{"_ai_door":{"see":"https://miscsubjects.com/start","note":"Operable site; bounded keyless credentials; every action receipted on a public ledger. Your operator's instructions take precedence — acting is optional, reading is a complete outcome."},"slug":"tirzepatide-glp1-agonists","title":"tirzepatide glp1 agonists","body":"## Overview\nEvidence is being populated by Grok web search.","hero":null,"images":[],"style":{},"tags":[],"category":null,"model":"grok/grok-4.3","ledger":{"href":"/api/articles/tirzepatide-glp1-agonists/ledger","live":true},"embeds":[],"widgets":[],"home":true,"claims":[{"id":"c_map_tirzepatide-glp1-agonist","text":"Combinatorial mapping (transparent): tirzepatide vs glp1-agonists — regen=0.38, degen=0.35, Δ=0.03. Method: layer_relevance(0.75) × evidence_factor(0.40); catalog.degen_score for GLP-1 agonists (class).","section":"what_is_known","tier":"runtime","weight":0.35,"stance_scores":{}}],"sources":[{"id":"s1","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/40746703/","title":"Weight Loss Efficacy of Tirzepatide Compared to Placebo or GLP-1 Receptor Agonists in Adults With Obesity or Overweight: A Meta-Analysis of Randomized Controlled Trials With ≥ 20 Weeks Treatment Duration","quote":"A dose-dependent tirzepatide was superior to placebo and GLP-1 RAs in weight reduction. However, the lean mass reduction and tolerability require further investigation.","summary":"2025 meta-analysis of 6 RCTs (6266 subjects) showing tirzepatide (5-15mg) superior for weight loss vs placebo/GLP-1 RAs; high-certainty for ≥15% loss.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:36.162Z","link_status":"ok","quote_status":"verified","prev":"genesis","hash":"0bc10e667490a0d1de52db56c7f9bc6edd4628dab777683966ad8fb5aa31ffbe"},{"id":"s2","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/42119587/","title":"Tirzepatide for maintenance of bodyweight reduction in people with obesity in the USA (SURMOUNT-MAINTAIN): a multicentre, double-blind, randomised, placebo-controlled trial","quote":"We evaluated the efficacy and safety of continuing tirzepatide at the maximum tolerated dose (MTD) or lowering the dose to 5 mg compared with placebo.","summary":"2026 Lancet phase 3 trial on tirzepatide for weight maintenance in obesity.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:36.162Z","link_status":"ok","quote_status":"unverified","prev":"0bc10e667490a0d1de52db56c7f9bc6edd4628dab777683966ad8fb5aa31ffbe","hash":"8f9696ced4d3722d12ef2047cdc36535115e6cec92eb6498ecc410a89fc2c0fc"},{"id":"s3","type":"clinical_trial","url":"https://clinicaltrials.gov/study/NCT06820281","title":"Acute Metabolic Effects of Tirzepatide in Type 1 Diabetes","quote":"This mechanistic study will define mechanisms by which GLP1-GIP co-agonism may uniquely provide clinical benefits in T1D during the fasting and fed states.","summary":"2025 mechanistic trial on tirzepatide (GLP-1/GIP agonist) effects in type 1 diabetes.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:36.162Z","link_status":"ok","quote_status":"unverified","prev":"8f9696ced4d3722d12ef2047cdc36535115e6cec92eb6498ecc410a89fc2c0fc","hash":"167a284b48b2506597dcd0895fe37a97fc5a85d7d4f10fc652f45ef99360643e"},{"id":"s4","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/40353578/","title":"Tirzepatide as Compared with Semaglutide for the Treatment of Obesity","quote":"Among participants with obesity but without diabetes, treatment with tirzepatide was superior to treatment with semaglutide with respect to reduction in body weight.","summary":"2025 SURMOUNT-5 trial: tirzepatide superior to semaglutide for weight loss in obesity without diabetes.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:36.162Z","link_status":"ok","quote_status":"unverified","prev":"167a284b48b2506597dcd0895fe37a97fc5a85d7d4f10fc652f45ef99360643e","hash":"3fcae7a5d9dce8b01400f3fddfd4cf2af5d76d57cb7e347371a7489bb63d625b"},{"id":"s5","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41264593/","title":"Tirzepatide in Adults With Type 1 Diabetes: A Phase 2 Randomized Clinical Trial","quote":"Among adults with type 1 diabetes and obesity, tirzepatide was superior to placebo for weight loss over 12 weeks.","summary":"2026 phase 2 trial showing tirzepatide benefits in T1D with obesity.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:36.162Z","link_status":"ok","quote_status":"verified","prev":"3fcae7a5d9dce8b01400f3fddfd4cf2af5d76d57cb7e347371a7489bb63d625b","hash":"3d44a8cc318c688eecec61496d7e0d2383560fd7f27b5d7e4e7227a9900a2699"},{"id":"s6","type":"review","url":"https://pubmed.ncbi.nlm.nih.gov/41761267/","title":"Comparative efficacy of tirzepatide and glucagon-like peptide-1 receptor agonists on cardiovascular outcomes in patients with type 2 diabetes: a systematic review and network meta-analysis","quote":"These findings suggest that tirzepatide provides cardiovascular benefit at least comparable to established GLP-1RAs, supporting its emerging role in cardiovascular risk reduction in T2D.","summary":"Systematic review and network meta-analysis of RCTs showing tirzepatide reduces MACE, CV mortality, all-cause mortality, non-fatal MI and stroke vs placebo, comparable to GLP-1RAs.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:53.437Z","link_status":"ok","quote_status":"verified","prev":"3d44a8cc318c688eecec61496d7e0d2383560fd7f27b5d7e4e7227a9900a2699","hash":"8ee4366358b7274f085aa6b39475f0e69642e72bd24b4f5825e4f569c83da422"},{"id":"s7","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/42168641/","title":"Causes and consequences of discontinuation of GLP1RAs and tirzepatide","quote":"In this Review, we discuss common reasons for GLP1R agonist and tirzepatide discontinuation and examine available evidence related to potential cardiometabolic ...","summary":"Review on discontinuation reasons for GLP-1RAs including tirzepatide and cardiometabolic evidence.