Tirzepatide does not force you to lose weight, it makes it much easier to stick to your diet. Maybe too easy, since people who are not prepared to manage their diet may find themselves missing meals accidentally (lots of stories of people losing more than 2 pounds a week, which is very satisfying when it happens but not the healthiest way to drop weight).
Make sure you are getting sufficient calories and you won't lose any weight.
The caveat is that it slows digestion down and this effectively reduces your capacity to eat a lot of food. So maintaining a high calorie diet may require some changes to increase the energy density of your food.
> lots of stories of people losing more than 2 pounds a week, which is very satisfying when it happens but not the healthiest way to drop weight
Folks should follow medical advice and do what works for them, but be aware that these guidelines were established prior to the obesity epidemic. I’d be highly surprised if someone weighing 300lbs vs. the same person weighing 190lbs should be losing weight at the same rate per week.
I imagine these will be updated to be body weight (or fat) adjusted as time goes on, like some doctors are already doing.
Also, I haven't really found anything that says losing fat faster than 2 pounds per week (and realistically it's not possible to lose more than like ~2500kcal/day * 7 = 5 lbs per week even when 100% fasted) is actually unhealthy. Studies show it does not make it any more or less likely that you'll regain weight if you do it fast vs slow. Folks say this but I'm not sure why...
This study says you may get a better body composition if you do it slowly, but also resistance training during weight loss helps prevent 93% of muscle mass loss. [1, 2]
This study says fast loss means more loss, and is actually better for long-term maintenance. [3]
Due to the risk profile of obesity, and this is not medical advice, I think there's a lot of room to take more risk if it helps get you back to a normal weight. The consequences of not are just too high.
Make sure you are getting sufficient calories and you won't lose any weight.
The caveat is that it slows digestion down and this effectively reduces your capacity to eat a lot of food. So maintaining a high calorie diet may require some changes to increase the energy density of your food.