Tirzepatide (Monjauro, Zepbound) Superior To Semaglutide (Ozempic, Wegovy) For Weight Loss

A study just published in JAMA Internal Medicine  https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2821080 showed that a greater weight loss occurred for study subjects who used Tirzepatide (Mounjaro or Zepbound) in comparison with study subjects who used Semaglutide (Ozmpic, Wegovy). This study is the first published scientific research that was a head to head comparison of the two medications. Both tirzepatide and semaglutide belong to the class of drugs called GLP-1s.

Both of these medications were first FDA approved for diabetes but have since become widely used for weight loss. https://www.webmd.com/obesity/news/default.htm

The methodology of this study was the analysis of electronic health records of over 41,000 patients, of an average age of 52 and a starting weight of 243 pounds. The study subjects used the medications between May 2022 and September 2023.The study was conducted by the research firm Truveta Inc which specializes in electronic health record data analysis. 

In reviewing patient records of people using these medications, they documented and compared the weight loss achieved after 3, 6 and 12 months.

The comparison revealed the following:

After 3 months:        

  • Tirzepatide average weight loss- 5.9% of body weight.
  • Semaglutide average weight loss- 3.6% of body weight  

After 6 months:

  • Tirzepatide average weight loss -10.1%, of body weight .
  • Semaglutide average weight loss- 5.8% of body weight.

After 1 year:

  • Tirzepatide average weight loss-15.3% of body weight.
  • Semaglutide average weight loss- 8.3 % of body weight. 

These results were not a big surprise because previous research has already suggested that Tirzepatide might be a more successful medication, but this was the first head-to-head comparison study of the two medications.

Prior clinical trials had shown that patients who lost weight with  tirzepatide had a weight loss of more than 20% after 1 year and 5 months, and Semaglutide had previously shown to provide an average 15% of body weight after about 1 year and 4 months.

Minor gastrointestinal side effects such as nausea, constipation or heartburn were not found to differ between the two medications. https://www.nejm.org/doi/full/10.1056/NEJMoa2032183

Prescription Weight Loss Medications

Keeping your weight in check can be a lifelong challenge for many. Following a healthy diet and staying physically active helps, but was not enough for many people.

Weight loss drugs are considered a medical option if you are classified as  obese, which is technically defined as a body mass index (BMI) of 30 or higher. For an adult who is 5 foot 8 inches tall, that’s a weight of 197 pounds or more.

Your doctor may prescribe medication if your BMI is at least 27, and you have one or more weight-related health conditions, such as diabetes or high blood pressure.

They’re intended to be used along with a reduced-calorie eating plan and exercise program. Many people lose a significant amount of weight with the medications, and it’s natural that everyone wants to know which of the two popular GLP-1 meds is the best. 

Most insurance plans don’t cover weight loss medications, but they’re more likely to be covered if you need the drugs for an added purpose, like reducing your heart disease risk.

The success of both Semaglutide (Wegovy) and Tirzepatide (Zepbound) has resulted in them becoming recognized as revolutionary in Weight Loss Medicine.

GLP-1s

The class of drugs of which semaglutide and tirzepatide fall under are called glucagon-like peptide-1 (GLP-1) agonists. They are used to treat both obesity and type 2 diabetes. GLP-1 is a hormone naturally made in your digestive tract. When you eat it is released and it promotes insulin production to control your blood sugar. Another action of the hormone is called the slowing of gastric emptying- it  slows down the period of time it takes for  food to move from your stomach into your intestines so that you feel full and don’t have the desire to eat more.

Semaglutide was originally approved as a diabetes treatment- brand name-Ozempic. It subsequently then received FDA approval for the treatment of obesity. Tirzepatide was approved, also for diabetes as- brand name monjauro. And it received the approval for obesity-brand name Zepbound.

Along with their beneficial effects for diabetes and weight control they have  been shown to improve your blood pressure and cholesterol readings, and thus lower your heart disease risk as well.  

How to take these medications:

They are self-administered as a subcutaneous (under the skin) skin injection to your abdomen or thigh, once per week. Generally the dose is started low to prevent side effects and is increased under a physician’s guidance for maximal effectiveness for appetite control and weight loss success.  

Are they approved for long term use? Yes they are. Side effects?

Most side effects are mild and temporary. They include:

  • Nausea and vomiting 
  • Diarrhea 
  • Abdominal cramping 
  • Constipation 
  • Fatigue
  • Heartburn 

Less common but more serious possible side effects include an allergic reaction; problems with your gallbladder, kidneys, or pancreas. These medications have been shown to have potential long-term benefits beyond their effectiveness for weight control.

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