When do these symptoms show up, and how long do they last? We’ll walk through what to expect and how to manage the most common side effects, like nausea, vomiting, and stomach pain. We’ll go through how slow dose increases (known as titration) can help minimize side effects while maximizing results.
We’ll also compare how the side effects people report with Zepbound stack up against other GLP-1 medications used for weight loss, like Wegovy®.
Finally, we’ll touch on rare but serious side effects, such as pancreatitis and gallbladder complications, and explain what’s worth flagging to your healthcare provider.
Why Zepbound® can cause side effects
Zepbound® contains tirzepatide and is part of a class of medications called GLP-1 receptor agonists. These medications work by standing in for or mimicking a hormone called GLP-1 (glucagon-like peptide-1). GLP-1 is a hormone your body naturally makes to help control hunger after you’ve eaten. By mimicking this hormone, the tirzepatide in Zepbound® helps lower your appetite, slow digestion, and regulate blood sugar, essentially making you feel like you’ve already eaten, even if you haven’t!
Zepbound® also targets GIP (glucose-dependent insulinotropic polypeptide) receptors, another hormone involved in regulating appetite and fat metabolism. This dual action amplifies Zepbound®’s ability to reduce hunger, support healthy blood sugar levels, and promote weight loss.
But while these effects can help you lose weight, they can also cause side effects. When food stays longer in your stomach or digestive tract, it can lead to nausea, vomiting, bloating, heartburn, diarrhea, or constipation. What’s happening? Your body is adjusting to slower digestion and altered hunger signals, which can feel unfamiliar and unpleasant at times, especially if your diet doesn’t change. Many of these side effects improve as your body adapts to the medication, especially if your dose is increased gradually.
When will I experience side effects?
People are more likely to experience side effects when they first start the medication or when their dose is increased. Symptoms usually get better as the body adapts.
To help ease this adjustment, Zepbound® is started at a low dose and gradually increased over time. This slow approach helps your body get used to the medication and may lower the chances of uncomfortable side effects.
Here’s how it works: Everyone begins with 2.5 mg of tirzepatide once a week for at least 4 weeks. After that, the dose may increase to 5 mg, then continue in 2.5 mg steps (up to a maximum of 15 mg weekly). Your dose will increase to keep you losing steady weight (1 to 2 pounds per week) while minimizing side effects. Not everyone needs the highest dose to see results—many people see benefits at lower doses.
The most common side effects and symptoms seen with Zepbound®
Digestive issues are among the most common side effects reported when starting Zepbound® or increasing the dose. Here’s a closer look at some of the most frequently reported gastrointestinal symptoms, along with tips to manage them:
| Symptom | Zepbound® 5 mg | Zepbound® 10 mg | Zepbound® 15 mg | What can help |
|---|---|---|---|---|
| Nausea | 25% | 29% | 28% | Eat smaller, low-fat meals and avoid greasy or spicy foods to help manage nausea. |
| Diarrhea | 19% | 21% | 23% | Stay hydrated and choose easy-to-digest, low-fiber foods to ease digestion. |
| Vomiting | 8% | 11% | 13% | Stick to clear liquids and bland foods like toast or crackers to settle your stomach. |
| Constipation | 17% | 14% | 11% | Gradually increase fiber intake, drink plenty of water, and stay active to prevent constipation. |
| Abdominal pain | 9% | 9% | 10% | Try clear liquids and avoid solid foods for a short time to ease abdominal pain. |
| Dyspepsia (indigestion) | 9% | 9% | 10% | Eat slowly and avoid eating greasy and fizzy foods to reduce indigestion. |
Other symptoms
While digestive issues often receive the most attention with Zepbound® (tirzepatide), there are other potential side effects that affect energy, mood, the nervous system, and cardiovascular function. These symptoms are typically manageable and may improve over time, especially with dose adjustments. Let’s explore these side effects in more detail, along with tips that can help manage them:
| Symptom | Zepbound® 5 mg | Zepbound® 10 mg | Zepbound® 15 mg | What can help |
|---|---|---|---|---|
| Dizziness | 4% | 5% | 4% | Stay hydrated throughout the day and avoid rising quickly to reduce lightheadedness. |
| Fatigue | 5% | 6% | 7% | Ensure adequate rest, maintain a balanced diet, and incorporate light exercise to help boost energy. |
| Sinus tachycardia (Fast heart rate) | 4.6–7% | 5.9–9.3% | 10–23% | These episodes tend to be temporary, but if you experience heart palpitations or a racing pulse, contact your provider. |
| Hair loss | 5% | 4% | 5% | Hair shedding can occur with weight loss and often resolves over time. Ask your provider about treatments like biotin. |
Can Zepbound® cause depression?
