Understanding Semaglutide, Ozempic, Wegovy, Mounjaro and Zepbound

In the past 2 years, Semaglutide has become a big buzz. There are many branded forms on the market, and due to the shortage of branded forms for the medication, we also have many compounded versions on the market. Semaglutide is a glucagon-like peptide-1 (GLP-1) agonist medication branded by Novo Nordisk under the names of Ozempic® and Wegovy® and also branded by Eli Lily under the names Mounjaro® and Zepbound®.  Semaglutide was initially created and utilized for type 2 diabetes. Many years later, it was researched that Semaglutide is safe and very effective for weight loss.  At The Natural Path, Dr. Cara has created a very effective protocol around using Semaglutide as a “tool” to dial in healthy lifestyle habits so that weight loss can be maintained. We have been so impressed with the results of our patient population study.

HOW DO SEMAGLUTIDE, OZEMPIC, WEGOVY, AND MOUNJARO WORK?

Ozempic is the most widely known form of Semaglutide.  Semaglutide works as a GLP-1 agonist.  This means that it mimics the hormone GLP-1.  We make a form of GLP-1 in our gastrointestinal system in response to a big meal.  The GLP-1 hormone produced in our gut sends signals to the brain, impacting appetite and metabolism. Below is a compilation of a few ways these medications can contribute to weight loss. We still have a lot more to learn. 

GLP-1 can work by stimulating the secretion of insulin and slowing the release of glucagon. This mechanism of action helps to lower blood sugar. Lower blood sugar leads to less insulin secretion and, therefore, easier thermogenesis or fat burning. 

+GLP-1 agonists work on both leptin and ghrelin, impacting hunger and satiety signaling. Most of our patients experience appetite suppression ranging from 30% to 80%, which makes it easier to make better food choices. For some, cravings seem to go away as well.

+ GLP-1’s are also known to delay gastric or stomach emptying.  This mechanism of action keeps people feeling satiated for longer.

Several medical studies have suggested that GLP-1 agonists may help convert white fat to brown fat—the fat we have in greater quantities in our youth. Brown fat is more metabolically active. This is one suggested possibility as to why GLP-1s might improve metabolic rate.

+ GLP-1s may work to lower your set point. Your set point is the weight your body naturally gravitates towards due to the interaction between metabolic health, genetics, and environment.

+ Leptin mainly acts on the brain stem and hypothalamus by preventing hunger and helping the body use energy as fuel. Overweight or obese people can become leptin-resistant, meaning their brains do not respond as well to leptin.

SEMAGLUTIDE BENEFITS AND EXPECTATIONS

• In our patient population, we often use the compounded form of Semaglutide. We find a good average for weight loss is 4-10 lbs per month or .5-2.5 lbs per week. Many variables can increase/decrease this average. For patients with less weight to lose, even 1/4-1/2 lbs per week or 1-2 lbs per month can be normal.

• Food cravings decrease for most during the process. We recommend a specific lifestyle diet in conjunction with using Semaglutide. We find the best results by following the lifestyle diet and using the medication.

• In most cases, Semaglutide leads to weight loss and improved metabolic health. It also helps to create healthy habits.

• Our goal when prescribing Semaglutide is to keep our patients on the lowest dose while sharing with them the lifestyle tools needed to maintain the losses for long-term success.

• Semaglutide has also been shown to reduce inflammation in many organ systems and has been associated with a reduction in blood pressure. Research is ongoing using Semaglutide to slow the progression of Alzheimer’s and Parkinson’s disease.

• Semaglutide has been shown to regulate cholesterol and triglycerides in Type 2 diabetics by modulating key liver lipid metabolism enzymes.

• Studies have shown that Semaglutide reduces cardiovascular disease.

WHAT’S THE DIFFERENCE BETWEEN SEMAGLUTIDE, OZEMPIC, WEGOVY, AND MOUNJARO?

Semaglutide – a GLP-1 agonist is the active ingredient in Ozempic and Wegovy.  Semaglutide is not sold generically in commercial pharmacies at this time. Due to the shortage of the branded forms of the medication, the FDA allows compounding pharmacies to temporarily make versions of the medication. The advantage of using this generic form from a compounding pharmacy is the ability to adjust dosing. For example, we can use a .75 mg dose between .5 mg and 1 mg which I find to be very useful. Compounded Semaglutide is less expensive for the patient and can be combined with B12, B-6 or carnitine for weight loss support. I  find that patients often successfully lose weight at lower doses and then transition off easily.

Ozempic – this is a branded form of Semaglutide created by Novo Nordisk.  This drug has been FDA-approved for Type 2 diabetes. It comes as a pen-injector to make it easy for the patient to administer. For Type 2 diabetes patients, the starting dose is 0.25 mg weekly, and the pen has presets that dictate dose increases as follows: starting dose – 0.25 mg, after four weeks – 0.5 mg once weekly if tolerating and further diabetes control is needed, the patient will increase to 1 mg weekly. In Ozempic drug trials, significant weight loss occurred, and this drug was later approved as a weight loss medication under the name Wegovy.

Wegovy – this is a branded form of Semaglutide created by Novo Nordisk.  This drug has been FDA-approved for weight loss. Wegovy is a weight-loss version of Ozempic. Wegovy also comes in an injection to make it easy for the patient to administer. The downside of the pen-injector is that the patient cannot start lower than 0.25 mg weekly – even at this low starting dose, many patients experience intolerable side effects.

Mounjaro – is a drug that works on two receptors. It is an agonist on both a GLP-1 and a GIP receptor. The generic name of this med is Tirizipide. This drug was FDA-approved for Type 2 diabetes in May 2022 but is often used off-label for weight loss. Mounjaro also comes in an injection pen to make it easy for the patient to administer. What has been promising about Mounjaro is that, similar to GLP-1 agonists, it is a diabetes medication that can lead to weight loss.

Zepbound – this is Eli Lily’s version of Tirzepatide for weight loss.

Semaglutide at The Natural Path

Over the past 20 years, we have treated thousands of patients with our medically supervised weight loss programs. This is Dr. Cara’s passion. In the past 2 years, we have had incredible success with our Semaglutide weight loss program.

Patients joining the program begin with an in-office consultation and body composition analysis on our In BOdy 720 Scale.  The program includes the medication, weekly B12 (methylated) injections or lozenges;  dietary recommendations, and ongoing clinical support.  Patients continue with the program in monthly increments for as long as they find it necessary and beneficial to achieving or maintaining their goal weight loss goals.