Zepbound Weight Loss: Health Experts Answer 10 Frequently Asked Questions

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Zepbound, a prescription anti-obesity drug similar to Mounjaro, is now available in pharmacies.Antonio Diaz/Getty Images
  • Zepbound (trade name for tilsiparatide) received FDA approval for weight loss in November.
  • It is a dual agonist drug that activates GIP (glucose-dependent insulinotropic peptide or gastric inhibitory peptide) and GLP-1 (glucagon-like peptide-1) hormone receptors, aiding in blood sugar management and helping Patients feel full longer.
  • In the trial, patients lost an average of 26% of their weight over 88 weeks, a higher rate than those taking semaglutide.

On Nov. 8, 2023, Ozempic, Wegovy, and Mounjaro joined Ozempic, Wegovy, and Mounjaro when the U.S. Food and Drug Administration approved Zepbound for use in overweight individuals who are obese or have at least one weight-related disease.

Zepbound is the latest drug in a class of drugs that joins Ozempic, Wegovy and Mounjaro in helping patients achieve significant weight loss.

Although Zepbound and Mounjaro have the same generic drug name, tilsiparatide, and are both manufactured by Eli Lilly and Company, Mounjaro is the only drug approved by the FDA for use in patients with type 2 diabetes.

However, Ozempic, like Mounjaro, is only suitable for people with type 2 diabetes, while Wegovy can also be used to treat obesity and overweight in certain conditions. These drugs make headlines, are mentioned in pop culture, and become extremely popular.

One doctor said the interest is for good reason.

They work, says Dr. Dina Peralta-Reich, MD, FAAP, FOMA, director of Weight Health Medical Center in New York. Finally, we have safe and effective medications on the market to control overweight and obesity.

However, buzz can cause confusion and misinformation. Experts believe it is important for patients to know the facts to manage expectations, make informed decisions about their health care and make positive changes to achieve health and weight loss goals.

Jihad Kudsi, MD, ABOM, MBA, MSF, FACS, an obesity medicine specialist and bariatric surgeon, says many weight loss medications come with contraindications and a variety of side effects, emphasizing the need for close medical supervision. Additionally, not practicing healthier habits like eating a balanced diet and exercising regularly can create challenges in achieving lasting weight loss.

To assist, providers answer frequently asked questions about Zepbound.

Zepbound or Tirzepatide is an FDA-approved injectable drug used to treat certain conditions of obesity and overweight.

It’s a combination of two incretins, GLP-1 (or glucagon-like peptide-1) and GIP (or gastric inhibitory peptide), Peralta-Reich said.

according to FDA Approvedan individual qualifies for Zepbound if:

  • Body mass index (BMI) of 30 kilograms per square meter (kg/m2) or above (obesity)
  • Have a BMI of 27 kg/m2 or higher (overweight) and have at least one weight-related disease, such as high blood pressure, type 2 diabetes, or high cholesterol

Matthew Tucker, PA-C, of ​​the Novant Health Salem Surgical Bariatric Center, added that the drug is given as a weekly injection at home. The starting dose is 2.5 mg per week, which can be increased by 2.5 mg intervals monthly to a maximum weekly dose of 15 mg. Maintenance doses are 5mg, 10mg and 15mg.

In a trial of more than 2,500 adults published in 2022, participants lost an average of 15% of their weight, with patients losing as much as 22.5%. Another recent trial showed an average weight loss of 26%.

One expert said the results were encouraging but warned patients should manage expectations.

There is no one-size-fits-all treatment for obesity, said Dr. Katherine H. Saunders, MD, DABOM, co-founder of Intellihealth and an obesity medicine physician at Weill Cornell Medical College. Some people will be very successful using Zepbound, while others may not lose much weight at all.

Zepbound activates two hormone receptors: GIP (glucose-dependent insulinotropic peptide or gastric inhibitory peptide) and GLP-1 (glucagon-like peptide-1).

Tirzepatide is a drug that mimics the effects of natural GIP and GIP receptors, Peralta-Reich said. When bound to the GLP-1 receptor, it contributes to insulin secretion and regulates glucose and lipid metabolism.

Peralta-Reich explained that these hormones are secreted by cells in the gut. After a person eats, these hormones are secreted by intestinal cells and begin to work.

They also slow gastric emptying, making people feel full for longer, Peralta-Reich says. This ultimately leads to weight loss in people with chronic obesity.

