$169 to $269 a month, depending on your weekly dose, with doctor visits, messaging and shipping included.
At 2.5–5 mg/wk:
Gentle Health
$169/mo
Brand directwithout doctor support
$299/mo
up to $399
Hims / Ro
$448/mo
up to $548
At >5–10 mg/wk:
Gentle Health
$219/mo
Brand directwithout doctor support
$449/mo
up to $699
Hims / Ro
$598/mo
up to $848
At >10–15 mg/wk:
Gentle Health
$269/mo
Brand directwithout doctor support
$449/mo
up to $699
Hims / Ro
$598/mo
up to $848
What each price is made of
Gentle Health
Medication, injection supplies, doctor reviews and dose decisions, unlimited messaging and video visits, refrigerated delivery and licenses.
Brand direct
Medication. A stripe shows the band’s higher dose, or the price if you don’t reorder within 45 days.
Hims / Ro
The brand price for medication, plus a $149 monthly membership for access to a prescriber, messaging with a care team, and dose and side-effect support. New members: $39 for the first month.
A doctor can check whether tirzepatide is safe for you and whether you need it in the first place.
Complete the intake and I’ll review your history. Message me with any questions, or book a video visit if you’d like one. The intake and my first review are free.
James Simmons, MD · Medical Director, board-certified in emergency medicine
Possibly. On the top dose, 15 mg, 31% of people had nausea at some point, mostly mild to moderate and mostly while the dose was still going up.
Nausea
31%
on placebo9.5%
Diarrhea
23%
on placebo7.3%
Vomiting
12.2%
on placebo1.7%
Constipation
11.7%
on placebo5.8%
On tirzepatideOn placebo
How this was studied · SURMOUNT-1 trial · 1,273 people · 72 weeks · vs placebo
Who took part
Adults with obesity, or with overweight plus a weight-related condition such as high blood pressure. People with diabetes were excluded.
How many people
630 on 15 mg and 643 on placebo. The trial also tested 5 mg and 10 mg in 1,266 more people.
How long
72 weeks: up to 20 weeks of stepping up the dose, then 15 mg for the rest
What they got
Weekly shots of Lilly’s tirzepatide, the drug sold as Zepbound, starting at 2.5 mg and rising by 2.5 mg every 4 weeks to 15 mg, plus diet and activity counseling
Compared with
Dummy shots with no medicine (placebo), plus the same counseling. Nobody knew which they had.
What was measured
Whether each person had a side effect at any point during treatment
15.0% of your body weight on 5 mg, on average, over 72 weeks in the main trial, where 68.5% of people lost at least 10%.19.5% of your body weight on 10 mg, on average, over 72 weeks in the main trial, where 78.1% of people lost at least 10%.20.9% of your body weight on 15 mg, on average, over 72 weeks in the main trial, where 83.5% of people lost at least 10%.
Enter your weight to see what these results mean in pounds.
lb
At 5 mg:
Lost 5% or moreat least 10 lb
85.1%
on placebo34.5%
Lost 10% or moreat least 20 lb
68.5%
on placebo18.8%
Lost 15% or moreat least 30 lb
48.0%
on placebo8.8%
Lost 20% or moreat least 40 lb
30.0%
on placebo3.1%
Lost 25% or moreat least 50 lb
15.3%
on placebo1.5%
At 10 mg:
Lost 5% or moreat least 10 lb
88.9%
on placebo34.5%
Lost 10% or moreat least 20 lb
78.1%
on placebo18.8%
Lost 15% or moreat least 30 lb
66.6%
on placebo8.8%
Lost 20% or moreat least 40 lb
50.1%
on placebo3.1%
Lost 25% or moreat least 50 lb
32.3%
on placebo1.5%
At 15 mg:
Lost 5% or moreat least 10 lb
90.9%
on placebo34.5%
Lost 10% or moreat least 20 lb
83.5%
on placebo18.8%
Lost 15% or moreat least 30 lb
70.6%
on placebo8.8%
Lost 20% or moreat least 40 lb
56.7%
on placebo3.1%
Lost 25% or moreat least 50 lb
36.2%
on placebo1.5%
On tirzepatideOn placebo
How this was studied · SURMOUNT-1 trial · 2,539 people · 72 weeks · vs placebo
Who took part
Adults with obesity, or with overweight plus a weight-related condition such as high blood pressure. People with diabetes were excluded.
How many people
630 on 5 mg, 636 on 10 mg, 630 on 15 mg and 643 on placebo
How long
72 weeks, including up to 20 weeks of stepping up the dose
What they got
Weekly shots of Lilly’s tirzepatide, the drug sold as Zepbound, at a fixed 5, 10 or 15 mg, reached by rising 2.5 mg every 4 weeks. Everyone had counseling toward eating 500 fewer calories a day and at least 150 minutes of activity a week.
