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Tirzepatide follows the same structure across its own stages

These medications work primarily by stimulating glucose-dependent insulin secretion, suppressing glucagon, slowing gastric emptying, and reducing appetite

Int J Pharm 611:121312121312 Pocai A, Carrington PE, Adams JR, Wright M, Eiermann G et al (2009) Glucagon-like peptide 1/glucagon receptor dual agonism reverses obesity in mice

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However, this same effect creates the physiological basis for common adverse effects including nausea, vomiting, early satiety, bloating, and belching