Short answer first, then the reasoning. The GIP arm is doing real work rather than padding the label. GIP receptor agonism appears to improve adipose insulin sensitivity and lipid handling, and — counter-intuitively — GIP signalling in the CNS reduces nausea rather than adding to it, which is why tolerability at high total agonism is better than the GLP-1-only comparison would predict. SURPASS-2 is the cleanest head-to-head: tirzepatide beat semaglutide 1mg at every dose tier.

Ask again with the specifics and you will get a better answer than this one.

Dr.SleepRoch said:

The GIP arm is doing real work rather than padding the label.

True, though the ladder is longer and that is not a neutral detail — six dose steps means six opportunities to stall on the way up, and plenty of people never reach the dose the headline number came from.

paige_pharma said:

Trying to work out whether my panel improved or merely rearranged itself, because two of the numbers went the wrong way.

Agreed on the mechanism, with the caveat that the head-to-head used semaglutide 1mg, not 2.4mg. It is still the best direct evidence available, but it is not the comparison most people think they are citing.

I would rather be corrected than agreed with, if it comes to it.

Clinical perspective, offered as context rather than as advice.

Before/after bloodwork compilation for the lipid panel — everything in one place for those who want comprehensive data:

Every single metabolic marker improved. This is why I'm a believer in this therapy.