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This happened for two reasons: Its real performance was already near the top

According to the FDA prescribing information, these reactions vary by dose and product, typically manifesting as localized redness (erythema), itching (pruritus), swelling, or mild discomfort at the injection site

The variability in trial durations, ranging from 3 to 12 weeks across the included studies, and differences in the number of titration steps for each drug may further influence the reported incidence of gastrointestinal adverse events, particularly for agents like tirzepatide, where nausea risk escalates with higher doses (e.g., OR = 4.36, 95% CI: 3.425.61 at 10 mg) (Liu et al., 2025)

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The affected area may feel firm or rubbery under the skin