Ozempic®, Mounjaro®, or Wegovy®? Perhaps None.

Wegovy, Ozempic or Mounjaro

It was hard to ignore Jimmy Kimmel at his Academy Awards opening monologue…. [“When I look around this room, everybody looks great, I can’t help but wonder ‘Is Ozempic® right for me?’”]

Ozempic, Mounjaro and Wegovy have become the new weight loss craze. Celebrity spotlights and social media trends promise quick, dramatic, and almost effortless results when using these injections. Even non-doctor led companies are offering prescription-based weight loss programs promising to get you looking your best self yet. But how does this group of medications work and how should they be used?

How do these medications work?

These medications stimulate GLP-1 (glucagon-like peptide-1) receptors, and work by mimicking the activity of GLP-1, a type of hormone produced by our body in response to eating. GLP-1 regulates appetite, sugar metabolism and fullness by slowing stomach emptying and activating specific centers in the brain leading to satiety. Weight loss can vary reach as high as 15-22%.

Semaglutide is the active ingredient in Ozempic®, Rybelsus® and Wegovy®.

Semaglutide is the active ingredient in brand-name medications Ozempic, Wegovy and Rybelsus. All three are manufactured by Novo Nordisk. OzempicÒ  (and its oral form RybelsusÒ ) is indicated for the management of Type 2 diabetes mellitus. WegovyÒ was FDA approved specifically for obesity. No generic brands are currently available and compounded versions are a health risk.

Studies show that the benefits extend beyond sugar control and weight loss. Ozempic is approved to lower the risk of serious cardiac events such as stroke, heart attack, and death in individuals with diabetes and heart disease. Preliminary data of a recent study showed that Wegovy reduced the risk of heart attack by up to 20% in people with excess weight.

What about Mounjaro®?

Mounjaro is the brand name for Tirzepatide, manufactured by Eli Lilly & Co, and FDA approved in May 2022 for the treatment of Type 2 diabetes and soon to be approved for the treatment of Obesity. MounjaroÒ has dual function: it stimulates GLP-1 and GIP (glucose-dependent insulinoptropic polypeptide) receptors making it a more potent agent.

Who is a Good candidate for Wegovy®, Ozempic® or Mounjaro®?

A good candidate for Ozempic, Mounjaro (and Ryblesus) is someone with a history of diabetes and body mass index (BMI) of at least 27. A good candidate for Wegovy is someone with a BMI of 27 and at least one weight-related complication, or a BMI of 30 with or without a weight related complication. Examples of complications include high cholesterol, high blood pressure, depression, anxiety, and PCOS.

Does Evexia Medical prescribe these medications?

Yes, Wegovy® (semaglutide) is one of several GLP-1 medications prescribed at Evexia Medical.  There are also several other anti-obesity medications FDA approved for obesity, in addition to medical nutrition therapy. All medications are used within the context of a nutrition and lifestyle program, tailored to the patient’s health needs, tolerance and insurance coverage.

What are the side effects of these medications?

Common side effects include: nausea, constipation, headaches, vomiting, and abdominal pain. It is always important to take these medications under medical supervision. Slow titration and close monitoring of body composition, laboratory analysis, dietary protein intake and resistance training is important to avoid side effects such as kidney problems, pancreatitis, muscle loss, and low blood sugar. Rare but possible changes in vision can occur. It is important to seek immediate medical care if severe adverse reactions occur.

Are the compounded versions the same?

No. Compounded versions of Ozempic and Wegovy may swap out pure semaglutide for salt-based forms, which have not been shown safe nor effective in clinical trials. Compounding pharmacies mix, alter, or combine FDA-approved drugs with different ingredients for people with specific needs. If there is a shortage of a drug, compounded versions become legal in the US. Compounded drugs are not regulated by the FDA, meaning there is no assurance that they are what they claim to be. Novo Nordisk does not sell its patented semaglutide and in June of this year announced it is taking legal action against medical spas, weight loss and wellness clinics selling questionable compounded or so-called generic versions of semaglutide.  Sometimes, the compounded versions also include vitamin B12, HCG or other metabolism “boosting” injections promising the enhance weight loss even further, without any evidence to support their use.

There are other safe, sustainable options for long term weight loss.

Importantly, Wegovy, Ozempic and Mounjaro are far from a magic fix to excess weight. High cost, insurance coverage and tolerability are factors that need to be considered. When used under supervision of a trained medical specialist in obesity, the benefits can be life changing and extend beyond the lower number on the scale. If there is one thing that the commercial dieting and weight loss industry has proven time and again is that all fads wane. Not everyone is a candidate for these medications and there are many other safe and sustainable options for long term weight reduction.

 

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