Ozempic, Wegovy and Mounjaro are all medications that fall under the category of GLP-1 receptor agonists. This class of medications has been around since 2005. Today, we have a fair amount of data to prove both class safety and efficacy.
GLP-1 receptors promote fullness, so these medications mainly work by helping you get full quickly. They can also be combined with other medications used for weight loss.
Don’t let the word “injectable” scare you! All three of these medications are given by pen with a tiny needle (not much thicker than a human hair). There is nothing to draw up, and you only take them once a week. There is a button on the end of the pen that gives you the exact dose you need, so they are truly foolproof.
Effects are dose dependent, meaning there is better appetite suppression at higher doses. Side effects are mainly GI (gastrointestinal) related such as nausea and constipation. Both are easily controlled by slowing the titration rate, increasing fluids, or adding fiber to your diet.
Let’s take a look at each medication more closely to see how they differ.
The generic name for Ozempic is semaglutide. It is a GLP-1 receptor agonist manufactured by Novo Nordisk. Ozempic was FDA approved in December 2017 for type 2 diabetes. Due to excellent cardiovascular prevention data, most insurance companies will now cover semaglutide for pre-diabetes as well.
Ozempic started out dosed at 0.25mg for 4 weeks, then 0.5mg for 4 weeks, titrating to a dose of 1mg weekly. In 2022, a 2mg dose was approved which was a game changer, nearly doubling the 6.1% body weight loss seen on the 1mg dose in clinical trials. This change resulted in a 10-12% average weight loss in our patients.
The main side effects of semaglutide are nausea, vomiting, and constipation. If you are a fast eater, it is important to understand that all GLP-1s decrease gastric emptying (slowing how long the food stays in your stomach). As a fast eater, you may have more issues so eating slowly can help dramatically.
In recent years, we have seen supply chain issues with Ozempic. Certain doses may not be available in pharmacies which causes frustration for patients. It has been announced that the problem will be corrected soon, but we have decreased prescription rates for this reason.
Wegovy and Ozempic are the exact same medication: semaglutide. Novo Nordisk did a tricky thing here by trying to control both the diabetes and obesity markets. They did so by getting FDA approval for the same drug at different doses for 2 different indications.
Wegovy is approved for obesity and weight loss instead of diabetes. The dosing is from 0.25mg to a maximum dose of 2.4mg – titrating up every 4 weeks as with Ozempic.
Before the 2mg dose of Ozempic was approved, Wegovy was a huge hit. It was almost 2.5x the dose of the maximum dose of Ozempic, resulting in a 15% loss of body weight. Now that the 2mg dose of Ozempic is available, the weight loss is pretty close.
Wegovy has had supply issues since day one. At MWL, we rarely write this medication because there seems to be a continuous shortage of certain doses all the time, making it impossible to complete the titration.
Mounjaro (tirzepatide) is a new, injectable medication indicated for use in patients with type 2 diabetes. Very recently, it has been fast-tracked to the FDA for the indication of obesity. If all goes smoothly, it should be approved by early to mid 2023.
Like other GLP-1s, it is administered subcutaneously 1x a week with a recommended starting dosage of 2.5mg. After 4 weeks, doses are increased in 2.5mg increments up to a maximum of 15mg once weekly.
Mounjaro works similarly to the other drugs in the GLP-1 family, but it contains a GIP receptor agonist in addition to a GLP-1 receptor agonist. By adding this additional receptor and offering higher dosing, the weight loss with Mounjaro is a whopping 22.5% in clinical trials!
Which Do We Choose?
While all of these drugs have proven effective, we are in favor of prescribing Mounjaro to our patients for a number of reasons:
- By adding the GIP receptor, patients start to lose weight quickly, and often can’t even reach the 15mg dosing because they get so full so quickly.
- Mounjaro is manufactured by Eli Lilly which is an American company. Therefore, it is readily available. We have not seen supply issues with this medication.
- Mounjaro is very well tolerated, even at higher doses. We are seeing lower GI issues vs. other GLP-1s.
- There is a fantastic 1-year coupon program that bypasses insurance. Therefore, the cost for the patient is only $25/month maximum.
Wendy Scinta MD,MS
Our weight loss plans are customized to fit your specific needs. For further questions about the medications we offer, call our office at 315-407-4315.