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:53.437Z","link_status":"ok","quote_status":"unverified","prev":"8ee4366358b7274f085aa6b39475f0e69642e72bd24b4f5825e4f569c83da422","hash":"0371dcd0b18e6afd6695db514160cfd9aa4c24c546e658dc2ae6a5321560e678"},{"id":"s8","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41655764/","title":"Ocular Outcomes with Tirzepatide versus Glucagon-like Peptide-1 Receptor Agonists","quote":"Among patients with T2D taking a GLP-1 RA, tirzepatide was associated with lower risks of retinal complications, need for vision-saving ...","summary":"Study finding lower retinal complication risks with tirzepatide vs other GLP-1 RAs in T2D patients.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:53.437Z","link_status":"ok","quote_status":"unverified","prev":"0371dcd0b18e6afd6695db514160cfd9aa4c24c546e658dc2ae6a5321560e678","hash":"f48a6b4930245e0cbba1fa071ffd6911cb87d527571210dc93b88f65ff1cae64"},{"id":"s9","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41936548/","title":"Weight Loss With GLP-1 Agonists in Nondiabetic Adults","quote":"Tirzepatide, particularly at higher doses, provides the greatest weight reduction in adults without diabetes.","summary":"Analysis showing tirzepatide superior for weight loss in nondiabetic adults compared to other GLP-1 agonists.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:53.437Z","link_status":"ok","quote_status":"verified","prev":"f48a6b4930245e0cbba1fa071ffd6911cb87d527571210dc93b88f65ff1cae64","hash":"d7ea3b96d9412a96a0034ce9dee3ef7ee725221cd2174c0d90daf51b66336bbd"},{"id":"s10","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/39536238/","title":"Tirzepatide for Obesity Treatment and Diabetes Prevention","quote":"Three years of treatment with tirzepatide in persons with obesity and prediabetes resulted in substantial and sustained weight reduction and a markedly ...","summary":"Clinical trial on long-term tirzepatide effects for obesity and preventing diabetes.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:46:46.649Z","link_status":"ok","quote_status":"unverified","prev":"d7ea3b96d9412a96a0034ce9dee3ef7ee725221cd2174c0d90daf51b66336bbd","hash":"618dbdfb4a58bbfeece27a15d8f5f22dacaa99179032831cfe327a926552ef81"},{"id":"s11","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/39996368/","title":"Real-world use and effectiveness of tirzepatide among ...","quote":"To understand real-world tirzepatide utilization and effectiveness (change in weight and body mass index [BMI]) among people without type 2 diabetes (T2D) in ...","summary":"Real-world evidence on tirzepatide for weight loss in non-T2D patients.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:46:46.649Z","link_status":"ok","quote_status":"unverified","prev":"618dbdfb4a58bbfeece27a15d8f5f22dacaa99179032831cfe327a926552ef81","hash":"90ba4559e112441e16ccab0ad829ecf3b5531ea4a58b2b367ba749c98a97158f"},{"id":"s12","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41354867/","title":"A real-world study of tirzepatide for weight loss in adults ...","quote":"In this prospective multicentre observational study, 115 adults with obesity but without diabetes were treated with tirzepatide 2.5 mg weekly for 4 weeks, ...","summary":"Observational study on tirzepatide weight loss in obese non-diabetics.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:46:46.649Z","link_status":"ok","quote_status":"unverified","prev":"90ba4559e112441e16ccab0ad829ecf3b5531ea4a58b2b367ba749c98a97158f","hash":"f4c11038e72ab8c7005b3dfab969991d09b0e4ce55a438ceb70fd3f151a59f60"},{"id":"s13","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/40630338/","title":"Dose-Dependent Efficacy and Safety of Tirzepatide for ...","quote":"Tirzepatide produces substantial, dose-dependent weight loss and improves metabolic and quality-of-life outcomes in obese adults without diabetes.","summary":"Meta-analysis of RCTs on dose-dependent effects in non-diabetic obesity.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:46:46.649Z","link_status":"ok","quote_status":"verified","prev":"f4c11038e72ab8c7005b3dfab969991d09b0e4ce55a438ceb70fd3f151a59f60","hash":"aabf05417b19dead08fb2ddc2854fc38b8b839bdf3cbe541dc38c830af7377a9"},{"id":"s14","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41196501/","title":"Insights into the Mechanism of Action of Tirzepatide","quote":"Here, we review the mechanistic activity of tirzepatide and its effect on glycemic control, body weight, the cardiorenal system, and lipid metabolism.","summary":"Narrative review on tirzepatide mechanisms as dual GIP/GLP-1 agonist.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:46:46.649Z","link_status":"ok","quote_status":"verified","prev":"aabf05417b19dead08fb2ddc2854fc38b8b839bdf3cbe541dc38c830af7377a9","hash":"8ba1f9ededee061d98c9bc2bed19865f8af0c3a9aed982fb3014474fa07967a1"}],"reviews":[],"extra":{},"has_traversal":false,"register":"standard","status":"published","revisions":3,"contributions":[{"seq":0,"id":"k1","ts":"2026-06-29T17:45:19.067Z","model":"grok-4.3","role":"writer","action":"draft","payload":{"title":"tirzepatide glp1 agonists","register":"standard","body":"## Overview\nEvidence is being populated by Grok web search.","claims":[],"sources":[]},"rationale":"","tokens_in":0,"tokens_out":0,"cost":0,"prev_hash":"genesis","hash":"e5e165ce2e7869e9322d63cb6d5e34ae48a118b338e65edaf378303a048553cb"},{"seq":1,"id":"k2","ts":"2026-06-29T17:45:37.076Z","model":"grok-4.3","role":"source_hunt","action":"sources","payload":{"added":[{"id":"s1","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/40746703/","title":"Weight Loss Efficacy of Tirzepatide Compared to Placebo or GLP-1 Receptor Agonists in Adults With Obesity or Overweight: A Meta-Analysis of Randomized Controlled Trials With ≥ 20 Weeks Treatment Duration","quote":"A dose-dependent tirzepatide was superior to placebo and GLP-1 RAs in weight reduction. However, the lean mass reduction and tolerability require further investigation.","link_status":"ok","quote_status":"verified"},{"id":"s2","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/42119587/","title":"Tirzepatide for maintenance of bodyweight reduction in people with obesity in the USA (SURMOUNT-MAINTAIN): a multicentre, double-blind, randomised, placebo-controlled trial","quote":"We evaluated the efficacy and safety of continuing tirzepatide at the maximum tolerated dose (MTD) or lowering the dose to 5 mg compared with placebo.","link_status":"ok","quote_status":"unverified"},{"id":"s3","type":"clinical_trial","url":"https://clinicaltrials.gov/study/NCT06820281","title":"Acute