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Think of it as less goes in, less comes out. Fewer bowel movements can be normal ( even as few as three per week ), but experiencing hard stool, difficulty passing stool, bloating, abdominal pain, or incomplete evacuation would be considered constipation

The maintenance dose is the steady weekly dose you take after titration ends

Nausea, diarrhea, vomiting, constipation, and abdominal pain mostly early, mostly at each dose step-up, and mostly transient as the gut adapts

Concurrent use of medications that promote insulin resistancesuch as high-dose glucocorticoids, certain antipsychotics (olanzapine, clozapine), or immunosuppressantscan directly counteract tirzepatide's benefits and should be identified during treatment evaluation