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Tirzepatide (MOUNJARO) is a once-weekly subcutaneous injectable agent first authorized for T2DM and later extended to the management of obesity or overweight with at least one weight-related comorbidity, thereby aligning its therapeutic scope with subcutaneous liraglutide and semaglutide [34,35,36]

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Brainstem Activity Alters Diaphragm Circuit GLP-1 activity in brainstem centers may also alter the excitability of the diaphragm control circuit, thereby increasing the likelihood of brief spasms after meals or injections

Protocol Initiation: Treatment begins with conservative dosing that is gradually optimized based on symptom response and lab results