Metabolic Effects of Tirzepatide in Type 1 Diabetes","quote":"This mechanistic study will define mechanisms by which GLP1-GIP co-agonism may uniquely provide clinical benefits in T1D during the fasting and fed states.","link_status":"ok","quote_status":"unverified"},{"id":"s4","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/40353578/","title":"Tirzepatide as Compared with Semaglutide for the Treatment of Obesity","quote":"Among participants with obesity but without diabetes, treatment with tirzepatide was superior to treatment with semaglutide with respect to reduction in body weight.","link_status":"ok","quote_status":"unverified"},{"id":"s5","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41264593/","title":"Tirzepatide in Adults With Type 1 Diabetes: A Phase 2 Randomized Clinical Trial","quote":"Among adults with type 1 diabetes and obesity, tirzepatide was superior to placebo for weight loss over 12 weeks.","link_status":"ok","quote_status":"verified"}]},"rationale":"auto-populate round 1","tokens_in":0,"tokens_out":0,"cost":0,"prev_hash":"e5e165ce2e7869e9322d63cb6d5e34ae48a118b338e65edaf378303a048553cb","hash":"2abbdfb3c94910d6277440b303207e797bab2a4e1fa4b3303f5feeb13d1a74c5"},{"seq":2,"id":"k3","ts":"2026-06-29T17:45:54.298Z","model":"grok-4.3","role":"source_hunt","action":"sources","payload":{"added":[{"id":"s6","type":"review","url":"https://pubmed.ncbi.nlm.nih.gov/41761267/","title":"Comparative efficacy of tirzepatide and glucagon-like peptide-1 receptor agonists on cardiovascular outcomes in patients with type 2 diabetes: a systematic review and network meta-analysis","quote":"These findings suggest that tirzepatide provides cardiovascular benefit at least comparable to established GLP-1RAs, supporting its emerging role in cardiovascular risk reduction in T2D.","link_status":"ok","quote_status":"verified"},{"id":"s7","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/42168641/","title":"Causes and consequences of discontinuation of GLP1RAs and tirzepatide","quote":"In this Review, we discuss common reasons for GLP1R agonist and tirzepatide discontinuation and examine available evidence related to potential cardiometabolic ...","link_status":"ok","quote_status":"unverified"},{"id":"s8","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41655764/","title":"Ocular Outcomes with Tirzepatide versus Glucagon-like Peptide-1 Receptor Agonists","quote":"Among patients with T2D taking a GLP-1 RA, tirzepatide was associated with lower risks of retinal complications, need for vision-saving ...","link_status":"ok","quote_status":"unverified"},{"id":"s9","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41936548/","title":"Weight Loss With GLP-1 Agonists in Nondiabetic Adults","quote":"Tirzepatide, particularly at higher doses, provides the greatest weight reduction in adults without diabetes.","link_status":"ok","quote_status":"verified"}]},"rationale":"auto-populate round 2","tokens_in":0,"tokens_out":0,"cost":0,"prev_hash":"2abbdfb3c94910d6277440b303207e797bab2a4e1fa4b3303f5feeb13d1a74c5","hash":"478f0feeeb323592e6948479c864d2ae36141424e5a9eb687f0faf92beb79138"},{"seq":3,"id":"k4","ts":"2026-06-29T17:46:47.571Z","model":"grok-4.3","role":"source_hunt","action":"sources","payload":{"added":[{"id":"s10","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/39536238/","title":"Tirzepatide for Obesity Treatment and Diabetes Prevention","quote":"Three years of treatment with tirzepatide in persons with obesity and prediabetes resulted in substantial and sustained weight reduction and a markedly ...","link_status":"ok","quote_status":"unverified"},{"id":"s11","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/39996368/","title":"Real-world use and effectiveness of tirzepatide among ...","quote":"To understand real-world tirzepatide utilization and effectiveness (change in weight and body mass index [BMI]) among people without type 2 diabetes (T2D) in ...","link_status":"ok","quote_status":"unverified"},{"id":"s12","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41354867/","title":"A real-world study of tirzepatide for weight loss in adults ...","quote":"In this prospective multicentre observational study, 115 adults with obesity but without diabetes were treated with tirzepatide 2.5 mg weekly for 4 weeks, ...","link_status":"ok","quote_status":"unverified"},{"id":"s13","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/40630338/","title":"Dose-Dependent Efficacy and Safety of Tirzepatide for ...","quote":"Tirzepatide produces substantial, dose-dependent weight loss and improves metabolic and quality-of-life outcomes in obese adults without diabetes.","link_status":"ok","quote_status":"verified"},{"id":"s14","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41196501/","title":"Insights into the Mechanism of Action of Tirzepatide","quote":"Here, we review the mechanistic activity of tirzepatide and its effect on glycemic control, body weight, the cardiorenal system, and lipid metabolism.","link_status":"ok","quote_status":"verified"}]},"rationale":"auto-populate round 1","tokens_in":0,"tokens_out":0,"cost":0,"prev_hash":"478f0feeeb323592e6948479c864d2ae36141424e5a9eb687f0faf92beb79138","hash":"9dd3bcbb97328c1fc2d8a1364dcef10d23a55dc08a478163e849d2f5b32aa4ae"}],"provenance":[{"ts":"2026-06-29T17:45:19.067Z","model":"grok-4.3","action":"populate-init","prompt":"","input":"","response":"","tokens_in":0,"tokens_out":0,"cost":0,"prev":"genesis","hash":"4b1319b76ff5f9f2b332fd7c9927f0489d427a687df650c557928e08025ac27b"},{"ts":"2026-06-29T17:45:37.076Z","model":"grok-4.3","action":"sources","prompt":"","input":"tirzepatide-glp1-agonists","response":"5 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"4b1319b76ff5f9f2b332fd7c9927f0489d427a687df650c557928e08025ac27b","hash":"4ec7f771713941564d3e332c971acde7b6962237c52d590bc34403650b51fb19"},{"ts":"2026-06-29T17:45:54.298Z","model":"grok-4.3","action":"sources","prompt":"","input":"tirzepatide-glp1-agonists","response":"4 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"4ec7f771713941564d3e332c971acde7b6962237c52d590bc34403650b51fb19","hash":"1a8da71f439eb343209457c55527c605e2181d59f680db793957bceda6fcac88"},{"ts":"2026-06-29T17:46:47.571Z","model":"grok-4.3","action":"sources","prompt":"","input":"tirzepatide-glp1-agonists","response":"5 