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The Pros and Cons: Should I Choose Tirzepatide or Semaglutide?

  • Tuesday 2 July 2024
  • 5 minute(s) read
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Tirzepatide and semaglutide are two of the newest and most talked about drugs for managing type 2 diabetes and losing weight. But with both being so new, how do you decide which one is better for your needs?

In this article, we'll break down everything you need to know about tirzepatide and semaglutide. We'll explain how tirzepatide works in the body, how semaglutide functions, compare their key differences, and evaluate the latest clinical research on their effectiveness.

What is Semaglutide?

Semaglutide is the key ingredient in three different FDA-approved medications, each with a unique purpose:

  • Ozempic delivers semaglutide through a weekly injection. For adults with type 2 diabetes, Ozempic enhances blood sugar control when combined with diet and exercise. It also lowers the risk of cardiovascular events for those managing both diabetes and heart disease.
  • Rybelsus provides semaglutide in a daily tablet. Rybelsus can improve blood sugar levels when used with lifestyle changes by adults living with type 2 diabetes.
  • Wegovy is FDA-approved for chronic weight management in obese adults and children over 12 years old. Overweight adults with at least one weight-related health issue may also benefit from Wegovy. 1

While each medication targets specific conditions, doctors may prescribe any of them off-label for weight management based on your medical history and symptoms. 2

How Do Semaglutides Work?

Semaglutide is an engineered form of the hormone GLP-1 that works in three ways to help regulate blood sugar levels and curb appetite:

  • Insulin release: Semaglutide signals the pancreas to release insulin. Insulin is a hormone that acts like a janitor, sweeping excess sugar out of the bloodstream and into cells where it can be used for energy.
  • Glucagon inhibition: Semaglutide inhibits the release of glucagon. Normally, this hormone triggers the liver to release stored sugar into the bloodstream.
  • Appetite regulation: Semaglutide delays stomach emptying, so you feel full for longer. 3

Unlike natural GLP-1, which only lasts a few minutes, 4 semaglutide is designed to stick around in your body for up to five weeks, 3 providing extended benefits.

What is Tirzepatide?

Tirzepatide is one of the newest medications on the market for type 2 diabetes and weight loss. It is FDA-approved in two different formulations, each with a different purpose:

  • Mounjaro: A once-weekly injection designed to regulate blood sugar levels in adults with type 2 diabetes.
  • Zepbound: A once-weekly injection used for weight loss in obese adults (BMI over 30). It can also be used for overweight adults (BMI over 27) with a weight-related complication such as sleep apnea, hypertension, or type 2 diabetes. 5

Though the two brand-name drugs have separate purposes, they share the same active ingredient: tirzepatide.

How Do Tirzepatides Work?

Unlike semaglutides that target a single pathway, 3 tirzepatide takes a dual-pronged approach to blood sugar control and weight management. This innovative drug activates both GLP-1 and GIP - two key hormones that work in tandem to keep blood sugar in check after meals. 6

By mimicking GLP-1 and GIP, tirzepatide is able to:

  • Stimulate insulin secretion from the pancreas: This helps lower blood sugar levels by transporting excess glucose into cells.
  • Suppress glucose production by the liver in between meals: This prevents sudden spikes in blood sugar.
  • Regulates appetite: Tirzepatide slows down stomach emptying so you feel full for longer. 6

Semaglutides vs. Tirzepatides: Key Differences

overweight woman talking to a doctor

Both tirzepatide and semaglutide offer promising options for managing type 2 diabetes or losing excess weight. However, there are some key differences between tirzepatide and semaglutide that are worth noting:

  • Mechanism of action: Semaglutide is a GLP-1 receptor agonist, meaning it mimics the effects of GLP-1, a hormone that stimulates insulin production while suppressing appetite. 3 Tirzepatide takes a dual approach, activating both GLP-1 and GIP hormone receptors for amplified blood sugar and weight control. This dual action gives tirzepatide an edge when it comes to weight loss potential. 6
  • Administration method: Tirzepatide is only available as a weekly injection. 6 Semaglutide provides more flexibility with once-weekly shots of Ozempic 3 or daily oral tablets with Rybelsus. 7 The choice between injection or pill may sway some patients towards semaglutide.
  • Approved uses: Both meds can help with weight loss and A1c management, but only Ozempic (a semaglutide) is approved for reducing cardiovascular risks. 3

What is Better: Tirzepatide or Semaglutide?

woman standing on a scale

A recent review of clinical trials suggests that tirzepatide may be the most effective medication yet for managing type 2 diabetes and promoting weight loss. The study, which analyzed data from over 23,000 participants across 28 trials, found that tirzepatide outperformed injectable semaglutide on several key markers: 8

  • HbA1c: After 12 weeks on the maximum dose of Tirzepatide (15 mg), HbA1c dropped by 1.96% on average. The maximum dose of semaglutide (2 mg) led to a 1.59% reduction. Both are substantial improvements, but tirzepatide seems to have an edge.
  • Weight loss: Participants taking 15 mg of Tirzepatide lost a remarkable 21 pounds over 12 weeks. That's nearly double the 10.9 pounds lost by those on the maximum semaglutide dose. 8

In summary, while both injectable semaglutide and tirzepatide offer benefits, tirzepatide appears to maximize outcomes for managing type 2 diabetes and shedding excess weight. For individuals looking to shed a substantial amount of weight, tirzepatide may be the best option. However, before making a decision, it’s essential to have a thorough discussion with your healthcare provider.

Conclusion

When it comes to choosing between tirzepatide and semaglutide, there's no one-size-fits-all answer. The best medication for you depends on your specific health goals and needs, as well as your doctor's recommendation.

Both meds can be highly effective for weight loss and blood sugar control in people with obesity or type 2 diabetes. Tirzepatide seems to have a slight edge over semaglutide in clinical trials, leading to slightly more weight loss and A1C reduction on average. However, every person responds differently.

The key is finding the medication that aligns with your health goals and lifestyle. While tirzepatide and semaglutide have similarities, there are some key differences that may make one a better fit for you.

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical conditions, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.

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