Indeed, acute elevated peripheral insulin levels may increase insulin in cerebrospinal fluid, whereas, chronic peripheral hyperinsulinemia (such as insulin resistance or T2DM) may downregulate insulin receptors of the BBB, impair brain insulin uptake, and ultimately lead to learning, memory, and cognitive deficits (14, 52)
Tirzepatide doesn't directly interact with the biliary system, so prior cholecystectomy is not an absolute contraindication
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This is important if you have health issues like metabolic syndrome [7] or kidney failure
Secondly, you want foods that are easier to tolerate