Ozempic vs Zepbound for Weight Management

In the realm of obesity treatment, two notable medications have emerged as significant options: Ozempic and Zepbound.

Ozempic, a product of Novo Nordisk, functions as a glucagon-like peptide-1 (GLP-1) receptor agonist, replicating the effects of the natural hormone GLP-1 to regulate blood sugar levels. Its ability to suppress appetite and slow down stomach emptying has made it a popular choice for weight loss, even though it is not primarily approved for this purpose by the FDA.

On the other hand, Zepbound, known initially as Tirzepatide and marketed as Mounjaro by Eli Lilly, entered the market more recently. It stands out with its dual mechanism of action, targeting both GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 receptors. Notably, Zepbound has been FDA-approved specifically for weight loss, exhibiting remarkable efficacy in clinical studies, often surpassing other medications in its category.

Overview of Ozempic

Treatment Options for Type 2 Diabetes

Ozempic, a medication developed by Novo Nordisk, was approved by the U.S. Food and Drug Administration (FDA) in 2017. Its primary use is for the treatment of type 2 diabetes. However, it has gained significant popularity, especially among celebrities, for its effectiveness in promoting weight loss.

Weight Loss and Off-Label Use

One of the notable side effects of Ozempic is weight loss. While it is not FDA-approved for weight loss, healthcare providers are legally permitted to prescribe it for this purpose. This practice is known as prescribing "off-label." The drug's reputation for aiding in weight reduction has contributed to its increased demand.

Supply Shortage and Challenges

The popularity of Ozempic has led to a supply shortage. Since March 2022, it has been listed on the FDA's drug shortage inventory. The demand for the medication has surpassed its production capacity, posing challenges for those who need it, particularly for its intended use in diabetes treatment. In response, Novo Nordisk has taken steps to limit the number of new patients beginning treatment with Wegovy, a similar medication used for weight management.

Overview of Zepbound

Introduction to Tirzepatide (Mounjaro) and Zepbound

While Ozempic, a medication for type 2 diabetes and weight loss, has seen a surge in popularity, another drug from Eli Lilly, known as Tirzepatide, is also gaining attention. Marketed under the brand name Mounjaro since May 2022, it primarily helps regulate blood sugar in individuals with type 2 diabetes. However, it has quickly become known for its effective weight loss benefits, outperforming Ozempic in this regard.

FDA Approval for Weight Loss and Brand Name Zepbound

Initially, like Ozempic, Tirzepatide faced shortages due to its growing popularity. The situation changed when the FDA approved Tirzepatide specifically for weight loss on November 8. Following this approval, it was introduced under the brand name Zepbound. This makes Zepbound a dual-purpose drug: effective for both diabetes management and FDA-approved for weight loss.

Clinical Studies and Effectiveness

Two significant studies highlighted Zepbound's effectiveness in weight loss. Patients who took 15 mg of Zepbound lost 18% and 12% of their body weight, significantly more than those on a placebo. These results suggest that Zepbound might be more effective than other weight management medications, including Wegovy, which contains Semaglutide. Some data even indicates that Tirzepatide can lead to more substantial weight loss than Semaglutide, the active ingredient in Wegovy and Ozempic.

Who Can Use Anti-obesity Medications?

Patients must qualify for weight loss and meet the criteria for weight management therapy:

• Individuals with a body mass index (BMI) equal to or exceeding 30 kg/m² (indicative of obesity) or
• Those with a BMI of 27 kg/m² or higher (signifying overweight) and experiencing weight- related conditions such as elevated cholesterol, hypertension, type 2 diabetes, obstructive sleep apnea, or cardiovascular disease

Comparing Mechanism of Action

Ozempic

Ozempic is a GLP-1 receptor agonist, functioning by mimicking the natural GLP-1 hormone. It primarily regulates blood sugar levels in individuals with type 2 diabetes. In addition, it promotes weight loss by suppressing appetite, increasing the sensation of fullness, and slowing gastric emptying, though it's not FDA-approved for weight loss.

