Mounjaro/Zepbound (tirzepatide) and Wegovy/Ozempic (semaglutide), are GLP-1 and GIP medications, the newest weight loss medications getting a lot of attention lately. What are they? What are the differences? Which one is more effective?
These medications belong to a class of drugs called glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which are used for diabetes management and weight loss.
These medications are prescribed as part of a comprehensive weight management program that includes other lifestyle changes such as a healthy diet and increased physical activity.
A physician can assess an individual’s medical history, current health status, and weight loss goals to determine if these medications are an appropriate treatment option.
What is Mounjaro or Zepbound (tirzepatide)?
Zepbound and Mounjaro are similar medications- they both contain the active component tirzepatide and are manufactured by Eli Lilly. The difference is that Mounjaro is FDA approved for diabetes whereas Zepbound is FDA approved for chronic weight loss. Tirzepatide is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist. It works by activating both the GIP and GLP-1 receptors. GIP and GLP-1 are hormones that are released from the gut after eating. By activating these receptors, tirzepatide stimulates insulin secretion, inhibits glucagon secretion, slows gastric emptying, and promotes satiety. Mounjaro and Zepbound dosing includes 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg and 15 mg strengths. These are all given as a once-weekly injection, which starts at the lowest dose and slowly increases to avoid side effects and to maximise weight loss.
What is Wegovy or Ozempic (semaglutide)?
Ozempic, manufactured by Novo Nordisk, is the trade name for semaglutide, an FDA-approved medication for managing type 2 diabetes. Conversely, Wegovy is FDA-approved for weight loss. Semaglutide is a glucagon-like peptide (GLP-1) 1 receptor agonist, distinguishing it from dual GIP and GLP-1 receptor agonists like Mounjaro and Zepbound. GLP-1 is a hormone that is released from the gut after eating, and it plays a crucial role in regulating blood sugar levels and appetite. Semaglutide mimics the action of GLP-1 in the body, leading to increased insulin secretion, decreased glucagon secretion, slowed gastric emptying, and increased feelings of fullness. Ozempic dosing options include 0.25 mg, 0.5 mg, 1.0 mg, and 2 mg strengths. Wegovy dosing includes 0.25 mg, 0.5 mg, 1.0 mg, 1.7 mg, and 2.4 mg strengths. These are all given as a once-weekly injection, which starts at the lowest dose and slowly increases to avoid side effects and to maximise weight loss.
Who Qualifies?
• Adults with a BMI > 30 (obesity) or
• Adults with a BMI > 27 with one weight-related condition such as high blood pressure, high cholesterol, or pre-diabetes
Who Should Not Take Semaglutide or Tirzepatide?
• Personal or Family History of Medullary Thyroid Carcinoma (MTC): They have been linked to a risk of developing thyroid C-cell tumors in rodent studies, though it’s not known if this risk applies to humans.
• Multiple Endocrine Neoplasia Syndrome Type 2 (MEN 2): Patients with this condition should not use semaglutide or tirzepatide. MEN 2 is a disorder that can lead to the development of endocrine tumors, including MTC.
Other Possible Side Effects and Risks (although rare, could be serious)
• Pancreatitis
• Gallbladder disease
• Low blood sugar
• Kidney disease
• Severe allergies or allergic reaction
• Vision problems (diabetic retinopathy)
• Gastroparesis
• Rapid heartbeat
• Suicidal thoughts or behaviors
• Injection site reactions (itching, redness, swelling)
Please see the full Prescribing Information (Wegovy, Ozempic, Zepbound, including the BOXED WARNING, for complete safety information.
Other Alternatives for Losing Weight
Weight loss medications may not be suitable for everyone, and some may not qualify. There are certain contraindications and precautions to consider before considering a weight loss medication. Many people are able to lose weight with lifestyle changes. Some examples of lifestyle changes that can help you lose weight:
- Eat enough protein: Helps you feel full, reduces your appetite and can increase your metabolism. Protein helps you feel full and satisfied for longer periods of time, reducing the temptation to snack or overeat. Eat Whole Foods. Focus your diet on whole foods, including vegetables, fruits, whole grains, lean proteins, and healthy fats, which can keep you feeling full longer. Avoid processed foods.
- Limit Sugar and Refined Carbs: Foods high in added sugars and refined carbohydrates can spike blood sugar levels and lead to more fat storage and hunger.
- Increase physical activity. Get regular exercise. Find an activity you like and do it (walking, basketball, or swimming, etc.)
- Strength Training. It can increase calorie burn and muscle mass, improving metabolism.
- Mindful Eating. Pay attention to what and when you eat. Avoid distractions while eating, chew your food slowly, and learn to recognize when you’re full to avoid overeating.
- Stress Management. High stress can lead to emotional eating. Find healthy ways to manage stress, such as through meditation, yoga, or talking to a professional.
- Adequate Sleep. Ensure you’re getting enough sleep. Poor sleep is linked to weight gain, as it can affect hunger hormones and motivation to exercise.
- Drink Water: Sometimes thirst is confused with hunger. Drinking water before meals can also help you feel fuller, potentially reducing calorie intake.
- Aim for 25-35 grams of fiber daily. Fiber is very filling, which can help you feel full. Fiber-rich foods tend to be slowly digested, which can help control hunger, keep blood sugar levels stable and help you avoid constipation.
- Seek Support: Joining a support group or working with a health coach, nutritionist, or personal trainer can provide motivation and accountability.
Let MD by the Sea help you with your weight loss journey!
MD BY THE SEA offers an online weight loss program to help you with your weight loss journey.
We offer weight loss medications, including the newest GLP-1 medications (if appropriate), a nutrition and exercise plan, as well as continued ongoing support by email, text, phone and/or video.
Dr. Jami Feltner will review your medical history and can help determine which medication is right for you based on your specific health needs and treatment goals.
These medications when used in combination with other lifestyle changes, including the support of a physician, can lead to dramatic weight loss and continued long term success.
