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Current safety data from clinical trials is reassuring, but long-term effects beyond 2-3 years are not yet fully known since the medication is relatively new

Tirzepatide exerts its dual incretin therapeutic effects through simultaneous activation of two gut hormone receptors, each contributing distinct and complementary mechanisms: Synergy of Dual Agonism Tirzepatides unique imbalanced and biased receptor activation leads to synergistic enhancement of glycemic control and body weight loss beyond what is observed with GLP-1 receptor agonists alone

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As noted, semaglutide often leads to harder stools or less frequent bowel movements because the gut is moving slower and perhaps absorbing more water from stool