Compared with
Dummy shots with no medicine (placebo), plus the same counseling. Nobody knew which they had.
What was measured
Average change in body weight after 72 weeks, and the share of people who lost at least 5%, the trial’s two main results (primary endpoints). Losing 25% or more was an exploratory result.
You will probably regain about half of the weight you lost: people who stopped after 36 weeks went from 20.9% below their starting weight to 9.9% a year later.
How this was studied · SURMOUNT-4 trial · 670 people · 88 weeks · vs placebo
Who took part
Adults with obesity, or with overweight plus a weight-related condition such as high blood pressure. People with diabetes were excluded. Only people who reached 10 or 15 mg in the first 36 weeks went on to the split.
How many people
783 started on tirzepatide. At week 36, 670 were split at random: 335 kept taking it and 335 switched to placebo.
How long
88 weeks: 36 weeks on tirzepatide for everyone, then 52 weeks after the split
What they got
Weekly shots of Lilly’s tirzepatide, the drug sold as Zepbound, rising from 2.5 mg by 2.5 mg every 4 weeks to 10 or 15 mg, the highest dose each person tolerated. Everyone had counseling toward eating 500 fewer calories a day and at least 150 minutes of activity a week, the whole time.
Compared with
From week 36, dummy shots with no medicine (placebo), with the same counseling. Nobody knew which they had. In the first 36 weeks, everyone knew they were taking tirzepatide.
What was measured
Average change in body weight from week 36 to week 88, the trial’s main result (primary endpoint). The chart shows the change from the very start (week 0 to week 88), a secondary result.
Our estimate
“About half” is our arithmetic: 11.0 of the 20.9 points lost came back (53%). The 20.9% is the average of all 670 people at week 36, before the split.
Yes, usually at the dose that got your weight down. In a 2-year trial, people who stayed on 10 or 15 mg kept the weight off; on 5 mg, 25% regained at least half of what they had lost.
How this was studied · SURMOUNT-MAINTAIN trial · 378 people · 112 weeks · vs placebo
Who took part
Adults with obesity, or with overweight plus a weight-related condition, who had tried dieting at least once without success
How many people
441 started on tirzepatide; at week 60, 378 were split: 140 kept the full dose, 144 dropped to 5 mg, 94 switched to placebo
How long
112 weeks: 60 weeks on the full dose for everyone, then 52 weeks after the split
What they got
Weekly tirzepatide at the highest dose each person tolerated (10 or 15 mg), then either that dose or 5 mg
Compared with
From week 60, dummy shots with no medicine (placebo). Nobody knew which they had.
What was measured
Change in body weight from the start to week 112, the trial’s main result (primary endpoint)
On placebo
From week 84, anyone who had regained more than half of their lost weight could restart tirzepatide; 67% of the placebo group did (60 of 90), and 8% on the full dose.
Yes, for average weight loss. In a head-to-head trial, people lost 20.2% of their body weight on tirzepatide and 13.7% on semaglutide over 72 weeks.
Tirzepatide10–15 mg
−20.2%
Semaglutide1.7–2.4 mg
−13.7%
How this was studied · SURMOUNT-5 trial · 751 people · 72 weeks · vs semaglutide
Who took part
Adults with obesity, or with overweight plus a weight-related condition such as high blood pressure. People with diabetes were excluded.
How many people
375 on tirzepatide and 376 on semaglutide
How long
72 weeks
What they got
Weekly tirzepatide shots, rising from 2.5 mg by 2.5 mg every 4 weeks to 15 mg, or 10 mg if that was the highest dose the person tolerated, plus diet and activity counseling
Compared with
Weekly Wegovy shots, rising every 4 weeks to 2.4 mg, or 1.7 mg if that was the highest dose the person tolerated, plus the same counseling. Everyone knew which drug they were taking.
What was measured
Average change in body weight after 72 weeks, the trial’s main result (primary endpoint)
What it did not test
Heart attacks or strokes. For heart risk, semaglutide (as Wegovy) is FDA-approved to lower it in people with heart disease and overweight or obesity; tirzepatide (as Mounjaro) only in people with type 2 diabetes.
Who paid for it
Eli Lilly, the maker of tirzepatide (Zepbound and Mounjaro)
All three are weekly tirzepatide shots, and all are legal. Only Mounjaro and Zepbound are FDA-approved: Mounjaro for type 2 diabetes, Zepbound for weight loss.
