Are Semaglutide and Tirzepatide Weight Loss Miracle Cures? Why the Choice is Yours
If you have been frustrated with the difficulty of losing weight, you’re likely very interested in the new “miracle weight loss” drugs semaglutide (Wegovy(R)) and tirzepatide.
But are they as promising as the media has made them sound – and are they really “weight loss miracle cures”?
If you’re cynical about “miracle weight loss cures,” that means you’re paying attention. Claims of a “miracle cure” are everywhere, it seems – and should be met with disbelief – even if they come from (opens in a new tab)doctors who should be reputable.
However, two new medications have shown results that many are calling miraculous, but what are the downsides of these medications, are they truly the answer for your health goals, and is it possible to use these medications to help you achieve your health goals without becoming dependent on yet another expensive medication with unknown long term effects?
Let’s answer these questions.
Weight Loss is a Big Business
More than 70% of Americans are overweight or obese, and our health suffers. Over half of us now have diseases associated with unhealthy weight, such as high blood pressure, pre-diabetes, and fatty liver, among many others.
And our weight is not because we aren’t trying. An estimated $72 billion(opens in a new tab) is spent yearly on weight loss, even though most efforts fail(opens in a new tab) in the long run. One particularly eye-opening study(opens in a new tab) in over 176,000 people over nine years showed the chances of an overweight person achieving a normal weight was less than 1 in 100.
It’s no wonder the concept of a miracle weight loss medication is so attractive, and the pharmaceutical industry has been working diligently to find the answer.
Medicines for weight loss
However, the history of weight-loss drugs is, well, dismal.
Laxatives, thyroid hormone, and amphetamines have all been used with serious, potentially life-threatening side effects.
In the 1990s, a component of the popular weight loss drug Fen-Phen (fenfluramine) was withdrawn from the market(opens in a new tab) after reports of heart valve disease and pulmonary hypertension. In 2010, sibutramine was removed from the market(opens in a new tab) due to reports of increased risk for heart attack and stroke. And in 2020, the weight loss medication Belviq (lorcaserin) was withdrawn from the market(opens in a new tab) when studies suggested an increased risk for cancer.
Even the handful of available weight loss meds aren’t prescribed often, likely due to their cost and modest effect.
But now, we might have a new treatment that MAY change everything.
Is this a new beginning for weight loss?
A new era in the medical treatment for weight loss began with the STEP trial(opens in a new tab), which used a once-a-week injection of a diabetes medication called semaglutide for a little over a year.
And the results were stunning.
The weight loss in those who received the medication was 14.9% of the starting body weight, which was 15.3 Kg or 33.6 pounds on average.
To put this in perspective, most weight loss programs(opens in a new tab) and weight loss drugs(opens in a new tab) result in less than a 5% body weight loss in one year, and a sustainable 10% weight loss is uncommon.
In the STEP trial, 86% of people lost more than 5% of their body weight, and 69% lost more than 10% of their body weight. There was also a decrease in blood pressure and blood sugar levels in those on the medication.
And now, there is a medication with even more impressive results – tirzepatide, which was studied in the SURMOUNT-1 trial(opens in a new tab). Tirzepatide is similar to semaglutide but with an additional action – and the results were even more stunning.
On the highest dose, the average weight loss was 20.9% of body weight – that’s almost 50 pounds on average! In addition, blood pressure, blood sugar, and cholesterol numbers all improved.
While these results are exciting, there are some downsides to these medications to keep in mind and a choice for you to make.
Semaglutide Side Effects/Tirzepatide Side Effects
Semaglutide and tirzepatide both have potential side effects, like all medicines. Most were related to digestion issues. Diarrhea, constipation, nausea, upset stomach, abdominal pain, and vomiting were commonly described as mild and transient. Less than 10% of people stopped the medication, and serious side effects were no more common than in the placebo group.
Do semaglutide and tirzepatide always work?
No. Less than 5% of people who took these medications did not lose a significant amount of weight. At this point, we don’t know how to identify the people who don’t respond.
Semaglutide is available commercially – and is quite expensive – about $1,400 a month without insurance coverage. In addition, there are supply issues at least until the end of 2022 – and currently, doctors are being asked not to prescribe to new patients. Tirzepatide will be available commercially soon.
What You Need to Know About Semaglutide and Tirzepatide
So, the question remains, are semaglutide and tirzepatide a miracle weight loss cure?
And the answer is no. These medications are not a cure. However, they can be an important part of the cure.
Let me explain.
First, most people understand that while weight loss gets a lot of attention, the real goal is to improve health – and increase the time we have to live a vital life. We already know several ways to lose weight that result in a shortened lifespan (like starvation, advanced cancer, or severe, untreated illnesses like some chronic infections or AIDS) – nobody wants to lose weight that way. As effective as semaglutide and tirzepatide are at weight loss, they still are not going to give you all the life-enhancing benefits of eating the right foods for you, being physically active in a way that feels good, getting restorative sleep, managing stress, avoiding toxins, and being connected – socially and to your purpose.
Second, understand these medications are not a cure – they are chronic medications you will have to take forever if you don’t change your habits. Because, without changing your habits, you will regain the lost weight. Not only does this make sense, but it’s also been shown in a research study (opens in a new tab)that one year after stopping semaglutide, the average person regained ⅔ of their weight loss, and the improvements in blood pressure, cholesterol, and blood sugars mostly returned to baseline.
The point is, if you decide to take these medications, you have three choices:
- Take them for a period of time and get temporary results.
- Be dependent on the medication and take it indefinitely.
- Use the medication as a tool to accelerate your progress while you adopt the lifestyle choices that you know will improve the quality and length of your life.
What makes sense to you?
As a physician specializing in helping people avoid chronic diseases and live a long and vital life, the only option that makes sense is #3. I’ve already seen what happens when business interests are put above individual interests in the opioid epidemic – and even possibly in antidepressants. And while I’m not suggesting that semaglutide and tirzepatide will cause disastrous long-term side effects like opioids did, the truth is, we don’t know what the long-term effects of these medications will be – outside of knowing they will be prohibitively expensive for most people.
So, my practice will be to only use these medications for those who do not want to become dependent on them and want to use them as tools to achieve their health and longevity goals – and to ultimately not need the medication anymore. But if you are someone who just wants the medication, don’t worry – the pharmaceutical industry will love you, and there will be lots of providers who are willing just to write the prescription.
Are semaglutide and tirzepatide tools to help you achieve your health and longevity goals or chronic medications you will need to take indefinitely?
The choice is yours.