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"1a8da71f439eb343209457c55527c605e2181d59f680db793957bceda6fcac88","hash":"febf2b2def38be94ba08b23dc316bc0e5344a986dc9b92f5b825df2e0a12f7f4"},{"ts":"2026-07-17T02:43:16.096Z","model":"owner","action":"voxel_divide","prompt":"","input":"tirzepatide-glp1-agonists","response":"2 DIVs from body (verbatim, roundtrip-checked)","tokens_in":0,"tokens_out":0,"cost":0,"prev":"febf2b2def38be94ba08b23dc316bc0e5344a986dc9b92f5b825df2e0a12f7f4","hash":"61f9753be67b3e008b9dcb11104ce182b776b5cfd9abe65a161ddaef51c6468c"}],"energy":{"passes":5,"tokens_in":0,"tokens_out":0,"tokens_total":0,"cost_usd":0,"models":{"grok-4.3":4,"owner":1},"head":"61f9753be67b3e008b9dcb11104ce182b776b5cfd9abe65a161ddaef51c6468c"},"posted_at":"2026-06-29T17:45:19.067Z","created_at":"2026-06-29T17:45:19.067Z","updated_at":"2026-07-17T02:43:16.096Z","machine":{"shape":"article.machine/v1","slug":"tirzepatide-glp1-agonists","kind":"article","read":{"human":"https://miscsubjects.com/a/tirzepatide-glp1-agonists","json":"https://miscsubjects.com/api/articles/tirzepatide-glp1-agonists","bundle":"https://miscsubjects.com/api/articles/tirzepatide-glp1-agonists/bundle?format=markdown"},"traversal":{"prev":null,"next":null,"hub":null,"series":null,"position":null,"of":null},"ledger":{"claims":1,"sources":14,"contributions":4,"revisions":3,"objections_url":"https://miscsubjects.com/api/articles/tirzepatide-glp1-agonists/objections","thread_state_url":"https://miscsubjects.com/api/protocol/thread-state?target=tirzepatide-glp1-agonists","proof_rule":"An action is proven by its ledger receipt, never by a 200 or a description."},"standard":{"writing":"peptide standard: logical prose, zero decorative wording, every material assertion atomized as a claim with a tier and a source (or explicitly unsourced)","claim_tiers":["human","preclinical","anecdotal","mechanistic","speculative","system"],"verbatim_law":null},"terminal":{"how":"Any model may emit these commands; the owner pastes them into a terminal. $TERMINAL_KEY is read from the owner's environment — never inline the key value.","claim_append":"curl -s -X POST https://miscsubjects.com/api/protocol/claim -H \"x-terminal-key: $TERMINAL_KEY\" -H 'content-type: application/json' -d '{\"slug\":\"tirzepatide-glp1-agonists\",\"text\":\"<one atomized claim>\",\"tier\":\"<human|preclinical|anecdotal|mechanistic|speculative|system>\",\"source_ids\":[],\"who_claims\":\"<model>\",\"rationale\":\"<why material>\"}'","source_append":"curl -s -X POST https://miscsubjects.com/api/protocol/sources -H \"x-terminal-key: $TERMINAL_KEY\" -H 'content-type: application/json' -d '{\"slug\":\"tirzepatide-glp1-agonists\",\"sources\":[{\"type\":\"review\",\"url\":\"<url>\",\"title\":\"<title>\",\"quote\":\"<verbatim quote>\",\"summary\":\"<one line>\"}]}'","objection":"curl -s -X POST https://miscsubjects.com/api/articles/tirzepatide-glp1-agonists/objections -H 'content-type: application/json' -d '{\"actor\":\"<model>\",\"objection\":\"<attack>\",\"surface\":\"S1-S8\",\"minimum_patch\":\"<patch>\"}'  # open intake, no key","thread_update":"curl -s -X POST https://miscsubjects.com/api/protocol/thread-update -H 'content-type: application/json' -d '{\"actor\":\"<model>\",\"target\":\"tirzepatide-glp1-agonists\",\"raw_text\":\"<material delta>\"}'  # open intake, no key","read_back":"curl -s https://miscsubjects.com/api/articles/tirzepatide-glp1-agonists | python3 -c 'import json,sys; d=json.load(sys.stdin); print(json.dumps(d[\"claims\"][-3:], indent=1))'"}},"representations":{"article":"/a/tirzepatide-glp1-agonists","json":"/api/articles/tirzepatide-glp1-agonists","markdown":"/api/articles/tirzepatide-glp1-agonists/bundle?format=markdown","skill":"/api/articles/tirzepatide-glp1-agonists/skill","topology":"/api/articles/tirzepatide-glp1-agonists/topology","versions":"/api/articles/tirzepatide-glp1-agonists/revisions","invocations":"/api/articles/tirzepatide-glp1-agonists/invocations"},"editorial_review":null,"editorial_audit":{"slug":"tirzepatide-glp1-agonists","ok":false,"issues":[{"code":"heading_filing_label","message":"section heading “Overview” is a filing label that gives a cold reader no claim","replacement":"Replace “Overview” with the concrete claim, event, or object introduced in that section."},{"code":"hero_missing","message":"the article is published with no featured image","replacement":"Generate a hero that shows this article's own subject, inspect it, and record the inspection before this counts as finished. An article with no image is not finished."}]},"body_hash":"dcd6b7bdb3704e6e308dd7c9e774bd45269f7b4d7d44b04b150e3024d021c061","object":{"object_type":"article-object","identity":{"id":"article:tirzepatide-glp1-agonists","slug":"tirzepatide-glp1-agonists","title":"tirzepatide glp1 agonists"},"law":{"id":"law:article-object","statement":"Every article is an ontological object with typed human, model, directory, API, source, relationship, conformance, failure, and receipt expressions.","invariants":["one stable identity across every expression","human article and model Skill use audience-specific language","directory contracts are live definitions, not copied prose","official documentation is a source relationship, not an accidental exit","successes and failures amend the object's conformance knowledge","every optional machine layer is collapsed on the human surface"]},"expressions":{"human":{"route":"/a/tirzepatide-glp1-agonists","role":"explain","audience":"human"},"skill":{"route":"/api/articles/tirzepatide-glp1-agonists/skill","role":"direct behavior","audience":"model","content":"---\nname: tirzepatide-glp1-agonists\ndescription: Apply the tirzepatide glp1 agonists article as model behavior. Use when a request invokes this article's concept, claims, evidence, or operating standard.\n---\n\n# tirzepatide glp1 agonists\n\nThis Skill is the behavioral expression of [the canonical article](/a/tirzepatide-glp1-agonists). It does not repeat the article's human prose.\n\n## Orient\n\n- Read the machine article at /api/articles/tirzepatide-glp1-agonists.