In Weight Loss Medication

mounjaro weightless medication

While you have probably heard a lot of excitement around the impressive results with GLP-1 medications such as Ozempic, Saxenda and Wegovy, there is a new medication available which offers us a new, exciting option when it comes to weight loss and diabetes control. Mounjaro (generic name: tirzepatide), is a dual-action medication which acts on both GLP-1 and GIP receptors (mimicking hormones we naturally produce in the gut) to produce a reduced appetite, earlier fullness and improved blood sugar regulation.

What does the data show about Mounjaro for weightloss?

For people struggling with obesity without diabetes, the SURMOUNT-1 trial showed that the highest dose of Mounjaro produced an impressive 20.9% weight loss in 72 weeks, or an average of 52 pounds lost! In addition, more than one third of participants on the highest dose lost over 25% of their body weight, a weight loss range that gets close to the amount of weight loss seen after bariatric surgery and not previously seen with other anti-obesity medications. For comparison, the placebo-controlled group lost an average of only 3.1% with diet and lifestyle changes alone over the same time frame. While it is difficult to compare results across different studies, prior studies showed the next most impressive medication, Wegovy (generic: semaglutide), producing an average of 14.9% weight loss over a slightly shorter time frame.

Additional benefits in overall health were seen in this study as well. Over 95% of participants with prediabetes at the start of the study achieved normal blood sugar levels by the end of the study, compared with around 62% achieved by the placebo group with diet and exercise alone. There were also significant improvements in cholesterol levels, blood pressure and overall reported physical function for those on Mounjaro compared to placebo.

For people with Type 2 Diabetes, the SURPASS-1 trial showed that the highest dose of Mounjaro produced an average weight loss of 11%, or about 25 pounds, with an average a1c reduction of 2.3% over a 40 week period! While not a perfect comparison, prior studies on the highest dose of Wegovy (generic: semaglutide) showed that Wegovy produced an average of 9.6% weight loss and 1.6% reduction in A1c over 68 weeks in people with diabetes.

Can I take Mounjaro if I’ve already had bariatric surgery?

While there are no studies yet in the use of Mounjaro for weight regain or sub-optimal weight loss after bariatric surgery, there are studies that show that other GLP-1 agonists are safe and effective to use for patients after bariatric surgery. We are successfully using Mounjaro and others in this class to help with sub-optimal weight loss after bariatric surgery with impressive results.

What are the side effects of Mounjaro?

As with any medication, side effects can occur on this medication. The most common side effects include nausea, diarrhea and constipation. Usually, these are mild-to-moderate and they usually improve over time. We recommend a slow escalation in dose on these medications to reduce any side effects and give your body time to adjust to the medication. We also recommend simple dietary strategies to improve side effects such as eating more slowly than you might usually, avoiding high fat, greasy foods and making sure to sip water throughout the day to stay hydrated.

While Mounjaro will not cause hypoglycemia, or low blood sugar, on its own, it can cause low blood sugars when combined with medications such as insulins or sulfonylurea medications. Your healthcare provider will likely need to reduce your dose or discontinue insulins or sulfonylurea medications when you start Mounjaro to avoid these risks. The great news is, insulins and sulfonylurea medications can actually cause weight gain, while Mounjaro causes weight loss, so being able to reduce or eliminate the need for insulins and sulfonylurea medications is beneficial to overall health and weight control for those with Type 2 Diabetes!

In rare cases, pancreatitis has been reported with this class of medications and therefore your healthcare provider should counsel you on signs and symptoms of pancreatitis, however, this is not a typical side effect. People with a family history of medullary thyroid cancer or MEN-2 syndrome should not take this medication and those who have previously had pancreatitis should also avoid this class of medications.

How is Mounjaro taken?

Mounjaro is a once weekly subcutaneous injection taken in the thigh, abdomen or upper arm that most patients can administer themselves. It comes in a single-dose pen with the medication dose already measured out and the needle already attached to be as user-friendly as possible. The needle is very small and medication is injected just under the skin. Most people report very little pain or discomfort with this injection, most describe it as similar to a small pinch.

Will my insurance cover this medication for weight loss?

Mounjaro is currently only FDA approved for treating type 2 diabetes and not yet approved for weight loss. However, it can be safely used off-label for weight loss in many people without diabetes. Whether you have diabetes or not, we are having success using a combination of insurance coverage and prescription savings card coupons from Eli Lilly, the drug manufacturer, to bring the cost down to $25 per month for most people with commercial insurance. Unfortunately, we are not yet seeing Mounjaro coverage for non-commercial health insurance plans but hope this will come in the future.

GLP-1 medications such as Wegovy and Ozempic remain fantastic options for many people struggling with weight and/or diabetes control. However, for those who need a bit more help to achieve their goal weight or goal a1c, the addition of Mounjaro to our toolbox is extremely exciting!

As with any medication, we advise you to consult a trusted healthcare provider to discuss whether this is the right medication for you. You can click here to schedule an appointment with Claire Pauley, our non-surgical weight loss PA, to discuss your options.

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References:
https://www.nejm.org/doi/full/10.1056/NEJMoa2206038
https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01324-6/fulltext
https://pubmed.ncbi.nlm.nih.gov/33667417/
https://onlinelibrary.wiley.com/doi/10.1111/cob.12323

Showing 2 comments
  • Crystal Lawson
    Reply

    I have been taking MOUNJARO Since June. I had gastric bypass surgery 15 years ago and had good results but still struggled with the last bit of weight. I am very active With hiking, cycling and swimming. Gastric bypass made it difficult to regulate my food while training for some harder events. Since I started taking MOUNJARO I’ve lost an average of 10 pounds a month. It also regulates the food much better and I don’t have dumping syndrome. I have more energy throughout the day. This medication is a godsend. I’ve had little to no side effects other than feeling full all the time. Energy levels have improved. I’m reporting this to the University of Washington bariatric department when I see them next.

    • Dr. Weiner
      Reply

      Yes, it is a great medication!

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