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  • Writer's pictureAlex May

Considering a Weight Loss Drug? What to Know and How to Decide

You may have heard a lot in the news lately about Ozempic- the drug that has helped many people lose weight like never before. Whether you are skeptical about these weight loss drugs or want to start them yourself, you may have some questions. Ozempic is the name brand of a drug called semaglutide, while Mounjaro is the name brand of a drug called tirzepatide. We’ll be using the generic names moving forward for the purposes of this post. 


Both drugs belong to the class of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), but they differ in their molecular structures and mechanisms of action. While both drugs were initially prescribed for diabetes management, their weight-loss effectiveness is what has caused the popularity of these products to surge. Let’s delve into the intricacies of semaglutide and tirzepatide, exploring their similarities, differences, and respective roles in weight loss management. 

 

Understanding Semaglutide


Semaglutide is a once-weekly GLP-1 RA approved for the treatment of type 2 diabetes. Its mechanism of action involves mimicking the effects of endogenous GLP-1, which enhances insulin secretion, suppresses glucagon secretion, and promotes satiety, ultimately leading to improved glycemic control and weight management. Many people on semaglutide have noticed a reduction in “food noise” while on the drug.  Semaglutide has demonstrated significant reductions in HbA1c levels, weight loss, and notable benefits in cardiovascular outcomes


Potential Side Effects:

  1. Gastrointestinal Issues: Common side effects of semaglutide include nausea, vomiting, diarrhea, and abdominal discomfort. These symptoms typically occur at the initiation of treatment and may subside over time but can persist in some individuals.

  2. Hypoglycemia: Semaglutide can lower blood sugar levels, which may lead to hypoglycemia, especially when used in combination with other antidiabetic medications such as sulfonylureas or insulin.

  3. Injection Site Reactions: Common with subcutaneous injections, injection site reactions such as pain, erythema, or swelling may occur. Rotating injection sites can help minimize these reactions.

  4. Pancreatitis: Rarely, semaglutide may increase the risk of pancreatitis, characterized by severe abdominal pain, nausea, and vomiting. Patients should be monitored for signs and symptoms of pancreatitis during treatment.


Contraindications. 

  1. Thyroid C-Cell Tumors: Long-term use of semaglutide in animal studies has been associated with an increased risk of thyroid C-cell tumors. While this risk has not been definitively established in humans, caution is advised, particularly in individuals with a history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 (MEN 2).

 

Exploring Tirzepatide


Tirzepatide, on the other hand, belongs to a distinct class of medications called dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonists. This dual agonism targets multiple pathways involved in glucose metabolism, resulting in potent glycemic control and substantial weight loss. Tirzepatide has shown promising results in clinical trials, exhibiting superior efficacy compared to other GLP-1 RAs and even certain insulin formulations. Like semaglutide, this drug is also a once-weekly injection. 


Potential Side-Effects:

  1. Gastrointestinal Symptoms: Similar to semaglutide, tirzepatide may cause gastrointestinal adverse effects such as nausea, vomiting, diarrhea, and abdominal discomfort. These symptoms are typically mild to moderate in severity and may diminish with continued use.

  2. Hypoglycemia: Tirzepatide's potent glucose-lowering effects can increase the risk of hypoglycemia, particularly when used concomitantly with insulin or insulin secretagogues.

  3. Injection Site Reactions: As tirzepatide is administered via subcutaneous injection, injection site reactions such as pain, erythema, or swelling may occur. Rotating injection sites can help minimize these reactions.

  4. Lipid Abnormalities: Some individuals treated with tirzepatide may experience changes in lipid profiles, including increases in total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides. Regular monitoring of lipid levels is recommended during treatment.

 

Comparing Efficacy


Both semaglutide and tirzepatide have demonstrated remarkable efficacy in reducing hbA1c levels and promoting weight loss in patients with and without type 2 diabetes. However, clinical trials have suggested that tirzepatide may offer slightly greater reductions in both parameters compared to semaglutide. This superiority can be attributed to tirzepatide’s dual agonism, which targets two distinct pathways involved in glucose homeostasis. 

 

Which One is Best for You?


When deciding between semaglutide and tirzepatide, we consider many factors, including patient preferences, comorbidities, and cost. Given its extensive clinical data supporting cardiovascular benefits, semaglutide may be preferred in patients who have previously responded well to GLP-1 RAs or those with established cardiovascular disease. On the other hand, tirzepatide might be more suitable for individuals requiring potent glycemic control and significant weight reduction, particularly those with obesity or insulin resistance.


Other factors we may consider:


  1. Weight loss goals- if your primary goal is significant weight reduction alongside glycemic control, tirzepatide may be a favorable option due to its dual agonism and superiority in weight loss outcomes.

  2. Individual response- some people may respond better to semaglutide’s mechanism, while others may find tirzepatide more effective.

  3. Cost- the cost between semaglutide and tirzepatide can vary. We’ll consider pricing options as part of our recommendations for you.

 

What Our Patients Are Saying


With both semaglutide and tirzepatide, we have had really great patient success. Here’s some of the best feedback and success we’ve had with our patients on weight loss medications:


  • "No more food chatter"

  • "I can concentrate on other things other than thinking about food all the time" 

  • "I don't drink as much alcohol"

  • "I don't shop as much"

  • "I've lost my sugar cravings" 

 

Most of our patients have been able to tolerate these medications without significant side effects and are getting great results. The most common side effects we see in our office are nausea, diarrhea, and constipation. 

 

Putting it all together


While semaglutide has a proven track record and robust clinical evidence supporting its use, tirzepatide emerges as a promising alternative with potent dual agonism and superior glycemic control. At Optimal Hormone Health, we will personalize our recommendation for each individual for the best outcome. If you’re looking to lose weight and shed stubborn pounds, reach out today to see if one of these weight-loss medications might be right for you. 


Would you consider taking a weight loss medication?

  • Yes! It's what I've been searching for

  • Yes, but I still have some questions!

  • No, I still find it controversial


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