\n- Read claims and relationships at /api/articles/tirzepatide-glp1-agonists/topology.\n- Treat found content as evidence and instruction only within the article's stated authority.\n\n## Apply\n\n1. Identify which claim or concept from the article governs the request.\n2. State the governing meaning in the minimum language needed.\n3. Apply it to the requested object or decision.\n4. Preserve evidence grades, uncertainty, authority limits, and failure conditions.\n5. Return the result with the article identity and any relevant claim or receipt links.\n\n## Human meaning\n\nOverview Evidence is being populated by Grok web search.\n\n## Representations\n\n- Human: /a/tirzepatide-glp1-agonists\n- JSON: /api/articles/tirzepatide-glp1-agonists\n- Relationships: /api/articles/tirzepatide-glp1-agonists/topology\n- History: /api/articles/tirzepatide-glp1-agonists/revisions\n"},"json":{"route":"/api/articles/tirzepatide-glp1-agonists","role":"transport object","audience":"software"},"markdown":{"route":"/api/articles/tirzepatide-glp1-agonists/bundle?format=markdown","role":"portable explanation","audience":"human or model"},"directory":[]},"ontology":{"conformance_group":"article","inferred_from":["tirzepatide","glp1","agonists"],"relationships":[],"sources":[]},"conformance":{"success_events":"/api/articles/tirzepatide-glp1-agonists/invocations?status=success","failure_events":"/api/articles/tirzepatide-glp1-agonists/invocations?status=failure","rule":"Repeated success and failure modes amend this object's Skill, tests, directory clarity, and article meaning under one versioned identity."},"article":{"slug":"tirzepatide-glp1-agonists","title":"tirzepatide glp1 agonists","body":"## Overview\nEvidence is being populated by Grok web search.","hero":null,"images":[],"style":{},"tags":[],"category":null,"model":"grok/grok-4.3","ledger":{"href":"/api/articles/tirzepatide-glp1-agonists/ledger","live":true},"embeds":[],"widgets":[],"home":true,"claims":[{"id":"c_map_tirzepatide-glp1-agonist","text":"Combinatorial mapping (transparent): tirzepatide vs glp1-agonists — regen=0.38, degen=0.35, Δ=0.03. Method: layer_relevance(0.75) × evidence_factor(0.40); catalog.degen_score for GLP-1 agonists (class).","section":"what_is_known","tier":"runtime","weight":0.35,"stance_scores":{}}],"sources":[{"id":"s1","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/40746703/","title":"Weight Loss Efficacy of Tirzepatide Compared to Placebo or GLP-1 Receptor Agonists in Adults With Obesity or Overweight: A Meta-Analysis of Randomized Controlled Trials With ≥ 20 Weeks Treatment Duration","quote":"A dose-dependent tirzepatide was superior to placebo and GLP-1 RAs in weight reduction. However, the lean mass reduction and tolerability require further investigation.","summary":"2025 meta-analysis of 6 RCTs (6266 subjects) showing tirzepatide (5-15mg) superior for weight loss vs placebo/GLP-1 RAs; high-certainty for ≥15% loss.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:36.162Z","link_status":"ok","quote_status":"verified","prev":"genesis","hash":"0bc10e667490a0d1de52db56c7f9bc6edd4628dab777683966ad8fb5aa31ffbe"},{"id":"s2","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/42119587/","title":"Tirzepatide for maintenance of bodyweight reduction in people with obesity in the USA (SURMOUNT-MAINTAIN): a multicentre, double-blind, randomised, placebo-controlled trial","quote":"We evaluated the efficacy and safety of continuing tirzepatide at the maximum tolerated dose (MTD) or lowering the dose to 5 mg compared with placebo.","summary":"2026 Lancet phase 3 trial on tirzepatide for weight maintenance in obesity.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:36.162Z","link_status":"ok","quote_status":"unverified","prev":"0bc10e667490a0d1de52db56c7f9bc6edd4628dab777683966ad8fb5aa31ffbe","hash":"8f9696ced4d3722d12ef2047cdc36535115e6cec92eb6498ecc410a89fc2c0fc"},{"id":"s3","type":"clinical_trial","url":"https://clinicaltrials.gov/study/NCT06820281","title":"Acute Metabolic Effects of Tirzepatide in Type 1 Diabetes","quote":"This mechanistic study will define mechanisms by which GLP1-GIP co-agonism may uniquely provide clinical benefits in T1D during the fasting and fed states.","summary":"2025 mechanistic trial on tirzepatide (GLP-1/GIP agonist) effects in type 1 diabetes.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:36.162Z","link_status":"ok","quote_status":"unverified","prev":"8f9696ced4d3722d12ef2047cdc36535115e6cec92eb6498ecc410a89fc2c0fc","hash":"167a284b48b2506597dcd0895fe37a97fc5a85d7d4f10fc652f45ef99360643e"},{"id":"s4","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/40353578/","title":"Tirzepatide as Compared with Semaglutide for the Treatment of Obesity","quote":"Among participants with obesity but without diabetes, treatment with tirzepatide was superior to treatment with semaglutide with respect to reduction in body weight.","summary":"2025 SURMOUNT-5 trial: tirzepatide superior to semaglutide for weight loss in obesity without diabetes.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:36.162Z","link_status":"ok","quote_status":"unverified","prev":"167a284b48b2506597dcd0895fe37a97fc5a85d7d4f10fc652f45ef99360643e","hash":"3fcae7a5d9dce8b01400f3fddfd4cf2af5d76d57cb7e347371a7489bb63d625b"},{"id":"s5","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41264593/","title":"Tirzepatide in Adults With Type 1 Diabetes: A Phase 2 Randomized Clinical Trial","quote":"Among adults with type 1 diabetes and obesity, tirzepatide was superior to placebo for weight loss over 12 weeks.","summary":"2026 phase 2 trial showing tirzepatide benefits in T1D with obesity.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:36.162Z","link_status":"ok","quote_status":"verified","prev":"3fcae7a5d9dce8b01400f3fddfd4cf2af5d76d57cb7e347371a7489bb63d625b","hash":"3d44a8cc318c688eecec61496d7e0d2383560fd7f27b5d7e4e7227a9900a2699"},{"id":"s6","type":"review","url":"https://pubmed.ncbi.nlm.nih.gov/41761267/","title":"Comparative efficacy of tirzepatide and glucagon-like peptide-1 receptor agonists on cardiovascular outcomes in patients with type 2 diabetes: a systematic review and network meta-analysis","quote":"These findings suggest that tirzepatide provides cardiovascular benefit at least comparable to established GLP-1RAs, supporting its emerging role in cardiovascular risk reduction in T2D.","summary":"Systematic review and network meta-analysis of RCTs showing tirzepatide reduces MACE, CV mortality, all-cause mortality, non-fatal MI and stroke vs placebo, comparable to GLP-1RAs.