Tirzepatide Titration to Reduce Side Effects in Individuals With Obesity

Inclusion Criteria: 1. Adults aged 18 years and older 2. A diagnosis of obesity (BMI ≥ 27 kg/m2) at screening with self-reported unsuccessful dietary efforts to lose weight. 3. No diagnosis of diabetes mellites. 4. Able to understand and sign the consent form 5. Able to undergo DEXA scan. Exclusion Criteria: * 1\. History of type 1 or type 2 diabetes mellites. 2. Obesity-related: * A self-reported change in body weight \>5 kg (11 lbs) within 90 days before screening irrespective of medical records. * Treatment with any medication for the indication of obesity within the past 90 days before screening. * Previous or planned (during the trial period) obesity treatment with surgery or a weight-loss device. However, the following are allowed: (1) liposuction and/or abdominoplasty, if performed \>1 year before screening; (2) lap banding, if the band has been removed \>1 year before screening; (3) intragastric balloon, if the balloon has been removed \>1 year before screening; or (4) duodenal-jejunal bypass sleeve, if the sleeve has been removed \>1 year before screening. * Uncontrolled thyroid disease, defined as thyroid stimulating hormone \>6.0 mIU/L or \<0.4 mIU/L as measured by the central laboratory at screening. 3\. Mental health: * History of major depressive disorder within 2 years before screening. * Diagnosis of other severe psychiatric disorder (e.g. schizophrenia, bipolar disorder). * A Patient Health Questionnaire-9 score of ≥15 at screening. * A lifetime history of a suicidal attempt. * Suicidal behavior within 30 days before screening. 4. General safety: * Use of non-herbal Chinese medicine or other non-herbal local medicine with unknown/unspecified content within 90 days before screening. * Presence of acute pancreatitis within the past 180 days prior to the day of screening. * History or presence of chronic pancreatitis. * Personal or first-degree relative(s) history of multiple endocrine neoplasia type 2 or medullary thyroid carcinoma. * Renal impairment measured as estimated glomerular filtration rate value of \<15 mL/min/1.73 m2 as defined by KDIGO 2012 by the central laboratory at screening. * History of malignant neoplasms within the past 5 years prior to screening. Basal and squamous cell skin cancer and any carcinoma in-situ are allowed. * Any of the following: myocardial infarction, stroke, hospitalization for unstable angina, or transient ischemic attack within the past 60 days prior to screening. * Subject presently classified as being in New York Heart Association Class IV. * Surgery scheduled for the duration of the trial, except for minor surgical procedures, in the opinion of the investigator. * Known or suspected abuse of alcohol or recreational drugs. * Known or suspected hypersensitivity to trial product(s) or related products. * Previous participation in this trial. Participation is defined as signed informed consent. * Participation in another clinical trial within 90 days before screening. * Female who is pregnant, breast-feeding, or intends to become pregnant, or is of child-bearing potential and not using a highly effective contraceptive method. * Any disorder, unwillingness, or inability, not covered by any of the other exclusion criteria, which in the investigator's opinion, might jeopardize the subject's safety or compliance with the protocol.