Curious about the buzzy new weight loss medications featured all over your social feeds? You’re not alone. In recent years, GLP-1 and GIP diabetes medications like Mounjaro (tirzepatide) and Ozempic (semaglutide) have been making waves. In 2023, Zepbound (tirzepatide) secured a spot on the roster as well.

However, understanding the nuances of these medications is crucial. In this blog, we'll dive into the differences in how Mounjaro, Ozempic and Zepbound function. We’ll also discuss their specific Food and Drug Administration (FDA) approvals, side effects and costs.

Considering these medications for your own weight loss journey? Keen on staying up-to-date with medical breakthroughs? This article aims to give you a clear and straightforward overview!

What is Zepbound?

Zepbound is a new weight loss drug that’s FDA-approved to treat obesity in adults. It’s made by pharmaceutical company Eli Lilly, and contains the active ingredient tirzepatide. Tirzepatide is also found in Mounjaro, a type 2 diabetes drug that is also made by Eli Lilly.

Zepbound is indicated for chronic weight management in adult patients with obesity, or who are overweight with weight-related medical health conditions. This approval makes it one of the few drugs on the market that is specifically designated for weight management, rather than diabetes management.

Tirzepatide belongs to a class of drugs called dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonists.

The dual action of GIP and GLP-1 affects blood sugar and food intake in multiple ways, including:

• Prompting the pancreas to release insulin when blood sugar levels are high
  
• Decreasing the release of glucagon, which aids in lowering blood sugar levels
  
• Slowing the process of stomach emptying, aiding in appetite control and reducing food consumption
  
• Encouraging a feeling of fullness following meals
  
  

Zepbound is supplied as a pre-filled pen with a needle on the end. It’s given to patients as a subcutaneous injection (delivered just under the skin) once a week.

What is Mounjaro?

Mounjaro is another brand name for the medication tirzepatide. Tirzepatide is the same active ingredient in Zepbound. However, Mounjaro was approved by the FDA in May of 2022 for the treatment of type 2 diabetes. Zepbound, on the other hand, was approved for chronic weight management.

Like Zepbound, Mounjaro is manufactured by the pharmaceutical company Eli Lilly. It belongs to the GIP/GLP-1 class of medications as well.

Mounjaro, which is also administered as a weekly injection, works just like Zepbound. As explained above, it helps the pancreas to control how much insulin is released. It also slows down food absorption to make you feel more full and reduce how much you eat.

In general, higher doses of tirzepatide have been shown to affect body weight. However, it’s indicated for diabetes management - not weight loss. In other words, weight loss is a side effect of Mounjaro. Prescribing it for weight loss is an off-label use of the medication.

What is Ozempic?

Ozempic is the brand name for semaglutide, a medication made by Novo Nordisk. The FDA has approved Ozempic to manage blood sugar levels in patients with type 2 diabetes.

Semaglutide belongs to a class of medications called glucagon-like peptide (GLP-1) 1 receptor agonists. This makes it slightly different from dual GIP and GLP-1 receptor agonists like Mounjaro and Zepbound.

GLP-1 (glucagon-like peptide-1) drugs mimic the action of GLP-1. GLP-1 is a natural hormone produced in the intestines in response to food intake. When you eat, GLP-1 is released from your intestines. It signals the pancreas to release more insulin, a hormone that lowers blood sugar levels.

Insulin helps glucose (sugar) in your bloodstream enter cells, where it can be used for energy or stored for later use. GLP-1 ensures that insulin is released when needed, such as after a meal when blood sugar levels rise.

GLP-1 also reduces the release of glucagon, another hormone produced by the pancreas. Glucagon has the opposite effect of insulin. It raises blood sugar levels by signaling the liver to release stored glucose into the bloodstream. By inhibiting glucagon, GLP-1 helps prevent excessive glucose release from the liver. This is important - too much glucose being released at once can lead to high blood sugar levels.

Medications like Ozempic, Zepbound and Mounjaro also help slow down the emptying of the stomach. This helps to control the rate at which carbohydrates from your meal enter the bloodstream. This gradual release of nutrients can prevent rapid spikes in blood sugar levels after eating.

Ozempic doesn't just help to regulate blood sugar levels. It also helps adults with type 2 diabetes who also have a known heart disease to reduce their risk of major cardiovascular events like heart attack or stroke.

Ozempic is available in several dosages and is given to patients as a once-weekly injection.

What is the difference between Zepbound, Mounjaro and Ozempic?

Mounjaro and Zepbound are the same compound: tirzepatide. However, Mounjaro has been branded by Eli Lily as a treatment for type 2 diabetes. Zepbound, on the other hand, has been branded as a treatment for weight loss.

