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NICE explicitly judged tirzepatide to be more effective overall than semaglutide for obesity management

Journal of obesity, 2016

Trimi's compounded semaglutide uses the same active pharmaceutical ingredient but is prepared per individual prescription by a 503A compounding pharmacy and isn't reviewed by the FDA for safety, effectiveness, or quality before marketing

FIGURE 4 This is complicated because as a polar, charged tripeptide, transport of GSH is significantly inhibited by the blood-brain barrier (BBB), thus limiting effective delivery to brain-resident immune cells such as microglia which are central drivers of neuroinflammatory pathology (Valdovinos-Flores and Gonsebatt, 2012

Shortages and side effects could play a role, along with steep costs and insurance coverage concerns