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The SURMOUNT-4 trial followed tirzepatide patients to a mean 20.9% weight loss, then switched half to placebo

Common examples include semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro, Zepbound), liraglutide (Victoza, Saxenda), and dulaglutide (Trulicity)

In the first 4-6 weeks, it's common to lose fat while retaining water especially if: You recently increased your dose You're eating higher sodium foods You're not drinking enough water (counterintuitively, dehydration causes retention) You're female and dealing with hormonal fluctuations Signs this is happening: Rings feel tight Ankles or hands look puffy Weight fluctuates 2-4 lbs day to day But clothes fit better and measurements are down What to do: Increase water intake to 3+ liters daily Watch sodium intake (processed foods are the culprit) Be patient water weight resolves as your body adapts Trust measurements over the scale during this phase Reason #4: You're Losing Muscle Instead of Fat This is the silent killer of "weight loss" that's actually body composition destruction

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