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Semaglutide (Ozempic, Wegovy) and Tirzepatide (Mounjaro, Zepbound) are medications that were originally designed for managing diabetes; however, there have been significant benefits for weight loss. These medications are GLP-1 and/or GIP medications that work by reducing appetite, promoting a feeling of fullness, turning down the “food noise” and leading to a decrease in overall caloric intake. Additionally, these medications help regulate blood sugar levels and improve insulin resistance, leading to substantial weight loss and improved metabolic health.
Originally used for managing diabetes under the name Ozempic, a higher dose of the same medication was evaluated for weight loss and the results were dramatic with the average person losing 15+% of their body weight with a BMI of 30 or greater. This is an injection that is typically administered once a week on a titration dose. Semaglutide works by mimicking a hormone called glucagon-like peptide-1 (GLP-1) that targets areas of the brain that regulate appetite and food intake; it is a powerful appetite suppressant. It also works by increasing the production of insulin and appears to enhance growth of β cells in the pancreas, which are the sites of insulin production. Additionally, it inhibits glucagon, which is a hormone that increases blood sugar. It has been known to aid not only in weight loss, but helps to lower glucose levels in those who are pre-diabetic or who have type 2 diabetes. Additionally, it will:
- Delay stomach emptying, leading to a feeling of fullness and smaller meal size
Slow intestinal motility - Lowers blood sugars, in part by reducing the production of sugar in the liver
Stimulates insulin secretion by the pancreas
We start our patients off at a low dose and gradually increase the dose weekly.
Expected weight loss is 1-2 pounds (average) per week with a targeted total weight loss of 15% of body fat (based upon a BMI over greater than 30%) according to data from clinical trials published by JAMA.
You may not be a good candidate for this medication if you have diabetic retinopathy, uncontrolled blood sugar, decreased kidney function, pancreatitis, medullary thyroid cancer, or multiple endocrine neoplasia type 2.
Tirzepatide is a novel drug used to treat diabetes, which has also been found to result in significant weight loss. According to clinical trials, it was shown to be effective in treating type 2 diabetes and expected to likely become the most effective weight loss medication available. This is very similar to semaglutide (GLP-1); however, tirzepatide is a dual GIP (glucose-dependent insulinotropic polypeptide or gastric inhibitory peptide) and a GLP-1 (glucagon-like peptide-1) receptor agonist, and it is the first drug of its kind. Known as a “game changer” by many medical professionals in the field of endocrinology and metabolic health, this medication has 2 hormones that produce satiety. This is a once a week injection, which is titrated over a period of time. Clinical trials have shown an impressive weight loss of 5-22.5% of body weight! It works by:
Delaying stomach emptying, leading to a feeling of fullness and smaller meal size and craving control
Activates the satiety centers of the brain
Lowers blood sugars, in part by reducing the production of sugar in the liver and boosting insulin production and suppressing glucagon production
Lowers A1c levels and possibly reverses cardiovascular disease
We start our patients off at a low dose and gradually increase the dose weekly.
Expected weight loss is 1-4 pounds (average) per week with a targeted total weight loss of near 26% of body fat (based upon a BMI over greater than 30%) according to data from clinical trials published by JAMA.
You may not be a good candidate for this medication if you have diabetic retinopathy, uncontrolled blood sugar, decreased kidney function, pancreatitis, medullary thyroid cancer, or multiple endocrine neoplasia type 2.
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