Tirzepatide also be prescribed at different doses for the treatment of type 2 diabetes compared with use for weight loss, which is another reason why it is sold under two different brand names, and will likely have slightly different administration devices (Mounjaro with adjustable dosing in an injectable pen device, and Zepbound with fixed dosing in an injectable pen device).

Ozempic, on the other hand, has a different active compound (semaglutide). Ozempic is categorized as a GLP-1 receptor agonist instead of a GIP/GLP-1 receptor agonist, like Zepbound and Mounjaro.

In a head-to-head trial of semaglutide and tirzepatide, tirzepatide was superior in weight loss outcomes. At the highest doses, users of tirzepatide lost about 12 additional pounds compared to those using semaglutide (about 5.5kg).

Who are these medications recommended for? Are there people who should not use them?

The evidence for the efficacy of these medications is strong, but they are not without side effects and some risks. Patients will require physician’s guidance - and most likely blood work - to monitor their body’s response to the medication over time.

Clinicians will usually only prescribe these medications like Zepbound, Mounjaro and Ozempic if your body mass index (BMI) is 30 or higher (27 or higher if it's accompanied by weight-related medical conditions such as high blood pressure, heart disease, type 2 diabetes, pre-diabetes, high cholesterol, non-alcoholic fatty liver disease, obstructive sleep apnea or PCOS).

These medications are not indicated for people with any of the following conditions:

• A history of pancreatitis. It’s suggested that GLP-1 agonists are associated with an increased risk for pancreatitis and pancreatic cancer.
  
• A personal or family history of certain thyroid cancer. Both tirzepatide and semaglutide have a ‘boxed warning’ from the FDA. This is due to the rare but serious risk of developing thyroid tumors from this medication.
  
• A slow digestive system. GLP-1 agonists work in part by slowing motility. Motility is a term for how fast your gastrointestinal tract moves food through your body. This makes you feel full for longer, but also can increase the risk of GI issues. Use of these drugs was linked with a 4.22- and 3.67-times higher risk for bowel obstructions and gastroparesis, respectively.)
  
  

For these reasons, you should have an in-depth conversation with your doctor about your medical history before considering weight loss medication. This includes any allergies or other conditions that you may have. You should also have an extensive dialogue about the medicines or supplements that you're currently taking. Be sure to bring up if you are pregnant, breastfeeding or planning to get pregnant soon.

What's the cost difference between Zepbound, Ozempic and Mounjaro?

Costs are largely dependent on your insurance status. If you’re insured, the price of these medications depends on the rates negotiated by your insurer.

Without insurance, both semaglutide and tirzepatide cost around $1,000 per month. Prices for the diabetes versions (Ozempic and Mounjaro) are typically a bit lower than prices for the weight loss version (Zepbound). Here’s what prices look like without insurance:

• Zepbound (tirzepatide) has been set at a list price of $1,060 per month before insurance
  
• Mounjaro (tirzepatide) usually costs between $1,020 to $1,200 per month before insurance
  
• Ozempic (semaglutide) usually costs between $850-$1,000 per month before insurance
  
  

Doctors - including those at Sesame - can help patients compare price and medication options. They can also assist with insurance prior authorization requests for prescription coverage. Plus, they can direct you to medication savings coupons from manufacturers to assist with medication costs!

How can Sesame assist with weight loss goals?

Considering using weight loss medication to assist you with your weight loss journey? Sesame’s comprehensive online weight loss program can help! The program is a subscription which renews every 3 months. It includes a video consultation with a weight loss doctor or specialist, a GLP-1 prescription (if appropriate), insurance coordination for medication coverage and 90 days of unlimited messaging with your provider.


Sources:

• Abbasi J. (2023). FDA Green-Lights Tirzepatide, Marketed as Zepbound, for Chronic Weight Management. JAMA.
  
• Chavda, V. P., Ajabiya, J., Teli, D., Bojarska, J., & Apostolopoulos, V. (2022). Tirzepatide, a New Era of Dual-Targeted Treatment for Diabetes and Obesity: A Mini-Review. NIH.
  

• Farzam K, Patel P. (2023). Tirzepatide. NIH.
  

• Frías, JP., Davies, MJ., Rosenstock, J., Pérez Manghi, FC., Fernández Landó, L., Bergman, BK., Liu, B., Cui, X., Brown, K.(2021). Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. NEJM.
  
• Garvey, W.T., Batterham, R.L., Bhatta, M. et al. (2022). Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med.
  
• Scheen, André J. (2023). Dual GIP/GLP-1 receptor agonists: New advances for treating type-2 diabetes. Science Direct.
  

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