The GLP-1 Revolution
Whether you decide to focus on losing those extra pounds or take your metabolic health seriously, now is the right time to review the options in the medical weight loss world. Here’s an update on weight loss medications with a focus on the difference between Semaglutide and Tirzepatide.
Semaglutide: The First Wave
Semaglutide, marketed under the brand names Ozempic, Rybelsus, and Wegovy, is a peptide that has been FDA approved for the long-term treatment of type 2 diabetes. It belongs to a class of medications known as GLP-1 receptor agonists, which have been used for nearly 20 years. GLP-1 receptor agonists mimic the action of naturally occurring GLP-1 in the body, increasing insulin production when blood glucose levels are high and delaying gastric emptying, which helps to reduce hunger and cravings.
- Ozempic (approved 2017)—injectable, doses from 0.2 to 2 mg
- Rybelsus—oral medication, 7 and 14 mg tablets
- Wegovy (approved 2021)—for chronic weight management, tested at 2.4 mg for weight loss
It is important to understand that these medications are not magic bullets. Weight loss still requires effort, including eating well and increasing physical activity. However, the specific requirements for each individual can vary significantly.
Tirzepatide: The “Twincretin”
Tirzepatide, marketed under the brand name Mounjaro by Eli Lilly, works on both the GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) pathways. It is often referred to as the “twincretin” because of its dual action. The GIP hormone enhances the effects of the GLP-1 peptide on appetite, essentially signaling the brain to stop eating.
Why We Choose Compounded Forms
At TREVI, we generally choose compounded forms of these medications for four main reasons:
- Reserving brand-name medications for diabetic patients due to significant supply shortages
- Compounded forms allow for added ingredients like vitamin B6, B12, or BPC-157 for additional benefits
- Individual syringes provided monthly rather than a vial (which expires within 28 days of opening), ensuring patients receive fresh medication
- Cost considerations—we can purchase these medications at lower cost than after insurance co-pay costs
Sustained Results Require Sustained Effort
Clinical trials have shown that the effectiveness of these drugs is limited to the period they are being used. Sustained weight loss requires ongoing use of these peptides, along with behavioral changes, to regulate the underlying hormones that contribute to obesity. For most patients the commitment to these medications must be lifelong.
Potential Risks to Understand
Some common side effects include gastrointestinal issues like nausea, vomiting, diarrhea, and constipation. There is also a potential risk of pancreatitis, kidney failure, gallbladder disease, and a form of thyroid cancer called medullary thyroid carcinoma. Additionally, rapid weight loss can contribute to facial aging.
Apart from Semaglutide and Tirzepatide, there are four other drugs approved for chronic weight management: Liraglutide (Saxenda®), Orlistat (Alli and Xenical), Naltrexone plus Bupropion (Contrave), and Phentermine plus Topiramate (Qsymia). These medications work through various mechanisms and should be used under the guidance of a healthcare professional.
The Bottom Line
If you’re struggling with your weight, it is highly recommended to consult with a healthcare provider who can conduct a comprehensive wellness consultation. A personalized plan that addresses the complex mix of genetic, hormonal, and behavioral factors affecting your weight can lead to more sustainable long-term success.
Weight loss requires commitment and a multifaceted approach, and medications should always be used under medical supervision. At TREVI Health—Longevity & Aesthetics, we are committed to your weight loss goals with structured monthly programs for both Semaglutide and Tirzepatide regardless of your dose.
