Diabetes weight loss medications: Ozempic, Wegovy, Mounjaro, and more

Key Points

• GLP-1 agonist diabetes weight loss medications like Ozempic, Wegovy, Mounjaro, and Saxenda are popular.
• These drugs help you lose weight and lower A1c levels, but side effects include gastric issues like constipation, nausea, diarrhea, and more.
• Studies show that weight loss and managing type 2 diabetes work best with a nutritious diet and exercise.
• A Registered Dietitian can help you manage your diabetes and weight with a personalized nutrition plan.

The rising popularity of GLP-1 (glucagon-like peptide) agonists like Ozempic, Wegovy, Mounjaro, and Saxenda reflects a growing need for effective weight management solutions.

It may not be a surprise as over two-thirds of adults in America are either obese or overweight. Additionally, almost 15 million children aged 2-19 in the US struggle with obesity. 

People need effective ways to combat obesity and manage their blood sugar levels.

While Ozempic is more well-known because of the brand’s advertising, other GLP-1 agonists work in similar ways. These drugs offer potential weight loss benefits and reduce risks associated with obesity, such as type 2 diabetes, heart disease, and stroke.

Let’s learn more about these diabetes medications and how nutrition and exercise help treat obesity and diabetes.

Semaglutide drugs: Ozempic, Wegovy, and Rybelsus

Ozempic and Wegovy are GLP-1 agonist diabetes medications authorized by the US FDA (Food and Drug Administration) and use semaglutide as their main (active) ingredient. They are both once-weekly injections for adults, and Rybelsus is a once-daily semaglutide tablet.

Registered Dietitian Rita Faycurry, RD, explains, “Like other GLP-1 agonists, semaglutide mimics the hormone GLP-1 in the body to manage blood sugar levels in people with type 2 diabetes and results in weight loss. It has also been found to reduce the risk of heart disease, such as heart attacks and strokes, in obese or overweight people.”

How does semaglutide help you lower your A1c?

Semaglutide stimulates the pancreas to release more insulin after a meal, lowering blood sugar. It also slows digestion, which allows the blood sugar to be released more slowly.

In studies, Ozempic users lowered their A1c levels to under 7% (the American Diabetes Association recommends an A1c lower than 7% for people with type 2 diabetes).

How does semaglutide help you lose weight?

Semaglutide helps with weight loss by:

• Slowing down digestion, so you end up eating less
• Sending a signal to the brain to lower your appetite, hunger pangs, cravings, and the dreaded ‘food noise’ in your head.

In a clinical trial involving 2000 people with obesity, nearly half of the participants lost 15% of their body weight, and a third lost 20% using semaglutide, along with following a healthy diet and exercise plan.

Ozempic versus Wegovy

Faycurry, RD notes, “Both Ozempic and Wegovy have semaglutide as their main ingredient, so they work in similar ways. However, Wegovy has a slightly higher maximum dose compared to Ozempic, which may result in slightly higher weight loss results, but with a higher dose, side effects may be stronger.”

Indications for Ozempic, Wegovy, and Rybelsus

• Ozempic is indicated to treat type 2 diabetes and heart disease in people with type 2 diabetes and preexisting heart conditions like heart attacks and stroke. Ozempic is prescribed off-label as a weight loss drug.
• Wegovy is approved for weight loss and to lower heart disease in adults who are obese or overweight with known heart conditions.
• Rybelsus is prescribed to lower blood sugar levels in adults with type 2 diabetes.

Tirzepatide drugs: Mounjaro and Zepbound

Mounjaro and Zepbound, produced by Eli Lilly, contain a different GLP-1 receptor agonist chemical, tirzepatide. Both Mounjaro and Zepbound are once-weekly injections.

Apart from working the GLP-1 pathway like semaglutide, Mounjaro, and Zepbound also activates a different pathway called GIP (glucose-dependent insulinotropic polypeptide).

How does Mounjaro lower blood sugar?

By activating both GLP-1 and GIP receptors, tirzepatide has been shown to:

• Stimulate insulin production
• Improve insulin sensitivity
• Regulate blood sugar levels (lower A1c).

A 2021 trial (SURPASS-1) showed that 92% of people with type 2 diabetes on tirzepatide lowered their HbA1c levels to less than 7% (compared to 19% for those on placebo).

