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Alcohol is best avoided entirely during the first week or two, as it can worsen nausea and dehydration whilst also potentially interacting with the medication's effects on blood sugar regulation

The 2026 EASO pharmacotherapy update formalised this evidence by ranking tirzepatide above semaglutide for obesity management, while simultaneously supporting semaglutide as the better-documented agent for liver fibrosis improvement in metabolic dysfunction-associated steatohepatitis (MASH), based on more mature phase 3 ESSENCE trial data [1]

doi: 10.1016/j.diabres.2012.09.008 210 WenjingHShaoYYuYHuangWFengGLiJ

Variants in FTO (the fat-mass and obesity-associated gene), GLP1R (the receptor these compounds target), MC4R (central to satiety and energy balance), and TCF7L2 (tied to glucose homeostasis and GLP-1 secretion) describe the terrain any compound acts on