INS and obesity due to melanocortin 4 receptor deficiency: In another SRM analyzing the data from nine studies with 9,871 participants, tirzepatide use was not associated with increased pancreatitis (RR: 1.46; 95% CI: 0.59–3.61).24 However, the authors noted that the gallbladder or biliary disease composite was significantly higher with tirzepatide use than with placebo or basal insulin (RR: 1.97; 95% CI: 1.14–3.42).24 As gall bladder and biliary disease tend to be more common in people with obesity, caution needs to be exercised about the use of tirzepatide in these patients.