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In the case of alcohol the mechanism is well described: ethanol metabolism involving the CYP2E1 enzyme releases free radicals, and these reduce the level of reduced glutathione in the liver (Lieber, Drug Metabolism Reviews 2004, PMID 15554233)
Manage side effects early: Tell your provider if you experience nausea, constipation, reflux, or other concerns
Thorton MJ
A significant dose-dependent decrease in body weight from 7.5 to 12.9 kg was observed in the tirzepatide group, compared to a 2.3 kg increase in the insulin degludec group
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