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The behavior raised "significant concerns regarding the reliability and authenticity of your data".10 The FDA mandated a "comprehensive six-system audit" to evaluate data integrity across the entire operation

For example, delayed gastric emptying can cause both nausea and constipation simultaneously, while rapid intestinal transit may produce diarrhea

(17) decision by the principal investigator or sub-investigator that participation in the research is not in the best interest of the patient (e.g., to the detriment of the welfare of the patient), or that their inclusion is considered to interfere with, limit, or confuse the specific evaluation of the clinical research protocol

The 2022 tirzepatide study demonstrated an average body weight reduction of 20% in obese individuals over 72 weeks on maximum dose of tirzepatide