Zepbound® carries a label warning to monitor for changes in mood or behavior, especially in people with a history of mental health concerns. While mood-related side effects like depression or anxiety weren’t reported in Zepbound® clinical trials, real-world data from the broader class of GLP-1 medications has raised some concerns. The FDA has investigated and hasn’t found a clear link between Zepbound®, or any GLP-1 medication, and increased mood disorders.
If you or someone you know is struggling with thoughts of self-harm or suicide, help is available. Call or text the 988 Suicide & Crisis Lifeline for free, confidential support 24/7.
Zepbound®: Injection site reactions
When starting Zepbound® for weight loss, you’ll be injecting the medication yourself once a week. The injections are available in two forms: a prefilled, single-dose pen and a single-dose vial and syringe. With both, the reactions are typically mild and go away on their own within a few days. Clinical trials show injection site reactions occur in about 3% to 6% of people using Zepbound®.
Common reactions:
- Mild pain, redness, or swelling at the injection site
- Itching, lumps, or skin irritation
- Rare cases of bruising or rash, particularly with repeated injections in the same area
Tips to prevent or reduce injection discomfort:
- Rotate injection sites: Alternate between the thigh, abdomen, and upper arm to avoid injecting into the same spot every week.
- Clean skin gently: Use an alcohol swab and let the skin dry completely before injecting to minimize stinging.
- Avoid irritated or scarred areas: Only inject into healthy, intact skin.
- Warm the medication slightly: If stored in the fridge, let the pen or vial sit at room temperature for 15 to 30 minutes before use.
- Apply light pressure after injection: If necessary, use a cotton ball to reduce redness or minor bleeding.
If you experience persistent or worsening reactions or signs of infection (heat, pus, pain), contact your healthcare provider.
Side effects of stopping Zepbound®
Zepbound® is designed for long-term weight management and metabolic support. If you decide to stop taking it, your body may react in ways that make it harder to maintain the progress you’ve made. Here’s what you can expect if you pause or discontinue treatment:
- Hunger may return: Zepbound® works, in part, by reducing your appetite. Once you stop the medication, it’s common for hunger signals and food cravings to become more noticeable again.
- Weight regain is possible: Without the ongoing support from Zepbound®, some of the lost weight may come back, especially if you haven’t fully established healthy habits around eating, exercise, and mindset.
- Gradual tapering may help: In some cases, gradually reducing the dosage under your healthcare provider’s supervision can help ease the transition, allowing your body more time to adjust.
- Healthy habits are key: Building solid routines around nutrition, exercise, sleep, and stress management can make a big difference in preserving the progress you’ve made. Using tools like Noom for tracking, support, and accountability can also help you stay on track after discontinuing Zepbound®.
Side effects in females: Are there any differences?
While Zepbound® doesn’t cause side effects that are specific to females, there are some factors, like hormones and weight loss, that can affect how certain symptoms show up. Here’s what you should keep in mind:
- Polycystic ovarian syndrome (PCOS) and menstrual changes: For women with PCOS, Zepbound® might help regulate their menstrual cycle by improving insulin resistance and supporting weight loss. Some women using GLP-1 medications notice irregular periods or spotting, which is usually tied to the hormone changes that come with weight loss.
- Fertility and contraception: Losing weight can help restore regular ovulation, which might increase the chances of pregnancy. Zepbound® isn’t for use during pregnancy, so it’s important to use contraception and to stop taking Zepcound at least two months before trying to conceive.
- Gastrointestinal side effects: Nausea, vomiting, and constipation may be more noticeable or intense for women. Hormonal changes, especially during menopause, can also make fatigue and dizziness feel stronger.
- Hair loss: If you’re dealing with hair thinning due to PCOS or menopause, you might notice it becoming more noticeable when starting Zepbound®. This could worsen hair changes for some people.
- Bone and muscle health: Zepbound® isn’t directly linked to bone loss, but rapid weight loss could affect bone density and lead to muscle loss (sarcopenia) over time, especially if you’re not getting enough nutrients or engaging in resistance training.
