After surgery I moved from a BMI of 46 down to 21 or 22, a drop of 156 pounds. Over about five years it crept back up to around 24, then the newer medication brought me to 18.5 to 19. I doubt tirzepatide by itself would have produced that total change.
Although I never had the surgery myself, I have kept up with the research on it because those studies track large groups who lose a lot of weight and hold it for years. One clear finding is that dropping the pounds brings real health gains that were expected. Everyone already knew staying at a normal weight lifelong is better, yet it was not obvious that reaching it later would match those benefits. The data show the improvement does happen. On the downside, the same work shows surgery patients hit a ceiling on how much they can lose. One simple formula given is Minimum BMI equals starting BMI times 0.43 plus 11, and there is a linked calculator for estimates. With the newer shots I see far more discussion of the loss phase than of keeping the weight off afterward. Several reasons could explain that pattern, but it leaves me wondering