Tirzepatide is a dual-agonist weight loss medication that acts on two gut hormone receptors instead of one. Body Works offers physician-supervised tirzepatide therapy at our Franklin, TN and Nolensville, TN clinics for patients who want a medically guided path to sustainable weight loss, not a one-size-fits-all online prescription.
Our program is built around three commitments: lab-based candidacy screening before any prescription is written, dose escalation paced to your tolerance rather than a fixed calendar, and ongoing medical monitoring throughout treatment. Patients across Williamson County, Davidson County, Brentwood, Cool Springs, and Spring Hill come to us because they want a real medical relationship behind their GLP-1 therapy.
This page walks through how tirzepatide works, how it compares with semaglutide in the one head-to-head trial that has been run, who qualifies, what the Body Works program includes, what realistic results look like, how we manage side effects, and what happens when you reach your goal weight.
Tirzepatide is a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist. Semaglutide acts on the GLP-1 receptor alone; tirzepatide acts on both. GLP-1 signalling reduces appetite, slows gastric emptying, and quiets what patients describe as the constant background hum of food-related thoughts. Adding GIP activity appears to improve how the body handles fat and sugar and to improve tolerability at higher effective doses.
In the SURMOUNT-1 trial, adults with obesity who received weekly tirzepatide lost an average of 15.0% of body weight at the 5 mg dose, 19.5% at 10 mg, and 20.9% at 15 mg over 72 weeks, compared with 3.1% in the placebo group. More than half of the 15 mg group, 57%, lost at least a fifth of their starting body weight (Jastreboff et al., New England Journal of Medicine, 2022).
Tirzepatide is FDA-approved for chronic weight management in adults with a body mass index of 30 or greater, and in adults with a BMI of 27 or greater who have at least one weight-related condition such as high blood pressure, high cholesterol, type 2 diabetes, obstructive sleep apnea, or cardiovascular disease. It is prescribed alongside a reduced-calorie diet and increased physical activity, never as a substitute for them.
This is the question new patients ask first, and until recently the honest answer was that nobody had compared the two directly. That trial has now been run.
SURMOUNT-5 randomised 751 adults with obesity and without diabetes to weekly tirzepatide or weekly semaglutide for 72 weeks. Average weight reduction was 20.2% with tirzepatide versus 13.7% with semaglutide. Waist circumference fell 18.4 cm versus 13.0 cm. Participants on tirzepatide were more likely to reach every weight-loss threshold measured, including losses of 10%, 15%, 20%, and 25% (Aronne et al., New England Journal of Medicine, 2025). Gastrointestinal side effects were the most common in both groups and were mostly mild to moderate.
What that does and does not mean for you. Averages are not individuals. Some patients tolerate one medication considerably better than the other, some have a contraindication that decides it, and some respond well on a lower dose than the trial maximum. Cost and supply also differ. We look at your labs, your medical history, your tolerance, and your goals before recommending either one, and switching between them later is a normal clinical decision rather than a failure.
If you want the full comparison including retatrutide, our clinical team wrote one: retatrutide vs tirzepatide vs semaglutide. You can also read about semaglutide therapy at Body Works.
Candidacy is determined by a Body Works physician or nurse practitioner after a comprehensive intake that includes medical history, current medications, weight history, and baseline labs. We screen for thyroid history, pancreatic and gallbladder disease, severe gastrointestinal disease, and family history of medullary thyroid carcinoma or MEN-2 syndrome.
Candidacy criteria we apply at intake:
Patients with a BMI under 27 are not candidates for FDA-indicated tirzepatide weight management. We also decline to start therapy for patients seeking purely cosmetic weight loss without a documented health basis. If tirzepatide is not right for you, we will say so, and we will tell you what is.
A Body Works tirzepatide program is a clinical relationship, not a single transaction. Every patient receives the same structured care path at both our Franklin and Nolensville locations.
Initial visit and labs. Comprehensive intake, weight history, body composition baseline, full lab panel, and physician-led candidacy review. Lab results return within 3 to 5 business days.
Personalized prescription. If you qualify, we start at 2.5 mg once weekly. That first month is a tolerance-building dose, not a treatment dose. After four weeks we move to 5 mg, then increase in 2.5 mg steps at intervals of at least four weeks toward a maintenance dose of 5, 10, or 15 mg, chosen on your response and tolerability.
Weekly injections. Tirzepatide is a once-weekly subcutaneous injection given in the abdomen, thigh, or upper arm, at any time of day, with or without food. Our medical staff teaches injection technique on the first dose so you leave the office confident, and we rotate sites week to week. Patients who prefer in-clinic administration are welcome to come in for every dose.
Ongoing monitoring. Monthly check-ins for the first 90 days, then every 4 to 6 weeks once you stabilize. We track weight, body composition, side effects, lab markers, and your subjective hunger and satiety scores. Dose adjustments happen in the room with a clinician, never through a chat window.
Maintenance planning. Once you reach your goal weight, we transition you to a maintenance protocol designed to hold those results. This is the part most online-only programs ignore, and it is where lasting outcomes are won or lost.
Coordinated services. When clinically appropriate, your physician may pair tirzepatide with testosterone replacement therapy, hormone therapy for women, or peptide therapy for muscle preservation and recovery. All under one roof at both locations.
Most patients notice reduced appetite and quieter food cravings within the first 1 to 2 weeks on the 2.5 mg starting dose. Visible weight loss typically begins around weeks 3 to 4 as the dose escalates and the medication reaches steady state.
Realistic timeline expectations:
Body composition matters more than the scale alone. We measure fat mass and lean mass at each milestone so you can see exactly what is being lost. The goal is fat loss, not muscle loss, and the protocol is structured to protect lean tissue.
