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Tirzepatide is a different molecule and can produce different GI symptoms than semaglutide, so starting at 2.5mg and titrating up gives your body a chance to adjust

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Additionally, the second primary endpoint showed 37% of people treated with Wegovy 2.4 mg achieved improvement in liver fibrosis and no worsening of steatohepatitis compared to 22% on placebo with a statistically significant difference in response rate vs placebo of 14 (95% CI, 8;21)

This suggests the mechanism involves direct neurochemical effects rather than secondary consequences of improved metabolic health or self-esteem