Dr.KarenChen said:

Steady state is faster than people expect: half-life about five days, so you are at plateau in roughly three to four weeks rather than five.

This is where I part company with the consensus forming above. The "tirzepatide is simply better" summary irritates me. It is better on mean weight loss, and the cardiovascular outcome evidence is far thinner than semaglutide's. If the reason for treating is cardiovascular risk rather than weight, the evidence base points the other way.

Adding the numbers, since they settle part of this. Numbers worth memorising for this class: Tmax one to three days for the weekly peptides, terminal half-life about a week for semaglutide and about five days for tirzepatide, steady state at four to five half-lives, subcutaneous bioavailability high enough that site choice is irrelevant.

DebRD_ATL said:

The "tirzepatide is simply better" summary irritates me.

Adding the part of the answer the thread has not reached. The pharmacokinetics explain nearly every practical question asked here. Albumin binding above 99% slows clearance enough to make weekly dosing possible; a terminal half-life near a week means four to five weeks to steady state and therefore a four-week titration interval; subcutaneous bioavailability around 89% means injection site barely matters. Those three facts answer most timing questions before they are asked.

A narrower follow-up, since the general answer is now clear:

Whether anyone has held 10mg long term rather than climbing, and what happened over the following year?

Closing the loop on my own question.

Reporting back after another eight months at the same dose. Still losing slowly, no new side effects, and no reason I can find to climb further.