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With the availability and popularity of modern weight loss drugs like Wegovy® and ZepboundTM, patients have an ever-expanding tool chest for losing weight. We understand how difficult it can be to manage excess weight and obesity – we’ve helped tens of thousands do it for the past several decades. Until now, most patients have resorted to bouncing between diets (most tend to fail) as their only non-surgical weight loss option.
Those looking for an alternative will be pleased to know there are two weekly injectable weight loss drugs currently on the market. Wegovy is a derivative, high-dose version of the popular diabetes drug Ozempic®. Zepbound is the weight loss-approved form of MounjaroTM, a diabetes drug as well. The former is a Semaglutide, while the latter is a Tirzepatide. While they have different names, they essentially do the same thing. Both are GLP-1 receptor agonists. In other words, when injected into belly fat, these drugs stimulate an increase in beta cells within the pancreas and subsequently induce satiety and weight loss.
Neither of these injections’ active ingredients is new. GLP-1 receptor agonists were discovered in the late 1980s and distributed widely for diabetes in the early 2000s. Like their diabetes counterparts, these new weight loss drugs went through clinical trials, and both have shown excellent weight loss potential for some patients.
With All That Said, Let’s Compare the Two.
Weight Loss / Benefits: Zepbound seems to have a slightly better weight loss profile than Wegovy. In trials, about 56% of Zepbound patients lost 25% or more of their body weight, while 30% of Wegovy patients lost more than 20%, meeting their primary endpoints.2
Risks: Both drugs also have similar risk profiles, which should be discussed with your doctor. For most, the side effects are gastrointestinal, with an increased risk of vomiting, diarrhea, nausea, constipation, or GERD, which tend to diminish as you continue taking the drug. They may be more prominent when the dosages are upped to the next dosage, typically each month. Of course, no medication is without more severe risks, and both injections come with the possibility of pancreatitis, gallbladder inflammation, and gastroparesis or stomach paralysis.
Considerations: Besides the abovementioned risks, all patients must understand that these medications are simply tools for losing weight. They do not represent a cure for obesity or a reason to avoid dieting and proper exercise. If they choose medication, we encourage patients to use these tools to change their habits so that, over the long term, they can sustain their weight loss even without the medication.
Insurance Coverage
Because these drugs are relatively new, insurance coverage has yet to catch up with their popularity. For many, this means paying out of pocket for their use. We encourage you to ask if your insurance plan covers the medication.
Medications in the Continuum of Weight Loss
Of course, we would all like to lose excess weight using diet and exercise alone, but as most know, this is exceptionally difficult as our BMI increases. Even if we lose significant weight, we often regain it once we liberalize our diet and slow our exercise programs.
These weight loss medications give us noninvasive, straightforward options to improve patients’ lives – starting within a month or two of taking the drug.
For those with very high BMIs, medication may be a great way to lose some weight as they consider bariatric surgery. Even some postoperative bariatric surgery patients may benefit from weight loss medication to maintain their weight loss or get back on track if they have regained weight. However, for patients with a BMI of 40 or so and over, weight loss medications may not offer sufficient weight loss to improve obesity-related diseases the way surgery can.
The Bottom Line
Obesity is an insidious disease that slowly brings about metabolic concerns that eventually lead to severe and potentially life-threatening problems, including cardiovascular disease. Further, dropping the pounds and keeping them off becomes more challenging as we gain more weight. Weight loss medications and bariatric surgery are often excellent first steps in managing excess weight. We encourage you to discuss your weight loss options with our office so that we can learn more about your needs and create an appropriate treatment plan.
