Wegovy (Semaglutide)

Wegovy, also known as semaglutide, is a glucagon-like peptide-1 (GLP-1) receptor agonist. It works by mimicking the action of GLP-1, a hormone that helps regulate appetite and glucose metabolism. Wegovy is approved by the US Food and Drug Administration (FDA) for chronic weight management in adults with a body mass index (BMI) of 30 or higher (classified as obese) or a BMI of 27 or higher (classified as overweight) with at least one weight-related comorbid condition, such as hypertension or type 2 diabetes[1].

A clinical trial called the STEP program demonstrated the effectiveness of Wegovy in promoting weight loss. In the STEP 1 trial, participants who received Wegovy experienced an average weight loss of 14.9% of their initial body weight after 68 weeks, compared to 2.4% in the placebo group[2].

Ozempic (Semaglutide)

Ozempic is another GLP-1 receptor agonist that contains the same active ingredient as Wegovy but is FDA-approved for the treatment of type 2 diabetes in adults. It helps control blood sugar levels and has been shown to contribute to weight loss[3]. Although Ozempic is not specifically approved for weight loss, it is sometimes prescribed off-label for this purpose.

The SUSTAIN clinical trial program demonstrated the effectiveness of Ozempic for weight loss in patients with type 2 diabetes. In the SUSTAIN 6 trial, participants receiving Ozempic experienced an average weight loss of 4.5 kg (9.9 lbs) after 104 weeks, compared to 0.5 kg (1.1 lbs) in the placebo group[4].

Mounjaro (Tirzepatide)

Mounjaro, also known as tirzepatide, is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, which means it targets two different pathways involved in glucose metabolism and appetite regulation[5].  

The SURPASS clinical trial program has been investigating the effectiveness and safety of tirzepatide in patients with type 2 diabetes. In the SURPASS-4 trial, patients receiving tirzepatide experienced an average weight loss of 7.1 kg (15.7 lbs) after 52 weeks, compared to 2.5 kg (5.5 lbs) in the insulin glargine group[6]. 

The SURMOUNT-1 trial tested the ability of tirzepatide to produce weight loss in people with obesity who do not have diabetes. During 72 weeks of treatment, people taking tirzepatide at doses of 5, 10, or 15 mg lost an average of 15.0%, 19.5%, and 20.9%, respectively, compared with just 3.1% in people taking placebo. For the co-primary endpoint of the proportion of people attaining at least a 5% reduction in their baseline bodyweight, the corresponding values were 85%, 89%, and 91% versus 35%. [7]

Mounjaro is currently FDA approved for type 2 diabetes, but is frequently used safely and effectively “off label” for weight loss in individuals without type 2 diabetes.

Which medication may be right for you, depends on a variety of factors, including your personal medical history, insurance, cost preference, and more. Discuss with your physician to see which medication may be right for you.

References:

1. U.S. Food and Drug Administration. (2021). FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014. Retrieved from https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014.

2. Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., ... & STEP 1 Study Group. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384(11), 989-1002.

Ozempic (Semaglutide)

3. U.S. Food and Drug Administration. (2017). FDA approves new treatment for adults with type 2 diabetes. Retrieved from https://www.fda.gov/news-events/press-announcements/fda-approves-new-treatment-adults-type-2-diabetes.

4. Marso, S. P., Bain, S. C., Consoli, A., Eliaschewitz, F. G., Jódar, E., Leiter, L. A., ... & SUSTAIN-6 Investigators. (2016). Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. New England Journal of Medicine, 375(19), 1834-1844.

5. Frias, J. P., Nauck, M. A., Van, J., Kutner, M. E., Cui, X., Benson, C., ... & Haupt, A. (2021). Efficacy and safety of LY3298176, a novel dual GIP and GLP-1 receptor agonist, in patients with type 2 diabetes: a randomised, placebo-controlled and active comparator-controlled phase 2 trial. The Lancet, 398(10296), 143-155.

6. Rosenstock, J., Wysham, C., Frias, J. P., Kaneko, S., Lee, C. J., Fernández Landó, L., ... & SURPASS-4 Investigators. (2022). Tirzepatide versus insulin glargine in type 2 diabetes and increased cardiovascular risk (SURPASS-4): a randomised, open-label, parallel-group, multicentre, phase 3 trial. The Lancet, 399(10323), 535-546.

7. Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, Kiyosue A, Zhang S, Liu B, Bunck MC, Stefanski A; SURMOUNT-1 Investigators. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022 Jul 21;387(3):205-216. doi: 10.1056/NEJMoa2206038. Epub 2022 Jun 4. PMID: 35658024.