Why You Might Tolerate One Weight Loss Drug Better Than Another

Prescriptions for Ozempic, Mounjaro, and different glucagon-like peptide-1 (GLP-1) receptor agonist medicine have skyrocketed in recent times. However regardless that the drugs are used for related functions, individuals usually have vastly totally different reactions to them.

Gastrointestinal points, particularly nausea, are frequent amongst individuals who take GLP-1 medicine. Nevertheless, typically negative effects from tirzepatide (the lively ingredient in Zepbound and Mounjaro) or semaglutide (Wegovy and Ozempic) can drive individuals off the drugs or cause them to attempt a distinct drug altogether.

There isn’t a lot knowledge on the topic, however a 2024 research from researchers at Truveta discovered that, over a five-year interval, about 11% of GLP-1 drug customers switched from one treatment to a different.

And up to date celeb instances have introduced the problem additional into the highlight.

In a March video posted to her Instagram, comic Amy Schumer talked about how she switched from semaglutide to tirzepatide and is now having higher outcomes.

“I attempted Wegovy, and I used to be like, puking, I couldn’t deal with it. I don’t know in the event that they’ve modified the method, no matter. Mounjaro’s been nice,” she stated. “I’m having a very good expertise with it.”

Beforehand, on a January episode of Howard Stern’s SiriusXM present, Schumer shared that when she was on Ozempic three years in the past, she was left “bedridden” and “vomiting.”

So why, in Schumer’s case, did semaglutide trigger unmanageable negative effects, whereas tirzepatide didn’t?

In response to weight problems specialists, individuals can react in another way to GLP-1s, and the way your physique responds would possibly rely upon the treatment itself and numerous components, together with age, intercourse, and food plan.

Right here’s what to learn about semaglutide and tirzepatide negative effects, why the medicine don’t at all times set off the identical reactions, and the best way to reduce hostile results whilst you’re on a GLP-1 treatment.

Semaglutide and tirzepatide have rather a lot in frequent. Each are GLP-1 receptor agonist drugs that act on GLP-1 receptors within the mind, pancreas, and gastrointestinal tract, which in flip management blood sugar ranges, sluggish abdomen emptying, and cut back starvation and meals cravings.

Tirzepatide and semaglutide additionally share quite a few negative effects—nausea, acid reflux disease or indigestion, constipation, and full lack of urge for food (past the supposed impact) are commonest, Rekha Kumar, MD, an endocrinologist at Weill Cornell Drugs, informed Well being.

Past these, the labels for Zepbound, Mounjaro, Ozempic, and Wegovy all warn customers about doable diarrhea, vomiting, and abdomen ache.

However there are slight variations past these negative effects, significantly for the load loss variations of those drugs.

Whereas Wegovy or Zepbound customers are each warned about doable fatigue, belching, and heartburn, Zepbound may additionally trigger injection website reactions, allergic reactions, or hair loss, and Wegovy may trigger headache, dizziness, bloating, low blood sugar, abdomen flu, fuel, and runny nostril or sore throat.

Basically, although, these negative effects are pretty related. And for each drugs, signs have a tendency to enhance over time as individuals get used to them, added Jorge Moreno, MD, inner medication and weight problems medication doctor at Yale Drugs.

Moreover, Morgan Stewart, PharmD, scientific affiliate professor of pharmacy observe on the College of Texas at Austin, informed Well being that these negative effects are sometimes dose-dependent. Meaning, no matter whether or not persons are taking tirzepatide or semaglutide, negative effects are “extra prone to occur at larger doses,” she stated.

Although they’re related, tirzepatide and semaglutide are formulated in another way. Whereas semaglutide is only a GLP-1 agonist, tirzepatide is a dual-action treatment, which suggests it’s each a GLP-1 agonist and a glucose-dependent insulinotropic polypeptide (GIP) receptor agonist.

GIP is a hormone primarily chargeable for reducing blood sugar. So tirzepatide, which acts on each GLP-1 and GIP receptors, is ready to additional decrease blood sugar, trigger weight reduction, and enhance lipid ranges. This may very well be why each Zepbound and Mounjaro have been proven to outperform Wegovy and Ozempic by way of weight reduction advantages, stated Stewart.

It may additionally be a possible rationalization for why some individuals tolerate the drugs in another way. In her observe, Stewart stated she’s observed that “tirzepatide typically causes extra negative effects than semaglutide as a result of it really works on two hormones as an alternative of 1.”

However Kumar has seen the other. She stated it’s usually simpler to area out tirzepatide doses and improve them extra progressively over time, so she’s observed tirzepatide is much less prone to trigger gastrointestinal points amongst her sufferers as in comparison with semaglutide.

Moreno informed Well being that he’s handled many individuals who skilled intense negative effects with semaglutide that considerably lessened once they switched to tirzepatide. Nevertheless, “I’ve had the reverse happen as effectively, the place individuals tolerate semaglutide higher,” he defined.

For now, this sort of anecdotal proof is all that’s on the market—there’s little analysis placing tirzepatide and semaglutide’s negative effects head-to-head on a large scale.

It might be that tolerating tirzepatide or semaglutide merely comes down to every particular person—individuals can have totally different tolerances to treatment varieties and doses relying on their age, genetics, and intercourse, Kumar stated.

Way of life could change issues, too. Your exercise ranges, the drugs you are taking, and your food plan can have an effect on your threat of experiencing GLP-1 negative effects, stated Kumar.

The identical is true on your beginning dose. “If the beginning dose is simply too excessive or elevated too shortly, negative effects like nausea are extra doubtless,” stated Stewart.

So, when you’re having fewer negative effects after switching from Ozempic to Mounjaro, for instance, it may very well be as a result of your physique handles the formulation higher. Or it may very well be as a result of your doctor began you on a decrease dose, otherwise you’re now consuming effectively and exercising extra constantly.

No matter which GLP-1 treatment you’re taking, there are just a few steps you’ll be able to take to reduce your likelihood of creating negative effects.

For one, begin at a low dose and ramp up progressively over time, Stewart beneficial.

Consuming smaller meals and limiting consumption of fried meals, desserts, and high-fat meats equivalent to steak may also be extremely useful for some individuals, added Moreno, as these meals can exacerbate damaging gastrointestinal negative effects.

Prescription or over-the-counter anti-nausea or constipation drugs may also be a great way to alleviate a few of these points.

It’s essential to remain hydrated, too—Kumar stated individuals usually overlook to drink water when their urge for food is suppressed. “I’ve seen such unhealthy dehydration that individuals land within the [emergency room] with kidney failure,” she stated.

Should you proceed to expertise harsh or uncomfortable negative effects day after day, it’s greatest to speak to your physician—particularly if GLP-1 negative effects are interfering together with your potential to operate.

In these conditions, Kumar stated she often advises sufferers to cease taking their GLP-1 to see if negative effects go away. From there, she’ll ask for an in depth account of her affected person’s food plan to see if sure meals or drinks might need triggered the unhealthy response. Relying on these solutions, she’ll have the affected person attempt a decrease dose of the drug with just a few behavioral modifications, or she’ll swap their treatment.

On the finish of the day, each particular person—and physique—is exclusive, stated Moreno, and weight problems physicians ought to tailor the therapy plan to every affected person’s wants.

“Weight problems therapy is just not a one-size-fits-all method,” he stated.