Tirzepatide vs. Semaglutide (Mounjaro vs. Wegovy)

Many people are asking me what is better for weight loss, Mounjaro (tirzepatide) or Wegovy (semaglutide). Tirzepatide (Mounjaro) is a new medication recently approved for the treatment of diabetes but has not yet been approved to treat obesity (we expect this to come soon.) Semaglutide, is sold under the names Ozempic and Rybelsus for diabetes and Wegovy for weight loss. Mounjaro is known as a dual incretin or a “twincreatin” working on two hunger hormone receptors: GIP and GLP-1. The average weight loss with tirzepatide is an astounding 22.5%.

Even though the approved indication for tirzepatide is for diabetes, studies have found that tirzepatide is the most effective weight loss medication that has ever been available. My experience has been that insurance companies will not cover tirzepatide unless you have a diagnosis of type 2 diabetes, the only approved indication.

However, it is difficult to truly compare between these medications because in recently released research, a lower 1 mg dose of semaglutide was compared to the highest dose of tirzepatide. Many say this was an unfair comparison and if the full 2.4 mg dose of semaglutide was used the difference may have been smaller or nonexistent. To be fair, this was a diabetes study, not a weight loss study and at the time of the study, the maximum approved dose of semaglutide for diabetes treatment was 1 mg. Since then, however the diabetes maximum dose has been increased to 2 mg weekly (sold as Ozempic) which is close to the 2.4 mg dose (sold as Wegovy). Weight loss numbers in Mounjaro studies were double or triple that of other weight loss medications and approach the results seen with bariatric surgery.

GIP = glucose-dependent insulinotropic polypeptide

GLP-1 = glucagon-like peptide-1

We expect that soon, tirzepatide will have an official indication for weight loss.

Long-acting versions of other GLP-1 medications have been on the market for over a decade such as liraglutide (Victoza, Saxenda), dulaglutide (Trulicity) or exenatide (Byetta, Bydureon). Until now, semaglutide has been considered the newest and the most powerful weight loss medication, but tirzepatide appears to produce even greater weight loss by stimulating two satiety hormone receptors instead of just one.

The side effects of tirzepatide are like GLP-1 medications, mainly nausea and gastrointestinal disturbance. Most side effects are brief when the medication is started at the lowest dose and slowly boosted over time. There are 6 doses available.

Other weight loss medications include:

The best weight loss results are seen when weight loss medications are combined with intensive lifestyle modification and calorie restriction. The major benefit of weight loss is improvement comorbidities of obesity such as diabetes, high blood pressure, abnormal blood lipids and heart disease which can be seen with as little as 5% weight loss.

Remember, tirzepatide or any other weight loss medication is not a magic bullet but simply a tool to lower appetite for sustained calorie reduction. There is no perfect medication for obesity. A medication that may work for a family member or a friend may not be the ideal medication for you. Treating obesity can be complicated so it is best to work with a knowledgeable health care professional who is dedicated to working with you over the long term.

If you’d like to learn more about tirzepatide (Mounjaro) or other ways to achieve permanent weight loss, please feel free to call us or schedule an appointment with Dr. Isaacs using the online booking tool on this website.

Author
Scott Isaacs, MD Endocrinologist and Weight Loss Specialist

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