If the term “tezepatide” sounds familiar, that’s because it’s also a drug sold under the brand name Mounjaro, both of which are manufactured by Eli Lilly and Company.

How are they different? rare.

They are the same drug, Peralta-Reich said. The only difference is that Zepbound is FDA-approved to treat overweight comorbidities and obesity, while Mounjaro is approved to treat diabetes.

Ozempic and Wegovy are the brand names of the drug semaglutide.

Saunders said Zepbound is a dual agonist compared to other GLP-1 receptor agonists such as Wegovy. It targets both GLP-1 and GIP, while Wegovy only targets GLP-1.

Saunders said patients taking Tirzepatide may report fewer side effects, such as gastrointestinal discomfort, than Ozempic or Wegovy.

Although recent headlines point to a non-peer-reviewed study showing that patients taking tilsiparatide lost more weight than those taking semaglutide, Tucker said it’s too early to draw conclusions.

Tucker said there are currently no direct, peer-reviewed studies comparing the drugs.

Nonetheless, in SUMOUNT-3 and SURMOUNT-4 trials, patients taking tilsiparatide suffered more losses than participants taking semaglutide, 26.7% and 15%, respectively. However, the duration of the trial was shorter for semaglutide (68 weeks) than for tezepatide (84 weeks).

Like semaglutide, tilsiparatide is not a quick, short-term solution.

Sanders said anti-obesity drugs like Zepbound are not intended for short-term weight loss but for the long-term treatment of obesity, a chronic disease. Tezepatide is suitable for long-term use.

An Eli Lilly trial of more than 780 obese or overweight adults without diabetes found that patients who took Zepbound for 88 weeks lost more weight than those who stopped taking the drug after 36 weeks.

Those who switched to the placebo gained weight but still lost 9.5%.

Generally speaking, yes. However, Kudsi stressed that patients should be aware of side effects and contraindications. He said the most common questions related to geographical indications included:

  • nausea
  • diarrhea
  • Vomit
  • constipate
  • Stomach (abdominal) pain
  • indigestion

Cousy added that people may experience increased drowsiness, injection site reactions and hair loss.

More serious side effects may include:

It is recommended that patients with a history of medullary thyroid cancer (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2) not take this drug because it may cause thyroid tumors.

About $1,060, Sanders said. But the fees patients need to pay will vary.

Tucker said the cost can vary widely depending on insurance coverage. Patients need to check with their insurance provider to find out if their plan covers Zepbound.

It’s difficult for patients to get coverage for the anti-obesity drug Wegovy, and some plans have even recently reduced coverage. Sanders hopes she’s wrong, but predicts similar problems will arise with Zepbound.

It’s my understanding that plans typically cover or don’t cover entire classes of anti-obesity drugs, with various rules and limitations, so I expect plans that currently cover Wegovy will expand their armamentarium of anti-obesity drugs to include Zepbound, Saunders said.

Zepbound is showing great promise in trials. However, patients in the trial also experienced lifestyle changes. Kudsi believes others taking Zepbound will see the best results in weight loss and weight maintenance if they adopt a similar habit.

Cudsi said a healthy lifestyle, including a healthy balanced diet and exercise, is part of a complete obesity treatment.

These modifications include:

  • Record 150 minutes of moderate-intensity aerobic activity per week, such as biking or brisk walking
  • Strength training at least twice a week
  • Eat a balanced diet rich in lean protein and green leafy vegetables

Lifestyle changes play a critical role in overall health, Kudsi said, and relying solely on medications without addressing underlying lifestyle factors may limit the effectiveness of medications.

Zepbound is the brand name for tilsiparatide, which was approved by the FDA for weight loss in November.

It is a dual agonist drug that activates GIP (glucose-dependent insulinotropic peptide or gastric inhibitory peptide) and GLP-1 (glucagon-like peptide-1) hormone receptors, aiding in blood sugar management and helping Patients feel full longer.

Numbers vary across trials. In a later trial, patients lost an average of 26% of their weight over 88 weeks, a higher rate than those taking semaglutide.

Zepbound may have fewer side effects, such as gastrointestinal upset, but patients may experience these side effects.

Experts also say that lifestyle changes such as diet and exercise can help patients lose weight and maintain weight more effectively than Zepbound alone.

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