• GLP-1 Action: By acting as a GLP-1 receptor agonist, Ozempic imitates the effects of the natural GLP-1 hormone. This leads to increased insulin production in response to high blood sugar levels.
• Ozempic's effect on GLP-1 receptors also contributes to weight loss. It reduces appetite and increases satiety (feeling of fullness) by slowing down the emptying of the stomach. These effects lead to a reduction in overall calorie intake, which over time, aids in weight loss.

Zepbound

Zepbound stands out with its unique dual-action mechanism. It activates both GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) hormone receptors. This dual action not only helps in regulating blood sugar levels in type 2 diabetes but also effectively aids in weight loss, for which it has been FDA-approved.

• GLP-1 Action: GLP-1 is a hormone that plays a key role in blood sugar regulation. It promotes insulin secretion, which helps lower blood sugar levels. Additionally, GLP-1 reduces appetite and slows gastric emptying, meaning food stays in your stomach longer, enhancing the feeling of fullness.
• GIP Action: GIP is another hormone involved in blood sugar control. It also stimulates insulin release but is less known for its role in weight management. By activating GIP receptors, Zepbound may enhance the body's natural response to eating, further improving blood sugar control and potentially increasing the effectiveness of weight loss efforts.

Similarities and Differences in Mechanism

The primary similarity between Zepbound and Ozempic lies in their action on the GLP-1 receptor, which is crucial for blood sugar regulation and weight loss through appetite control. However, Zepbound's additional action on the GIP receptor is a distinguishing feature that potentially enhances its efficacy in weight management.

Dosage and Administration

Ozempic

Ozempic is available in doses of 0.25 mg, 0.5 mg, 1 mg, and 2 mg. It is administered as a subcutaneous injection, typically once a week. The exact dosage depends on the individual's medical condition and response to treatment.

Zepbound

The standard starting dosage of this medication is an injection of 2.5 mg under the skin once a week. After four weeks, your healthcare provider may adjust the dosage to 5 mg per week. Depending on how you respond to the treatment, the maintenance dose can be set at 5 mg, 10 mg, or 15 mg, administered weekly.

Side Effects

When comparing Ozempic and Zepbound, it's important to understand their respective side effects, as they share some similarities and also have distinct differences.

Common Side Effects

• Ozempic: nausea, vomiting, diarrhea or constipation, stomach pain, weight loss, reactions at the injection site, and low blood sugar (hypoglycemia)
• Zepbound: nausea, constipation or diarrhea, vomiting, abdominal pain, indigestion, fatigue, and reactions at the injection site

Serious Side Effects

Ozempic

• Potential lump in the neck and difficulty in breathing or swallowing
• Vision problems, including vision loss or blurriness
• Hypoglycemia (hunger, increased heartbeat, shakiness, and confusion)
• Swelling in legs, ankles, or feet, and extreme fatigue
• Rash or itching
• Black Box Warning: Risks of thyroid C-cell tumors and pancreatitis

Zepbound

• Severe allergic reactions (e.g., hives, difficulty breathing, swelling of lips/tongue/throat/face)
• Hypoglycemia (hunger, increased heartbeat, shakiness, and confusion)
• Severe stomach problems, including persistent pain, nausea, vomiting, and diarrhea
• Kidney problems, indicated by issues like nausea, difficulty urinating, swelling in ankles/feet, muscle cramps
• Gallbladder issues, with signs like upper stomach pain, fever, jaundice
• Pancreatitis, characterized by nausea, vomiting, and stomach pain
• Depression or suicidal thoughts

Speak with Your Doctor

Zepbound appears to have an edge for strictly obesity treatment due to its FDA approval for this use and its dual-action mechanism. However, Ozempic remains a valuable option, particularly for patients who also need diabetes management. Ultimately, the "better" drug depends on individual patient needs, medical history, and how they respond to the treatment. Both drugs represent significant advances in obesity treatment and should be considered as part of a comprehensive weight management plan that includes diet, exercise, and lifestyle changes. It's essential for patients to have a detailed discussion with their healthcare providers to determine the most appropriate and effective treatment option.