Most tirzepatide side effects are gastrointestinal, mild to moderate, and concentrated in the weeks just after a dose increase. The most common are nausea, diarrhea, constipation, vomiting, mild stomach pain, and fatigue. In both large trials, gastrointestinal events were the most frequently reported and were mostly mild to moderate, occurring primarily during dose escalation.
How Body Works manages side effects:
Stopping without a maintenance plan is the leading cause of weight regain, and for tirzepatide this has been measured directly rather than inferred.
In the SURMOUNT-4 trial, participants took tirzepatide for 36 weeks and lost an average of 20.9% of their body weight, then were randomised either to continue or to switch to placebo. Over the following year the group that continued lost a further 5.5% on average, while the group that stopped regained 14.0%. Nearly 90% of those who continued held onto at least four fifths of what they had lost, compared with 16.6% of those who stopped (Aronne et al., JAMA, 2024).
The Body Works approach to stopping:
We do not push patients to stop on a fixed timeline, and we do not pretend that stopping is consequence-free. If you are weighing that decision, our clinicians wrote this up in detail: what happens when you stop semaglutide or tirzepatide.
Tennessee patients have many options for GLP-1 therapy, including online-only providers and big-box wellness chains. Here is what is different about a Body Works program:
We are a Tennessee medical practice answering to Tennessee patients, not a venture-backed app team optimizing for monthly active users.
Learn more about our broader weight management options on our medical weight loss services page, read about tirzepatide in Franklin, TN, or browse evidence-based articles on GLP-1 therapy on our blog.
Your first consultation at Body Works is free. We will sit down, review your goals, look at your medical history, and tell you honestly whether tirzepatide therapy fits your situation. If it does, you can begin labs the same day.
Schedule a Free Consultation at our Franklin or Nolensville location and let us help you decide if this is the right next step.
Or call (615) 790-2548 for our Franklin clinic and (615) 941-1000 for our Nolensville clinic.
Tirzepatide is a dual agonist: it activates both the GIP receptor and the GLP-1 receptor. Semaglutide activates the GLP-1 receptor only. Both reduce appetite and slow digestion, and the practical difference shows up in the size of the average result.
In SURMOUNT-5, the head-to-head trial, average weight reduction at 72 weeks was 20.2% with tirzepatide and 13.7% with semaglutide (Aronne et al., NEJM, 2025). Individual results vary, and the right medication for you depends on your labs, your history, and how you tolerate it.
The molecule may be, the medical care is not. Online services typically operate on a one-size-fits-all questionnaire, asynchronous chat, and a mailed prescription. Body Works requires in-person intake, real bloodwork, physician-led candidacy review, and ongoing monitoring with the same medical team across your entire treatment.
If something goes wrong, you have a clinic to walk into rather than a help desk to email. Patients across Franklin, Nolensville, Brentwood, and Cool Springs come to us specifically for that accountability.
Everyone starts at 2.5 mg once weekly. That first month builds tolerance rather than driving weight loss. After four weeks the dose moves to 5 mg, and from there it increases in 2.5 mg steps with at least four weeks at each level.
Maintenance doses are 5 mg, 10 mg, or 15 mg weekly, and 15 mg is the maximum. Many patients reach their goals below the maximum, and we hold at the lowest dose that keeps you progressing comfortably.
No referral is required. You can call either clinic or book a free consultation directly. We will collect your medical history, run baseline labs, and have a physician determine whether tirzepatide is appropriate for your situation.
It is a once-weekly subcutaneous injection, given in the abdomen, thigh, or upper arm, at any time of day, with or without meals. Patients learn injection technique during their first dose at the clinic and self-administer at home afterward, rotating sites each week to prevent skin irritation.
Patients who prefer in-clinic administration can come into either Franklin or Nolensville for every dose instead.
Brand-name tirzepatide is manufactured under FDA-regulated supply chains. Compounded tirzepatide is custom-prepared by a state-licensed compounding pharmacy, typically when there is a documented shortage.
Body Works prioritizes brand-name tirzepatide and only sources compounded preparations from 503A or 503B pharmacies that meet strict quality, sterility, and chain-of-custody standards. We never source from gray-market suppliers, online resellers, or international pharmacies.
Without a maintenance plan, most of it does. In the SURMOUNT-4 trial, patients who stopped after 36 weeks regained an average of 14.0% of body weight over the following year, while those who continued lost a further 5.5%. Nearly 90% of the group that continued kept at least four fifths of their loss, against 16.6% of those who stopped (Aronne et al., JAMA, 2024).
This is why the Body Works program builds maintenance dosing, monitoring, and behavioral structure in from the start rather than treating the goal weight as the finish line.
After your free consultation, baseline labs typically return within 3 to 5 business days. Once your physician reviews the results and clears candidacy, your first dose can usually be administered within the same week. Most new patients are injecting their first dose within 7 to 10 days of their initial visit.
Low energy, foggy thinking, and diminished strength are common signs of low testosterone. Our TRT program restores energy, rebuilds strength, and sharpens mental clarity.
Custom IV blends to hydrate, energize, and support your immune system by delivering essential nutrients directly into your bloodstream.
Personalized hormone therapy to address fatigue, mood shifts, and metabolic slowdown. Frequently paired with semaglutide for women in perimenopause and menopause.
Peptides support muscle preservation, recovery, and metabolic resilience. A natural pairing with GLP-1 weight loss for body recomposition.
Botox, dermal fillers, and aesthetic treatments to enhance your refreshed look as your weight loss journey progresses.
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