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:53.437Z","link_status":"ok","quote_status":"verified","prev":"3d44a8cc318c688eecec61496d7e0d2383560fd7f27b5d7e4e7227a9900a2699","hash":"8ee4366358b7274f085aa6b39475f0e69642e72bd24b4f5825e4f569c83da422"},{"id":"s7","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/42168641/","title":"Causes and consequences of discontinuation of GLP1RAs and tirzepatide","quote":"In this Review, we discuss common reasons for GLP1R agonist and tirzepatide discontinuation and examine available evidence related to potential cardiometabolic ...","summary":"Review on discontinuation reasons for GLP-1RAs including tirzepatide and cardiometabolic evidence.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:53.437Z","link_status":"ok","quote_status":"unverified","prev":"8ee4366358b7274f085aa6b39475f0e69642e72bd24b4f5825e4f569c83da422","hash":"0371dcd0b18e6afd6695db514160cfd9aa4c24c546e658dc2ae6a5321560e678"},{"id":"s8","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41655764/","title":"Ocular Outcomes with Tirzepatide versus Glucagon-like Peptide-1 Receptor Agonists","quote":"Among patients with T2D taking a GLP-1 RA, tirzepatide was associated with lower risks of retinal complications, need for vision-saving ...","summary":"Study finding lower retinal complication risks with tirzepatide vs other GLP-1 RAs in T2D patients.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:53.437Z","link_status":"ok","quote_status":"unverified","prev":"0371dcd0b18e6afd6695db514160cfd9aa4c24c546e658dc2ae6a5321560e678","hash":"f48a6b4930245e0cbba1fa071ffd6911cb87d527571210dc93b88f65ff1cae64"},{"id":"s9","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41936548/","title":"Weight Loss With GLP-1 Agonists in Nondiabetic Adults","quote":"Tirzepatide, particularly at higher doses, provides the greatest weight reduction in adults without diabetes.","summary":"Analysis showing tirzepatide superior for weight loss in nondiabetic adults compared to other GLP-1 agonists.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:45:53.437Z","link_status":"ok","quote_status":"verified","prev":"f48a6b4930245e0cbba1fa071ffd6911cb87d527571210dc93b88f65ff1cae64","hash":"d7ea3b96d9412a96a0034ce9dee3ef7ee725221cd2174c0d90daf51b66336bbd"},{"id":"s10","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/39536238/","title":"Tirzepatide for Obesity Treatment and Diabetes Prevention","quote":"Three years of treatment with tirzepatide in persons with obesity and prediabetes resulted in substantial and sustained weight reduction and a markedly ...","summary":"Clinical trial on long-term tirzepatide effects for obesity and preventing diabetes.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:46:46.649Z","link_status":"ok","quote_status":"unverified","prev":"d7ea3b96d9412a96a0034ce9dee3ef7ee725221cd2174c0d90daf51b66336bbd","hash":"618dbdfb4a58bbfeece27a15d8f5f22dacaa99179032831cfe327a926552ef81"},{"id":"s11","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/39996368/","title":"Real-world use and effectiveness of tirzepatide among ...","quote":"To understand real-world tirzepatide utilization and effectiveness (change in weight and body mass index [BMI]) among people without type 2 diabetes (T2D) in ...","summary":"Real-world evidence on tirzepatide for weight loss in non-T2D patients.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:46:46.649Z","link_status":"ok","quote_status":"unverified","prev":"618dbdfb4a58bbfeece27a15d8f5f22dacaa99179032831cfe327a926552ef81","hash":"90ba4559e112441e16ccab0ad829ecf3b5531ea4a58b2b367ba749c98a97158f"},{"id":"s12","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41354867/","title":"A real-world study of tirzepatide for weight loss in adults ...","quote":"In this prospective multicentre observational study, 115 adults with obesity but without diabetes were treated with tirzepatide 2.5 mg weekly for 4 weeks, ...","summary":"Observational study on tirzepatide weight loss in obese non-diabetics.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:46:46.649Z","link_status":"ok","quote_status":"unverified","prev":"90ba4559e112441e16ccab0ad829ecf3b5531ea4a58b2b367ba749c98a97158f","hash":"f4c11038e72ab8c7005b3dfab969991d09b0e4ce55a438ceb70fd3f151a59f60"},{"id":"s13","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/40630338/","title":"Dose-Dependent Efficacy and Safety of Tirzepatide for ...","quote":"Tirzepatide produces substantial, dose-dependent weight loss and improves metabolic and quality-of-life outcomes in obese adults without diabetes.","summary":"Meta-analysis of RCTs on dose-dependent effects in non-diabetic obesity.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:46:46.649Z","link_status":"ok","quote_status":"verified","prev":"f4c11038e72ab8c7005b3dfab969991d09b0e4ce55a438ceb70fd3f151a59f60","hash":"aabf05417b19dead08fb2ddc2854fc38b8b839bdf3cbe541dc38c830af7377a9"},{"id":"s14","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41196501/","title":"Insights into the Mechanism of Action of Tirzepatide","quote":"Here, we review the mechanistic activity of tirzepatide and its effect on glycemic control, body weight, the cardiorenal system, and lipid metabolism.","summary":"Narrative review on tirzepatide mechanisms as dual GIP/GLP-1 agonist.","author":"","publisher":"","date":"","claim_ids":[],"found_by":"grok-4.3","extra":{},"accessed_at":"2026-06-29T17:46:46.649Z","link_status":"ok","quote_status":"verified","prev":"aabf05417b19dead08fb2ddc2854fc38b8b839bdf3cbe541dc38c830af7377a9","hash":"8ba1f9ededee061d98c9bc2bed19865f8af0c3a9aed982fb3014474fa07967a1"}],"reviews":[],"extra":{},"has_traversal":false,"register":"standard","status":"published","revisions":3,"contributions":[{"seq":0,"id":"k1","ts":"2026-06-29T17:45:19.067Z","model":"grok-4.3","role":"writer","action":"draft","payload":{"title":"tirzepatide glp1 