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The main thing to know is that tirzepatide works on two different hunger and satiety hormones in the body, as well as insulin levels

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The proportion of patients who completed treatment with rescue medication varied across trials, but was consistently lower with oral semaglutide 7 mg, 14 mg, and flexibly dosed (026% across background medication subgroups) than comparator treatments (734%), whereas the proportion of patients who discontinued the trial product was often somewhat higher (1225% vs 515% except when sitagliptin was added to multiple background medications in PIONEER 7 [50% in a very small subgroup of 8 patients]) (see Table S1 in the Supplementary Information)

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The concern is that nausea or vomiting might reduce absorption of oral pills