Zepbound®: Safety information and warnings
While serious side effects from Zepbound® are rare, it’s important to be aware of potential risks. If you experience any of the following, contact your get immediate medical attention:
- Pancreatitis: Signs include severe stomach pain that may spread to your back, often accompanied by persistent nausea or vomiting.
- Gallbladder issues: Look out for upper abdominal pain, fever, yellowing of the skin or eyes (jaundice), or pale stools.
- Kidney problems: You might experience swelling in the legs or ankles, reduced urination, fatigue, or trouble breathing, especially after prolonged vomiting or dehydration.
- Low blood sugar (hypoglycemia): Be alert for symptoms like shakiness, confusion, sweating, dizziness, blurred vision, or rapid heartbeat, particularly if you’re also taking insulin or sulfonylureas for diabetes.
- Vision changes: Sudden changes in eyesight, especially in people with type 2 diabetes, should be evaluated immediately.
- Allergic reactions: Symptoms include swelling of the face, lips, tongue, or throat, difficulty breathing, rash, or severe itching.
Boxed warning: Thyroid C-cell tumors
Zepbound® carries a boxed warning regarding the potential risk of thyroid C-cell tumors. While this has been observed in animal studies, its relevance to humans remains unknown.
Who shouldn’t take Zepbound®?
Zepbound® isn’t suitable for everyone, especially if you have certain health conditions. You shouldn’t take it if:
- You or a close family member has had medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2).
- You’re allergic to tirzepatide or any of its ingredients.
Talk to your doctor if:
- You’ve had pancreatitis. Since Zepbound® impacts digestion, it could worsen your condition if you’ve experienced inflammation of the pancreas before.
- You have a serious digestive condition, like gastroparesis, which slows food movement through your stomach. Tirzepatide could worsen symptoms like nausea, bloating, or discomfort.
Also, don’t take tirzepatide if:
- You’re pregnant or planning to get pregnant. Zepbound® should be stopped at least two months before trying to conceive.
- You’re breastfeeding.
Before starting Zepbound®, have an open discussion with your healthcare provider about your medical history. They can help you assess whether this medication is right for you.
For more information, visit the Zepbound® safety page.
Zepbound® vs. other GLP-1s: Side effect frequency comparison
All GLP-1 medications have similar side effects, but what you experience can vary depending on the specific medication and how your body responds. Here’s how Zepbound® compares to other popular GLP-1 medications:
| Medication | Nausea | Vomiting | Diarrhea | Constipation | Abdominal pain |
|---|---|---|---|---|---|
| Zepbound® (15 mg – tirzepatide) | 28% | 13% | 23% | 11% | 10% |
| Wegovy® (2.4 mg – semaglutide) | 44% | 24% | 30% | 24% | 20% |
| Saxenda® (3 mg – liraglutide) | 39% | 16% | 21% | 19% | 5% |
When it comes to GI side effects, Zepbound® appears to be better tolerated than Wegovy® (semaglutide) and Saxenda® (liraglutide) in clinical trials:
- Nausea was reported by 28% of people on Zepbound®, compared to 44% on Wegovy® and 39% on Saxenda®.
- Rates of vomiting and diarrhea followed a similar trend, with Zepbound® showing lower percentages (13% and 23%) than both Wegovy® (24% and 30%) and Saxenda® (16% and 21%).
- Constipation and abdominal pain were also less common with Zepbound®, suggesting that it may be more comfortable for some users.
While individual experiences vary, this data helps highlight how side effect profiles can influence the choice between GLP-1 medications.
Zepbound®: Managing side effects and beyond
Zepbound® offers a promising path for weight loss, and some data suggest side effects might be milder than those of other GLP-1 medications. Most common side effects—like nausea, constipation, and fatigue—tend to appear during dose increases and fade as your body adjusts. Eating smaller meals, staying hydrated, and gradually increasing your dose can all help reduce them.
As with any long-term treatment, success with Zepbound® comes down to more than the medication alone. Building lasting habits around food, movement, sleep, and stress can help amplify your results—and protect them if you ever decide to stop taking the drug. Whether you’re just starting out or already familiar with weight loss medication, understanding how Zepbound® works, what to expect, and how to support your body along the way can help you feel more confident and in control.
If you want more information, see if you qualify for Noom Med. Our clinicians can help figure out if weight loss medication like Zepbound® is right for you and prescribe it if needed. Then, you’ll get continuing medical support, a personal plan, and access to all of Noom’s tools and trackers to help you reach your goals.