In another study (SURPASS-2), tirzepatide helped people with type 2 diabetes lower their HbA1c by up to 2.30%, compared to those on semaglutide (1.86%).

These are just a few of the results. Similar trials show that tirzepatide is effective in lowering blood sugar levels in people with type 2 diabetes.

Does Mounjaro cause weight loss?

The US FDA has not approved Mounjaro for weight loss. However, Zepbound (also tirzepatide) is authorized for weight loss in obese individuals.

• In a 72-week 2022 clinical trial called SURMOUNT-1, participants lost over 20% of their body weight, a substantial amount. Additionally, the weight loss was accompanied by improvements in heart health, including lower blood pressure.

Mounjaro versus Ozempic

Both Mounjaro and Ozempic are approved to treat type 2 diabetes, and studies show greater weight loss with Mounjaro (both are not US FDA-authorized as weight loss drugs).

• In the SURMOUNT-1 study, people on tirzepatide lost over 20% of their body weight, a higher number than the studies on Ozempic (semaglutide).

Indications for Mounjaro and Zepbound

• Mounjaro is indicated for adults with type 2 diabetes.
• Zepbound is approved for weight loss for adults with a BMI greater than 30 or people with a BMI 27 or higher who also have co-existing type 2 diabetes or heart conditions like high cholesterol.

Liraglutide: Saxenda and Victoza

Liraglutide is another GLP-1 receptor agonist manufactured by Novo Nordisk. It is the main ingredient in the weight loss drug Saxenda and type 2 diabetes drug Victoza.

Saxenda and Victoza are once-daily injections.

How liraglutide works for weight loss

Liraglutide works similarly to semaglutide and other GLP-1 receptor agonists by curbing the appetite, slowing digestion, and stimulating insulin release.

In a study of over 3,000 people, 85% lost weight on Saxenda. One out of three people lost over 10% of their body weight, and three out of five lost 5% or more.

Indications

• Saxenda is US FDA-approved for chronic weight loss management in adults as well as children aged 12 and older.
• Victoza has lower amounts of liraglutide compared to Saxenda and is indicated for the treatment of type 2 diabetes in adults and children aged 10 and over.

Side effects of GLP-1 agonist diabetes weight loss medications

Side effects of GLP-1 receptor agonist drugs include gastrointestinal issues like constipation, nausea, diarrhea, abdominal pain, and more.

It’s important to know that most GLP-1 drugs, including Ozempic and Wegovy, come with a black box warning. The FDA issues a black box warning when there is a potential for serious adverse reactions, serious harm, and even death.

Some people taking GLP-1 agonists have experienced serious problems like gallbladder disease and gastroparesis, where the stomach muscles stop working properly, causing food to remain in the stomach for too long.

Says Faycurry, RD, “Gastroparesis can result in bloating, acid reflux, heartburn, and pain. The condition can also lead to a loss of appetite, malnutrition, and increased vomiting. Unfortunately, there is no cure for gastroparesis, and it requires lifelong medical management.”

So, it is important to consult with a healthcare provider and understand the risks before using GLP-1 agonists to treat obesity, diabetes, and weight gain.

Role of diet and nutrition in type 2 diabetes and weight loss

A significant point to keep in mind is that while the meds help, diabetes weight loss medications are not a magic cure-all.

• In clinical trials, people who lost weight using GLP-1 agonist drugs like Ozempic, Wegovy, and Mounjaro also followed a healthy diet and exercise plan. This highlights the importance of nutrition in controlling diabetes and sustaining long-term weight loss.
• Depending on the person, the side effects can be difficult to manage and, in some cases, quite severe.
• People with disordered eating can continue to binge eat while on semaglutide and other GLP-1 agonists like Ozempic.
• GLP-1 agonists must not be used when pregnant because they are associated with a higher risk of pregnancy loss, a negative effect on fetal development, and more.
• People on Ozempic and other GLP-1 agonist diabetes medications have been known to hit a weight plateau or even experience weight gain on the drugs.

If you would like to talk to someone about your weight or elevated blood sugar, consider a Registered Dietitian for a personalized nutrition plan.

Fay can connect you to a Registered Dietitian Nutritionist near you, covered by your insurance.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.