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The GLP-1 and GIP tolerance you built on tirzepatide is relevant, but the glucagon component is a wild card

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Dicembrini I, Nreu B, Mannucci E, Monami M

If lifestyle modification alone doesn't produce clinically significant weight loss (typically defined as 5% of baseline body weight), the patient can try phentermine (for patients without cardiovascular contraindications) or orlistat

[1] Be aware of symptoms such as sweating, tremor, confusion, or palpitations, and follow your healthcare team's advice on blood glucose monitoring

Resveratrol limits diabetes-associated cognitive decline in rats by preventing oxidative stress and inflammation and modulating hippocampal structural synaptic plasticity