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Advantages: Continuous appetite suppression Prevents weight regain during transition Preferred by patients with history of rapid rebound eating Disadvantages: Higher nausea and vomiting risk (estimated 35% vs 22% in first 2 weeks) Overlapping GLP-1 activation may transiently worsen gastroparesis symptoms Difficult to distinguish semaglutide vs tirzepatide side effects during overlap window Clinical data supporting overlap: a 2024 case series (Garvey et al., Journal of Clinical Endocrinology & Metabolism) described 89 patients who used 3-day overlap

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Milk also raises levels of Insulin-like Growth Factor-1 (IGF-1), which worsens acne