MounjaroZepboundCompoundedActive ingredienttirzepatidetirzepatidetirzepatideLegalYesYesYesTested in peopleYesYesNoFDA-approved forType 2 diabetesWeight loss and sleep apnea– not FDA-approved
Probably not. In the trials, 7.1% of women and 0.5% of men on tirzepatide reported hair loss, and shedding usually improves 3 to 6 months after weight stabilizes.
7 in 100women
under 1 in 100men
How this was studied · 2 trials · 3,477 people · 72 weeks · vs placebo
Who took part
Adults with obesity, or with overweight plus a weight-related condition such as high blood pressure. One trial excluded diabetes; the other enrolled only people with type 2 diabetes.
How many people
2,519 on tirzepatide and 958 on placebo, across 2 trials (SURMOUNT-1 and SURMOUNT-2)
How long
Up to 72 weeks of treatment, then 4 weeks off the drug
What they got
Weekly shots of Lilly’s tirzepatide, the drug sold as Zepbound, at 5, 10 or 15 mg (the diabetes trial used only 10 or 15 mg), plus diet and activity counseling
Compared with
Dummy shots with no medicine (placebo), plus the same counseling. Nobody knew which they had.
What was measured
Whether each person reported hair loss as a side effect
On placebo
1.3% of women and 0% of men reported hair loss. One person on placebo, and no one on tirzepatide, stopped treatment because of it.
Anyone with medullary thyroid cancer in themselves or their family, MEN2, or a serious allergy to tirzepatide.
Do not takeMedullary thyroid cancer, or MEN2in you or your family, or MEN2 in you
Do not takeA serious allergic reaction to tirzepatideor to an ingredient in the formulation
Do not take nowPregnant or tryingstop when you find out you are pregnant; Gentle Health does not start treatment while you are trying
Do not take nowBreastfeedingGentle Health does not start treatment while you breastfeed
Not offered herePrevious pancreatitisnot an FDA contraindication; Gentle Health does not offer treatment
Not offered hereSevere gastroparesisFDA: not recommended; Gentle Health does not offer treatment
Not offered hereType 1 diabetesnot addressed in the FDA label; Gentle Health does not offer treatment
Do not take nowAlready taking another GLP-1 medicinedo not overlap; your doctor plans the switch
Clinical reviewSevere mental illnessyour doctor reviews it with you before prescribing
Clinical reviewOn the birth-control pillit may work less well: switch to a non-pill method, or add condoms, for 4 weeks after starting and after each dose increase
Yes, some. But fat goes faster: over 72 weeks, people on tirzepatide lost 33.9% of their body fat, about three times the share of lean mass they lost.
Body fat lostshare of body fat, by week 72
33.9%
on placebo8.2%
On tirzepatideOn placebo
How this was studied · SURMOUNT-1 trial, body-scan group · 160 people · 72 weeks · vs placebo
Who took part
A subgroup of SURMOUNT-1 who had body scans: adults with obesity, or with overweight plus a weight-related condition such as high blood pressure. People with diabetes were excluded.
How many people
255 people were scanned. The numbers come from the 160 who had usable scans at both the start and week 72, with all three doses counted together.
How long
72 weeks
What they got
Weekly shots of Lilly’s tirzepatide, the drug sold as Zepbound, at 5, 10 or 15 mg, reached by rising 2.5 mg every 4 weeks, plus diet and activity counseling
Compared with
Dummy shots with no medicine (placebo), plus the same counseling. Nobody knew which they had.
What was measured
Change in body fat and in lean mass from the start to week 72, measured by a low-dose x-ray body scan (DXA). The paper reports the drop in fat as about three times the drop in lean mass.
Yes, as far as we know: in the longest obesity trial, people who also had prediabetes took it for 176 weeks (3.4 years) with no new safety problems.
Serious health problem34 vs 32 people
13.4%placebo 11.9%
Cancer6 vs 4 people
2.4%placebo 1.5%
Gallbladder diseasesevere or serious; 9 vs 2 people
3.6%placebo 0.7%
Stopped over a side effect31 vs 16 people
12.3%placebo 5.9%
On tirzepatide 15 mg, over 176 weeksOn placebo
How this was studied · SURMOUNT-1 trial, 3-year part · 523 people · 176 weeks · vs placebo
Who took part
People in SURMOUNT-1 who also had prediabetes, meaning blood sugar above normal but not yet diabetes. All had obesity, or overweight plus a weight-related condition.
How many people
253 on 15 mg and 270 on placebo. Another 509 took 5 or 10 mg, for 1,032 in this part of the trial.
How long
176 weeks on treatment, just over 3 years, then 17 weeks off it
What they got
Weekly shots of Lilly’s tirzepatide, the drug sold as Zepbound, at 5, 10 or 15 mg, reached by rising 2.5 mg every 4 weeks. The numbers here are for 15 mg.
