- Weight loss medications such as semaglutide, tirzepatide, and liraglutide help regulate appetite and digestion.
- They work by acting on a hormone called GLP-1, but some may be more effective than others.
- Newer drugs like retatrutide may have better results by acting on more hormones at once.
The latest class of weight-loss drugs has been a game-changer for the treatment of obesity and related conditions like diabetes, and more are on the way, pending further research and FDA approval. .
With new research emerging regularly, it can be difficult to keep track of all the options.
Here are the main weight loss drugs currently being used and studied, how they work, and the latest research and news on their effectiveness and side effects.
Semaglutide (sold as Ozempic, Wegovy)
Background: Semaglutide, a once-weekly injection originally designed to treat diabetes, is one of the first drugs of its kind to be called a “game changer” for weight loss. It was approved by the FDA for that purpose in 2021, and is marketed by Danish pharmaceutical giant Novo Nordisk.
The drugmaker also makes a once-daily pill version of semaglutide, with early evidence suggesting it may be as effective as injections.
How does this work: It mimics a naturally occurring hormone called GLP-1, which helps regulate appetite and digestion. As a result, patients notice reduced cravings, especially for highly palatable foods such as sweet foods or rich and fatty foods.
Efficacy in clinical trials: Clinical trials found that patients taking semaglutide lost an average of 15% of their body weight over 68 weeks. However, research suggests that people need to continue taking the drug to maintain weight loss.
Emerging evidence suggests that semaglutide may also help reduce the risk of heart attack and stroke. One study found that it may also help prevent colon cancer.
Side effects: Common drug side effects include nausea, diarrhea, vomiting, and constipation.
Why you heard it: Semaglutide has received great popularity thanks to mentions from celebrities such as Elon Musk. Social media trends have made Ozempic one of the most recognizable terms for a weight-loss drug, although that brand name is marketed for diabetes.
Popular terms such as “Ozempic face” refer to the brand while describing side effects, in this case the sagging skin associated with rapid weight loss.
Semaglutide has also been controversial due to widespread shortages starting soon after it was approved for weight loss. The high demand has prompted a wave of “copycat” versions of the drug, known as compounded semaglutide.
Cost: About $936 for Ozempic and $1,349 for Wegovy per month. Insurance coverage can be complicated, making the drug out of reach for many who could benefit from it.
Tirzepatide (sold as Mounjaro, Zepbound)
Background: Tirzepatide is a newer drug, which first gained FDA approval as a diabetes treatment in 2022 under the brand name Mounjaro from the pharmaceutical company Eli Lilly.
Lilly’s version specifically prescribed for weight control, branded Zepbound, received FDA approval in early November 2023.
How does this work: Tirzepatide acts on GLP-1, like semaglutide, but also works on another hormone called GIP, which can boost appetite and weight loss effects, obesity medicine doctors told Insider .
Efficacy in clinical trials: Available evidence suggests that it may be more effective than semaglutide in helping patients lose weight. An early study found that people taking the drug lost 20% of their body weight, an average of 52 pounds, in about 16 months.
A clinical trial found that nearly half of overweight, diabetic patients taking the drug lost at least 15% of their body weight, a “landmark” result, according to the lead author of study.
A recent study also found that people who stopped taking tirzepatide regained at least some of the weight lost on the drug.
Side effects: Tirzepatide has similar side effects as semaglutide, including gastrointestinal issues, but they may be less severe, mitigated by the drug’s effect on both hormones.
Why you heard it: Like semaglutide, tirzepatide has made a name for itself in the media with dramatic weight loss stories and social media trends, as well as concerns from patients about access to the drug. long term.
Cost: $1,023 per month for Mounjaro, $1,059.87 for Zepbound
Liraglutide (sold as Victroza and Saxenda)
Background: Liraglutide, also sold by Novo Nordisk, has been around longer than comparable GLP-1 drugs, approved in 2010 for diabetes and in 2014 for weight loss.
How does this work: It is less long-lasting than the newer drugs, and therefore needs to be given as a once-daily injection instead of once-weekly.
Efficacy in clinical trials: Research suggests that patients lose about 5 to 10% of their body weight, according to one review.
Side effects: Although liraglutide has similar gastrointestinal effects as other GLP-1 drugs, it is also associated with more concerning reactions, such as pancreatitis, gallbladder disease and in rare cases, symptoms in mental health such as worsening depression or insomnia.
Cost: About $1,349 per month for Saxenda
Retatrutide: the newest drug pending FDA approval
Background: Retatrutide is the latest contender among the once-weekly injectable GLP-1 drugs, currently slated for phase 3 testing, from the pharmaceutical company Eli Lilly.
How does this work: It got the nickname “triple G” because it works on three different hormonal pathways. Like semaglutide, reatrutide works on GLP-1, and like tirzepatide, it works on GIP. However, it adds another interaction to the mix by targeting receptors for another hormone called glucagon, which influences blood sugar.
Efficacy in clinical trials: The latest evidence, published on June 26 in The New England Journal of Medicine, showed that patients who took the highest dose of the drug once a week lost 24.2% of their body weight within 48 week, the results were comparable to those seen in bariatric surgery.
Side effects: Research is still underway to understand the possible side effects of retatrutide. Available evidence suggests that any issues are mostly gastrointestinal, and can be managed by starting at a lower dose and gradually increasing, similar to other GLP-1 drugs.
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