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The short answer is that yes, Zepbound (FDA-approved tirzepatide for weight loss) can cause fatigue

Any history of nerve-related conditions

Thats roughly 34-48 pounds for someone starting at 220 pounds

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Insulin Degludec SURPASS-3 [9] is a phase 3 study, with an inclusion criterion of age greater than 18 years, a baseline HbA1c of 7.0-10.5%, BMI of at least 25 kg/m2, and participants who were insulin-naive and treated with metformin alone or in combination with an SGLT-2 inhibitor for at least three months before screening