Ozempic and Mounjaro Diabetes Medications: Should You Prescribe For Weight Loss?

The media has shed light on people using a variety of drugs for weight loss that were previously reserved for people with type 2 diabetes. Some of these types of drugs are also approved by the U.S. Food and Drug Administration for weight loss in obese adults.

Several celebrities have also promoted their use for weight loss on social media, creating a stir about people who don’t seem to have much weight to lose.

Shortages caused by increased use for weight loss have raised concerns for some type 2 diabetics. Those who cannot afford the drug should switch to alternative treatments.

Here’s a look at drugs that have versions approved for weight loss and diabetes, how they work, and more.

Diabetes-type drugs used for weight loss

Despite online chatter, obesity is a valid medical diagnosis. If properly managed medically, medication may help people with this diagnosis lose weight.

Here are three things you should know about types of drugs and their uses.

1. Semaglutide (also known as Ozempic and Wegovy)

Studies have shown clinically relevant and sustained weight loss with semaglutide, a GLP1 (glucagon-like peptide-1) receptor agonist-type drug. An agonist is a chemical that activates a receptor and causes a biological response.

• FDA approved as Ozempic for Diabetes

• FDA approved as Wegovy for weight loss

• Both Ozempic and Wegovy are administered by injection

• There are differences in the types of injection pens, inert ingredients and maximum labeled doses.

2. Tirzepatide (also known as Munjaro) Tirzepatide combines GLP1 and GIP (gastric inhibitory polypeptide, also known as glucose-dependent insulinotropic polypeptide) receptor activation. Studies have shown that use results in significant and sustained weight loss.

• FDA approved as Munjaro for Diabetes

• Published studies have looked at munjaro for weight loss in non-diabetics. Under FDA review but not yet FDA approved for weight loss

3. Mounjaro, Ozempic and Wegovy are relatively new drugs.

• Munjaro just received FDA Diabetes Clearance in 2022.

• All three are weekly injections.

• Mounjaro and Ozempic are FDA-approved for the treatment of diabetes, but are prescribed off-label by obesity medicine experts and family physicians to help with weight loss.

How do they work for weight loss?

Various regions of the body, including the brain, have GLP1 receptors involved in regulating appetite. Activation of these receptors can reduce appetite and help people feel full faster, ultimately reducing calorie intake.

The additional action of GLP1 receptor agonists helps blood sugar control in diabetes.

“Studies show that these drugs can help you lose weight significantly more than other FDA-approved drugs for weight loss.” Brianna Johnson-Rabbett, MD, Endocrinology, Nebraska Medicine Academics, diabetes and metabolic experts say: “The data show that Munjaro can lose weight on average by more than 20% and Weegobee can lose weight by more than 14% on average. It’s important to note that it’s significantly less or more than the average.”

risks and side effects

Always consult your doctor to determine if these medicines are right for you.

All GLP1R agonists have a boxed warning regarding the risk of thyroid C-cell tumors based on animal studies. The corresponding risk to humans is not clear.

Side effects can vary from person to person and from drug to drug. The most common side effects are gastrointestinal and include:

• Nausea

• Vomiting

• diarrhea

• Constipation

• stomach ache

Gastrointestinal symptoms may subside over time. If your doctor prescribes one of these medications, he or she can work with you to adjust your diet to reduce potential side effects.

am i a good candidate?

In general, you might consider it if:

• Have a body mass index (BMI) of 30 or higher.

• Have a BMI of 27 or greater and have a weight-related medical condition

• not in a condition that impairs safe use;

• trying to reach a healthier weight

Those who do not meet the criteria include those who:

• Personal or family history of medullary thyroid cancer

• History of multiple endocrine neoplasia

Pancreatitis (relative contraindications)

What You Need to Know About the Cost of Weight Loss Drugs

Unfortunately, navigating financial investments can be difficult. Without insurance, these drugs can be very expensive, costing about $1,000 a month.

Insurance may or may not cover diabetes treatment for weight loss.

• Many insurance plans do not cover these drugs to treat obese people, resulting in off-label use of FDA-approved drugs.

• Some insurance companies may cover them without prior approval, others do not.

• Some insurance companies require a diagnosis of type 2 diabetes for coverage.

Beware of those offering “compound semaglutide”.

“There are entities that offer what are called ‘compound semaglutide drugs,'” adds Dr. Johnson-Rabbett. “This is problematic for many reasons, including patent violations and the lack of relevant quality and safety data.”

Be sure to discuss any medications you are considering with your doctor. They will help you decide the healthiest choices for you.