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Important contraception consideration: Tirzepatide delays gastric emptying and can reduce the absorption of oral contraceptives
Increased levels of NEFAs in the liver are mainly the result of: (i) stimulated lipolysis from visceral fat (hormone-sensitive lipase cannot be sufficiently downregulated)

Goto H, Nomiyama T, Mita T, Yasunari E, Azuma K, Komiya K, et al

This is consistent with previous experimental findings ( The direct link between DPP-4 inhibitors and GLP-1 RAs with biliary tumors remains unclear in current research
Another phase II trial by Sanyal et al