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Dual GIP/GLP-1 agonists add GIP receptor activation, which: Amplifies insulin secretion beyond what GLP-1 alone achieves Increases insulin sensitivity in peripheral tissues Appears to shift adipocyte metabolism toward fat oxidation (mechanism still under investigation) May reduce the nausea signal that limits GLP-1 dose escalation (GIP has anti-emetic properties in animal models) The weight loss ceiling for tirzepatide is approximately 20% to 22% of baseline body weight at the 15 mg dose over 72 weeks (SURMOUNT-1 data)