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Mounjaro injection pens have only been approved for type 2 diabetes treatment. Image credit: The Washington Post/Getty Images
  • In a new study, researchers reported that tirzepatide sold under the brand name Mounjaro was superior to semaglutide drugs such as Ozempic and Wegovy for diabetes management and weight loss.
  • They reported that the side effects of tirzepatide included nausea, vomiting, and diarrhea.
  • Experts point out that long-term weight loss requires a combination of diet, exercise, and behaviorial changes.

In a meta-analysis of 22 trials, researchers report that tirzepatide was superior to semaglutide for controlling blood sugar and weight loss.

The findings will be presented at the European Association for the Study of Diabetes annual meeting in Germany in early October.

The researchers have not yet published their study in a peer-reviewed journal.

The U.S. Food and Drug Administration (FDA) has approved tirzepatide (Mounjaro) to treat type 2 diabetes.

The FDA has approved semaglutide (Ozempic, Wegovy) for treating type 2 diabetes. In addition, Wegovy has been cleared to help treat obesity.

Of the 22 trials studied by researchers, two directly compared the drugs. The remaining trials compared one of the drugs to a placebo, basal insulin, or another GLP-1 RAs medication.

The researchers said that their analysis shows that tirzepatide is superior to semaglutide for diabetes management and weight loss.

Some of the results include:

  • Tirzepatide 15 mg resulted in a loss of 12 more pounds than semaglutide 2 mg.
  • Tirzepatide 10 mg resulted in a loss of nearly 8 more pounds than semaglutide 2 mg
  • Tirzepatide 5 mg resulted in a loss of almost 4 more pounds than semaglutide 1 mg

When compared to a placebo, both drugs showed an increased risk of side effects, including gastrointestinal problems such as nausea, vomiting, and diarrhea. However, tirzepatide showed a greater increased risk.

“Both drugs work by activating glucagon-like peptide-1 (GLP-1) receptors in the body,” said Dr. Kathleen Dungan, a professor of medicine and the interim director in the Division of Endocrinology, Diabetes and Metabolism at The Ohio State University Wexner Medical Center who was not involved in the study.

“GLP-1 is a critical hormone produced by the gut and works to regulate glucose through several mechanisms, particularly stimulating insulin secretion and inducing weight loss in large part via interaction with appetite centers in the brain,” Dungan explained to Medical News Today. “Tirzepatide also operates through stimulating receptors for an additional hormone called glucose-dependent insulinotropic polypeptide (GIP). This hormone is thought to accentuate the appetite suppressant effects of GLP-1 and promote weight loss, as well as enhance the glucose-lowering effects of GLP-1.”

“Therefore, it is the first drug to be FDA-approved that targets multiple hormone receptors at once, among several drugs currently under development,” she added. “Both type 2 diabetes and obesity are very complex, and it is anticipated that targeting multiple pathways simultaneously is more likely to be successful.”

“This large meta-analysis further documents from combining the effects across 22 studies the value of both tirzepatide and semaglutide in promoting significant weight loss, although overall to a greater extent in those taking tirzepatide,” noted Nathan Wong, PhD, a professor and director of the Heart Disease Prevention Program at the University of California Irvine School of Medicine as well as past president of the American Society for Preventive Cardiology.

“Nausea, vomiting, and diarrhea were more common in the highest 15mg dose of tirzepatide compared to lower 0.5 mg dosages of semaglutide, suggesting the latter may be a good option to minimize these side effects, although of course, with the trade-off being less weight loss,” Wong, who was not involved in the study, told Medical News Today.

“But I think people have to look beyond the weight loss benefits of these drugs,” he added. “They also improve levels of lipids, glucose, and blood pressure, and both Ozempic and Wegovy now are shown to benefit cardiovascular outcomes (topline results for Wegovy recently released with more complete results to be presented at the American Heart Association Scientific Sessions in November)” added Wong. “Both patients and doctors need to understand that these drugs also lower cardiovascular disease outcomes that may be even more important than their weight loss effects since cardiovascular disease is the leading cause of death for persons with diabetes or overweight/obesity (evidence already published for Ozempic showing reduction in cardiovascular events, pending for Wegovy and clinical trials are ongoing for Mounjaro).”

Type 2 diabetes can be managed.

One study completed at the University of Glasgow reported that type 2 diabetes can be reversed with sustained weight loss.

The researchers found that weight loss was associated with longer life expectancy in addition to disease remission.

Losing between 5% and 10% of your body weight can improve health and well-being. For a person weighing 200 pounds, a target would be weight loss of between 10 and 20 pounds, according to the Centers for Disease Control and Prevention.

After weight reduction, some people find their blood sugar levels are easier to manage and they need less medication. Some find they have more energy and their sleep is better.

“Mounjaro is FDA-approved only for diabetes. It is not approved for weight loss,” noted Dr. Mir Ali, a bariatric surgeon and medical director at the MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California who was not involved in the study.

“if prescribed, it has been done off-label. The patient would need to pay for the prescription. Even if prescribed with FDA approval, insurance companies may not be willing to pay for it,” he told Medical News Today.

“People still need to make good choices. They need to eat a healthy diet and exercise. If they don’t do this then as soon as they stop taking the medication the weight will start to return,” Ali added.

Losing weight is relatively easy, but maintaining that weight loss is often another story, according to Anne Danahy, MS, RDN, an Arizona-based registered dietitian and integrative nutritionist who was not involved in the study.

“Long-term weight loss requires the right combination of diet, exercise, and behavior changes, but finding the combination that works for you over time is essential,” she told Medical News Today.

Danahy offers these tips:

  • Set yourself up for success by having meals planned, prepped, and ready to go. It’s too easy to get off track when you don’t have a plan.
  • Limit highly processed foods such as fast food, packaged, ready-to-eat meals, and snack foods as much as possible. Diets high in these foods are linked with obesity and insulin resistance. Choose foods made with recognizable ingredients.
  • Fill up on high-fiber plant foods (fruits, vegetables, beans/legumes, whole grains, nuts, etc.) at each meal and snack. These are relatively low in calories and their fiber fills and satisfies you for a longer time. Higher fiber foods also help balance your blood sugar.
  • Increase your activity so you move more each day and focus on strength training at least three times weekly. Increased muscle mass improves insulin sensitivity and helps improve glucose levels.
  • If you find yourself slipping back into old habits, work with a dietitian who can help you learn strategies to make permanent lifestyle changes.