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Constipation is less dose-dependent and can persist, making it a more durable reason for discontinuation in patient reports.⁸ ²³ Sulfur burps reflect food sitting longer in a slowed stomach.⁹ ²³ Fatigue ranks second only to nausea in patient forums, although much of it tracks the calorie deficit rather than tirzepatide itself.²³ Fried or fatty foods, coffee, meat, and alcohol can also become less appealing

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Additional techniques for conjugating therapeutic moieties to antibodies are well known, see, e.g., Arnon et al., “Monoclonal Antibodies For Immunotargeting Of Drugs In Cancer Therapy,” in Monoclonal Antibodies And Cancer Therapy, Reisfeld et al