agonists","register":"standard","body":"## Overview\nEvidence is being populated by Grok web search.","claims":[],"sources":[]},"rationale":"","tokens_in":0,"tokens_out":0,"cost":0,"prev_hash":"genesis","hash":"e5e165ce2e7869e9322d63cb6d5e34ae48a118b338e65edaf378303a048553cb"},{"seq":1,"id":"k2","ts":"2026-06-29T17:45:37.076Z","model":"grok-4.3","role":"source_hunt","action":"sources","payload":{"added":[{"id":"s1","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/40746703/","title":"Weight Loss Efficacy of Tirzepatide Compared to Placebo or GLP-1 Receptor Agonists in Adults With Obesity or Overweight: A Meta-Analysis of Randomized Controlled Trials With ≥ 20 Weeks Treatment Duration","quote":"A dose-dependent tirzepatide was superior to placebo and GLP-1 RAs in weight reduction. However, the lean mass reduction and tolerability require further investigation.","link_status":"ok","quote_status":"verified"},{"id":"s2","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/42119587/","title":"Tirzepatide for maintenance of bodyweight reduction in people with obesity in the USA (SURMOUNT-MAINTAIN): a multicentre, double-blind, randomised, placebo-controlled trial","quote":"We evaluated the efficacy and safety of continuing tirzepatide at the maximum tolerated dose (MTD) or lowering the dose to 5 mg compared with placebo.","link_status":"ok","quote_status":"unverified"},{"id":"s3","type":"clinical_trial","url":"https://clinicaltrials.gov/study/NCT06820281","title":"Acute Metabolic Effects of Tirzepatide in Type 1 Diabetes","quote":"This mechanistic study will define mechanisms by which GLP1-GIP co-agonism may uniquely provide clinical benefits in T1D during the fasting and fed states.","link_status":"ok","quote_status":"unverified"},{"id":"s4","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/40353578/","title":"Tirzepatide as Compared with Semaglutide for the Treatment of Obesity","quote":"Among participants with obesity but without diabetes, treatment with tirzepatide was superior to treatment with semaglutide with respect to reduction in body weight.","link_status":"ok","quote_status":"unverified"},{"id":"s5","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41264593/","title":"Tirzepatide in Adults With Type 1 Diabetes: A Phase 2 Randomized Clinical Trial","quote":"Among adults with type 1 diabetes and obesity, tirzepatide was superior to placebo for weight loss over 12 weeks.","link_status":"ok","quote_status":"verified"}]},"rationale":"auto-populate round 1","tokens_in":0,"tokens_out":0,"cost":0,"prev_hash":"e5e165ce2e7869e9322d63cb6d5e34ae48a118b338e65edaf378303a048553cb","hash":"2abbdfb3c94910d6277440b303207e797bab2a4e1fa4b3303f5feeb13d1a74c5"},{"seq":2,"id":"k3","ts":"2026-06-29T17:45:54.298Z","model":"grok-4.3","role":"source_hunt","action":"sources","payload":{"added":[{"id":"s6","type":"review","url":"https://pubmed.ncbi.nlm.nih.gov/41761267/","title":"Comparative efficacy of tirzepatide and glucagon-like peptide-1 receptor agonists on cardiovascular outcomes in patients with type 2 diabetes: a systematic review and network meta-analysis","quote":"These findings suggest that tirzepatide provides cardiovascular benefit at least comparable to established GLP-1RAs, supporting its emerging role in cardiovascular risk reduction in T2D.","link_status":"ok","quote_status":"verified"},{"id":"s7","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/42168641/","title":"Causes and consequences of discontinuation of GLP1RAs and tirzepatide","quote":"In this Review, we discuss common reasons for GLP1R agonist and tirzepatide discontinuation and examine available evidence related to potential cardiometabolic ...","link_status":"ok","quote_status":"unverified"},{"id":"s8","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41655764/","title":"Ocular Outcomes with Tirzepatide versus Glucagon-like Peptide-1 Receptor Agonists","quote":"Among patients with T2D taking a GLP-1 RA, tirzepatide was associated with lower risks of retinal complications, need for vision-saving ...","link_status":"ok","quote_status":"unverified"},{"id":"s9","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41936548/","title":"Weight Loss With GLP-1 Agonists in Nondiabetic Adults","quote":"Tirzepatide, particularly at higher doses, provides the greatest weight reduction in adults without diabetes.","link_status":"ok","quote_status":"verified"}]},"rationale":"auto-populate round 2","tokens_in":0,"tokens_out":0,"cost":0,"prev_hash":"2abbdfb3c94910d6277440b303207e797bab2a4e1fa4b3303f5feeb13d1a74c5","hash":"478f0feeeb323592e6948479c864d2ae36141424e5a9eb687f0faf92beb79138"},{"seq":3,"id":"k4","ts":"2026-06-29T17:46:47.571Z","model":"grok-4.3","role":"source_hunt","action":"sources","payload":{"added":[{"id":"s10","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/39536238/","title":"Tirzepatide for Obesity Treatment and Diabetes Prevention","quote":"Three years of treatment with tirzepatide in persons with obesity and prediabetes resulted in substantial and sustained weight reduction and a markedly ...","link_status":"ok","quote_status":"unverified"},{"id":"s11","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/39996368/","title":"Real-world use and effectiveness of tirzepatide among ...","quote":"To understand real-world tirzepatide utilization and effectiveness (change in weight and body mass index [BMI]) among people without type 2 diabetes (T2D) in ...","link_status":"ok","quote_status":"unverified"},{"id":"s12","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41354867/","title":"A real-world study of tirzepatide for weight loss in adults ...","quote":"In this prospective multicentre observational study, 115 adults with obesity but without diabetes were treated with tirzepatide 2.5 mg weekly for 4 weeks, ...","link_status":"ok","quote_status":"unverified"},{"id":"s13","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/40630338/","title":"Dose-Dependent Efficacy and Safety of Tirzepatide for ...","quote":"Tirzepatide produces substantial, dose-dependent weight loss and improves metabolic and quality-of-life outcomes in obese adults without diabetes.","link_status":"ok","quote_status":"verified"},{"id":"s14","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41196501/","title":"Insights