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The base line is, if too much of nutrition intake, particularly protein, is cut back, the body will break down muscle for fuel

Apovian, M.D., DABOM, co-director of the Center for Weight Management and Wellness at Brigham and Womens Hospital and faculty member at Harvard Medical School

Nielsen says

Warning signs include: Severe, persistent abdominal pain that may radiate to the back Nausea and vomiting that does not resolve Abdominal tenderness or distension Patients experiencing these symptoms should discontinue tirzepatide immediately and seek emergency medical evaluation

Sometimes these are called non-preferred drugs. Zepbound is covered if its considered a preferred drug

Obesity: global epidemiology and pathogenesis