Craig Primack MD, FACP, FAAP, FOMA
The most powerful weight loss drug is currently glucagon-like peptide 1 (GLP-1).
GLP-1 is an incretin hormone that discharges from the intestine after absorbing glucose and other nutrients. It stimulates insulin secretion from the pancreas. The second primary incretin is Gastric inhibitory Polypeptide (GIP) which has insulin stimulating effects like GLP-1.
Both GLP-1 and GIP are considered gut hormones and are both involved in the control of appetite.
Semaglutide vs. Tirzepatide
In February 2020, a NEJM study was published showing that a specific GLP-1 drug with semaglutide at 2.4mg, was quite effective in weight loss. Since 2018, semaglutide (Wegovy™) has been approved for the treatment of diabetes at doses of up to 1mg. We are now waiting for its approval to treat weight loss at 2.4mg.
More recently, a study with a dual agonist with effects of both GLP-1 and GIP was released. This combo drug is called tirzepatide but has not been approved by the FDA yet.
Tirzepatide was shown to lower blood sugar levels and increase weight loss effects with 3 doses: 5, 10, and 15mg. It is considered to be slightly better than semaglutide (Ozempic®) for weight loss at its 1mg dose.
While we wait for the approval of Tirzepatide, Novo Nordisk has filed for the use of Ozempic® of up to 2mg for diabetes. GLP-1 and GIP can both have stomach-related side effects such as nausea, heartburn, constipation, and diarrhea. It is believed that because of these side effects, only 20-30% of users may be able to increase tirzepatide to its 10 or 20 mg doses.
What’s to Come of Weight Loss Drugs
Although we have second-generation weight loss drugs on the market, none of them stand out as revolutionary. However, there is still a lot of promise in the future for these two drugs as powerful anti-obesity medications.
Obesity is a serious, chronic disease but it is treatable. Be sure to incorporate prescription drugs into your weight loss program to make it more manageable.
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