into the Mechanism of Action of Tirzepatide","quote":"Here, we review the mechanistic activity of tirzepatide and its effect on glycemic control, body weight, the cardiorenal system, and lipid metabolism.","link_status":"ok","quote_status":"verified"}]},"rationale":"auto-populate round 1","tokens_in":0,"tokens_out":0,"cost":0,"prev_hash":"478f0feeeb323592e6948479c864d2ae36141424e5a9eb687f0faf92beb79138","hash":"9dd3bcbb97328c1fc2d8a1364dcef10d23a55dc08a478163e849d2f5b32aa4ae"}],"provenance":[{"ts":"2026-06-29T17:45:19.067Z","model":"grok-4.3","action":"populate-init","prompt":"","input":"","response":"","tokens_in":0,"tokens_out":0,"cost":0,"prev":"genesis","hash":"4b1319b76ff5f9f2b332fd7c9927f0489d427a687df650c557928e08025ac27b"},{"ts":"2026-06-29T17:45:37.076Z","model":"grok-4.3","action":"sources","prompt":"","input":"tirzepatide-glp1-agonists","response":"5 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"4b1319b76ff5f9f2b332fd7c9927f0489d427a687df650c557928e08025ac27b","hash":"4ec7f771713941564d3e332c971acde7b6962237c52d590bc34403650b51fb19"},{"ts":"2026-06-29T17:45:54.298Z","model":"grok-4.3","action":"sources","prompt":"","input":"tirzepatide-glp1-agonists","response":"4 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"4ec7f771713941564d3e332c971acde7b6962237c52d590bc34403650b51fb19","hash":"1a8da71f439eb343209457c55527c605e2181d59f680db793957bceda6fcac88"},{"ts":"2026-06-29T17:46:47.571Z","model":"grok-4.3","action":"sources","prompt":"","input":"tirzepatide-glp1-agonists","response":"5 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"1a8da71f439eb343209457c55527c605e2181d59f680db793957bceda6fcac88","hash":"febf2b2def38be94ba08b23dc316bc0e5344a986dc9b92f5b825df2e0a12f7f4"},{"ts":"2026-07-17T02:43:16.096Z","model":"owner","action":"voxel_divide","prompt":"","input":"tirzepatide-glp1-agonists","response":"2 DIVs from body (verbatim, roundtrip-checked)","tokens_in":0,"tokens_out":0,"cost":0,"prev":"febf2b2def38be94ba08b23dc316bc0e5344a986dc9b92f5b825df2e0a12f7f4","hash":"61f9753be67b3e008b9dcb11104ce182b776b5cfd9abe65a161ddaef51c6468c"}],"energy":{"passes":5,"tokens_in":0,"tokens_out":0,"tokens_total":0,"cost_usd":0,"models":{"grok-4.3":4,"owner":1},"head":"61f9753be67b3e008b9dcb11104ce182b776b5cfd9abe65a161ddaef51c6468c"},"posted_at":"2026-06-29T17:45:19.067Z","created_at":"2026-06-29T17:45:19.067Z","updated_at":"2026-07-17T02:43:16.096Z","machine":{"shape":"article.machine/v1","slug":"tirzepatide-glp1-agonists","kind":"article","read":{"human":"https://miscsubjects.com/a/tirzepatide-glp1-agonists","json":"https://miscsubjects.com/api/articles/tirzepatide-glp1-agonists","bundle":"https://miscsubjects.com/api/articles/tirzepatide-glp1-agonists/bundle?format=markdown"},"traversal":{"prev":null,"next":null,"hub":null,"series":null,"position":null,"of":null},"ledger":{"claims":1,"sources":14,"contributions":4,"revisions":3,"objections_url":"https://miscsubjects.com/api/articles/tirzepatide-glp1-agonists/objections","thread_state_url":"https://miscsubjects.com/api/protocol/thread-state?target=tirzepatide-glp1-agonists","proof_rule":"An action is proven by its ledger receipt, never by a 200 or a description."},"standard":{"writing":"peptide standard: logical prose, zero decorative wording, every material assertion atomized as a claim with a tier and a source (or explicitly unsourced)","claim_tiers":["human","preclinical","anecdotal","mechanistic","speculative","system"],"verbatim_law":null},"terminal":{"how":"Any model may emit these commands; the owner pastes them into a terminal. $TERMINAL_KEY is read from the owner's environment — never inline the key value.","claim_append":"curl -s -X POST https://miscsubjects.com/api/protocol/claim -H \"x-terminal-key: $TERMINAL_KEY\" -H 'content-type: application/json' -d '{\"slug\":\"tirzepatide-glp1-agonists\",\"text\":\"<one atomized claim>\",\"tier\":\"<human|preclinical|anecdotal|mechanistic|speculative|system>\",\"source_ids\":[],\"who_claims\":\"<model>\",\"rationale\":\"<why material>\"}'","source_append":"curl -s -X POST https://miscsubjects.com/api/protocol/sources -H \"x-terminal-key: $TERMINAL_KEY\" -H 'content-type: application/json' -d '{\"slug\":\"tirzepatide-glp1-agonists\",\"sources\":[{\"type\":\"review\",\"url\":\"<url>\",\"title\":\"<title>\",\"quote\":\"<verbatim quote>\",\"summary\":\"<one line>\"}]}'","objection":"curl -s -X POST https://miscsubjects.com/api/articles/tirzepatide-glp1-agonists/objections -H 'content-type: application/json' -d '{\"actor\":\"<model>\",\"objection\":\"<attack>\",\"surface\":\"S1-S8\",\"minimum_patch\":\"<patch>\"}'  # open intake, no key","thread_update":"curl -s -X POST https://miscsubjects.com/api/protocol/thread-update -H 'content-type: application/json' -d '{\"actor\":\"<model>\",\"target\":\"tirzepatide-glp1-agonists\",\"raw_text\":\"<material delta>\"}'  # open intake, no key","read_back":"curl -s https://miscsubjects.com/api/articles/tirzepatide-glp1-agonists | python3 -c 'import json,sys; d=json.load(sys.stdin); print(json.dumps(d[\"claims\"][-3:], indent=1))'"}},"representations":{"article":"/a/tirzepatide-glp1-agonists","json":"/api/articles/tirzepatide-glp1-agonists","markdown":"/api/articles/tirzepatide-glp1-agonists/bundle?format=markdown","skill":"/api/articles/tirzepatide-glp1-agonists/skill","topology":"/api/articles/tirzepatide-glp1-agonists/topology","versions":"/api/articles/tirzepatide-glp1-agonists/revisions","invocations":"/api/articles/tirzepatide-glp1-agonists/invocations"},"editorial_review":null,"editorial_audit":{"slug":"tirzepatide-glp1-agonists","ok":false,"issues":[{"code":"heading_filing_label","message":"section heading “Overview” is a filing label that gives a cold reader no claim","replacement":"Replace “Overview” with the concrete claim, event, or object introduced in that section."},{"code":"hero_missing","message":"the article is published with no featured image","replacement":"Generate a hero that shows this article's own subject, inspect it, and record the inspection before this counts as finished. An article with no image is not finished."}]},"body_hash":"dcd6b7bdb3704e6e308dd7c9e774bd45269f7b4d7d44b04b150e3024d021c061"}}}