Compared with
Dummy shots with no medicine (placebo). Nobody knew which they had.
What was measured
Change in body weight at 176 weeks and how many people developed type 2 diabetes, the main results of this 3-year part (key secondary endpoints). The safety numbers here come from the trial’s side-effect table (Table 3); they were counted, not formally compared.
It acts like two gut hormones, GIP and GLP-1: people eat less, food leaves the stomach more slowly, and the pancreas releases more insulin when blood sugar is high.
1Brain. Appetite decreases, which can reduce how much you eat.
2Stomach. Food leaves it more slowly. The effect is strongest after the first dose and fades over time.
3Pancreas. Insulin release increases when blood sugar is elevated.
4Fat tissue. In animal studies, fat cells take up more fat from a meal, so less of it builds up in other organs.
Because it mimics two gut hormones: GLP-1, which curbs appetite, and GIP, which may add to that. In animals, it acts on brain areas that control eating.
Some patients feel less hungry. Others say the constant thoughts about food become quieter. It feels different for everyone, and it does not always happen right away.
James Simmons, MD · Medical Director, board-certified in emergency medicine
The pharmacy is licensed in Illinois and compounds it for your prescription under Section 503A.
Licensed in IllinoisThe US pharmacy that fills it
Independent lab resultsWe hold an independent lab’s potency, sterility and endotoxin results for one batch from Evoluciona Pharma, of tirzepatide with B6 (pyridoxine).
Made for your prescriptionCompounded for one patient under Section 503A, not mass-produced
Yes, for one patient whose doctor documents why the brand won’t do, such as needing a dose Zepbound doesn’t come in.
Counts as a reasonA dose Zepbound doesn’t come in, written up by the doctor for that patient
Doesn’t countA copy of a Zepbound strength, with nothing changed that matters for that patient
How we got here · the FDA’s shortage rules
Oct 2, 2024
The FDA declared the tirzepatide shortage over, ending the exception that let pharmacies make copies
Dec 19, 2024
Asked by a court to look again, the FDA confirmed the shortage was over
Mar 5, 2025
A federal court declined to block that decision, so the grace period for pharmacies ended
Compounding lets me prescribe the dose a patient needs instead of limiting them to the fixed strengths available in single-dose brand pens. That flexibility can matter when someone needs to increase more slowly or stay at a lower dose.
James Simmons, MD · Medical Director, board-certified in emergency medicine
Tirzepatide plus one added vitamin: B12 (cyanocobalamin) or B6 (pyridoxine). No study shows that either vitamin adds weight loss.
Tirzepatidein every vial
and one of these, depending on the prescription
B12(cyanocobalamin)Covers B12, which people eating less can run low on.
B6(pyridoxine)A vitamin added in the hope of easing nausea.
The additives are not what makes tirzepatide work. B6 and B12 are vitamins. I go through the exact formulation with each patient so they know what is in their vial and why.
James Simmons, MD · Medical Director, board-certified in emergency medicine
There’s no reason to expect it for the usual formula: both contain tirzepatide. But one lab study shows that B12 (hydroxocobalamin or methylcobalamin) might degrade some of the tirzepatide.
How this was studied · lab study · 10 vials · no people
Who took part
No people: vials of compounded tirzepatide with B12 (hydroxocobalamin or methylcobalamin), bought from compounding pharmacies, medspas and telehealth sellers across the US
How many
10 vials
Compared with
Pure tirzepatide used as a lab reference
What was measured
How much tirzepatide each vial held, and any impurity. Every vial held a new molecule, B12 bonded to tirzepatide, making up as much as 10% of the protein in the vial.
Also found
Some vials held as little as 43% of the tirzepatide on their label
What it did not test
Any effect in people. The paper names only B12 (hydroxocobalamin) and B12 (methylcobalamin) as the forms in the vials.
Who paid for it
Eli Lilly, the maker of Zepbound and Mounjaro; all authors work there
Reviewed by James Simmons, MDMedical Director · board-certified in emergency medicine
Educational only, not medical advice: talk to a doctor about your own history before starting or stopping anything.
Every trial cited here studied the branded drug, not the compounded medication we dispense, which is not FDA-approved and has never been trialed on its own.
Step 1Fill in the intakeTell us about your health and goals
Step 2Request careAn online request, a message or a video visit
Step 3Doctor reviewa doctor licensed in Illinois decides whether it’s right for you
Step 4SubscribeIf prescribed, start your plan and we order your medicine
Step 5Get your medicineA licensed pharmacy ships it to your door