What's the difference between Semaglutide and Tirzepatide?

Weight loss medications have existed for decades, but few have gained the level of attention that semaglutide and tirzepatide have experienced recently.

You’ve likely already heard of them, but do you know how they work and how they compare? We will discuss each medication function individually and then compare them head-to-head to help you consider if either one may be right for you.

What is Semaglutide?

Semaglutide, which is known by the brand names of Ozempic® and Wegovy®, is a glucagon-like peptide 1 (GLP-1) receptor agonist originally developed to treat type 2 diabetes. In the process, semaglutide also demonstrated significant success with weight loss.

Glucagon-like peptide-1 (GLP-1) receptor agonists mimic the actions of a naturally occurring neurotransmitter or hormone. Therefore, they work by increasing the effects of a GLP-1, a neuroendocrine hormone that is produced in the gut in response to food intake.

GLP-1 helps lower blood glucose by sending it to organs and tissues to be used for energy. In addition, GLP-1 slows gastric emptying, increases fullness, reduces appetite,and leads to decreased overall calorie intake. By binding to GLP-1 receptors, GLP-1 receptor agonists increase the activity of GLP-1, improving glucose control and increasing weight loss. 

What is Tirzepatide?

Tirzepatide, which is known by the brand names of Mounjaro® and Zepbound®, is another medication designed to treat type 2 diabetes but shown to have significant weight loss effects as well.

While they work similarly, tirzepatide works on two main pathways instead of one. Tirzepatide is a dual agonist; it is a GLP-1 receptor agonist (like semaglutide) and also a glucose-dependent insulinotropic polypeptide (GIP) receptor agonist.

GIP is another neuroendocrine hormone involved in regulating blood sugar levels and insulin secretion. By targeting both the GIP and GLP-1 receptors, tirzepatide delivers not only a clinically significant reduction in blood glucose but also notable weight reduction through its synergistic effects on weight loss, decrease in fat mass, and reduction in appetite. 

Advantages and side effects of semaglutide for weight loss

For weight loss, semaglutide is available in a higher dose. Many clinical trials have shown impressive weight loss results. The STEP trial compared the use of semaglutide 2.4 mg weekly to placebo over two years, and semaglutide demonstrated a 15.2% weight loss, as compared to 2.6% with no medication.

One of the advantages of using semaglutide for weight loss is its convenient weekly dosing. However, the formulation of semaglutide approved for weight loss is an injection, which can be a downside for some people. 

Side effects

In addition, semaglutide can cause notable side effects, most commonly gastrointestinal upset (like nausea and vomiting) and hypoglycemia (low blood sugar), which can often be eased by dietary adjustments.

More serious side effects, such as pancreatitis and thyroid cancers, are rare. Semaglutide is not a magic weight loss remedy; it should be used in conjunction with a healthy diet, regular physical exercise and other lifestyle modifications.

Advantages and side effects of tirzepatide for weight loss

Tirzepatide has been shown to be very effective for weight loss. Within a randomized controlled trial, at a maximum dosage of 15 mg, tirzepatide demonstrated a 20.9% weight reduction over 3.1% in patients taking no medication. The increased effectiveness of tirzepatide is likely related to its dual action on both the GIP and GLP-1 receptors for additive impact.

Tirzepatide is less studied for weight loss, with ongoing research to further determine its long-term safety and efficacy. It's also often more expensive than semaglutide, although it may lead to cost savings in the long run.

Side effects

Tirzepatide is also given in a once-weekly injection, like semaglutide. The side effects of tirzepatide are similar to those of semaglutide, the most common ones being gastrointestinal upset and hypoglycemia, but evidence suggests the intensity of side effects may be more severe with tirzepatide.

Semaglutide vs. Tirzepatide: Key Differences

Now that we understand each medication individually, here’s how semaglutide and tirzepatide compare.

• Semaglutide acts as an agonist on GLP-1 receptors only, whereas tirzepatide acts as a dual agonist on both GLP-1 and GIP receptors.

• Both semaglutide and tirzepatide for weight loss are given as once-weekly injections.

• Semaglutide for weight loss offers 2 dosages (1.7 mg and 2.4 mg), whereas tirzepatide is available in dosages of 2.5, 5, 10, and 15 mg, potentially allowing patients to find a more suitable therapeutic dose with good results and tolerable side effects.

• While both medications are successful at weight reduction, studies show that tirzepatide may lead to greater weight loss than semaglutide.

• The side effect profiles are similar between both semaglutide and tirzepatide, although the severity of side effects may be greater with tirzepatide.

• Tirzepatide tends to be more expensive than semaglutide, although early studies suggest that tirzepatide may be more cost effective in the long run.

Semaglutide vs. Tirzepatide: How to Choose?

If you are wondering if using either semaglutide or tirzepatide for weight loss is right for you, the first step is to discuss it with your physician or other healthcare professional. There are a number of factors to consider when it comes to semaglutide and tirzepatide.

Considering your medical history, current medications, weight loss goals, other lifestyle factors, medication availability and cost differences will allow you to make an informed decision about the best choice for your medical weight loss.

With any weight loss medication, it is vital to remember that medication should be used as only one part of a comprehensive weight loss plan. A healthy diet, regular physical activity, adequate sleep and stress management are all necessary for long-term weight loss success.

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