If you're experiencing unexpected weight gain, many factors might explain this situation.
Increased food intake
You might eat more food without realizing it. Some people think the medication will offset any extra calories they consume. This assumption leads to higher calorie intake than before starting the medication.
Water retention
Tirzepatide can cause temporary fluid retention in some users. This water weight might show up on your scale but doesn't represent true fat gain. This effect usually resolves after your body adjusts to the medication.

Muscle growth
If you've added exercise to your health routine, you might gain muscle mass. Muscle weighs more than fat, so the scale number might go up even as your body composition improves.
Medication timing and dosage
The proper dose matters. Your doctor starts you on a low dose and increases it gradually. During this adjustment period, the full weight-loss effects might not appear yet. If you're struggling with results, your dosage might need adjustment, unlike others of the best peptides for weight loss that work differently.
Metabolic adaptation
Your body might adapt to the medication over time. This adaptation can slow weight loss progress or cause temporary plateaus.
Underlying Health Conditions
Sometimes other health issues cause weight gain that overrides tirzepatide's effects. Thyroid problems, hormonal imbalances, or other medical conditions might contribute to weight gain despite medication.
Sometimes the issue isn't the medication itself but how your unique body responds to it. You can read more about plateaus in my article about why I am not losing weight on tirzepatide which covers related challenges.