Tirzepatide vs Semaglutide: Pros and Cons

[Nelson Vergel]

Tirzepatide and semaglutide are both injectable medications used for weight loss and type 2 diabetes management, but they differ in their mechanisms of action and effectiveness. Here's a comparison of the two drugs:

Mechanism of Action​

Tirzepatide:

• Dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist
• Activates both GIP and GLP-1 receptors

Semaglutide:

• Selective GLP-1 receptor agonist
• Activates only GLP-1 receptors

Effectiveness for Weight Loss​

Tirzepatide:

• Associated with greater weight loss compared to semaglutide
• In a study of adults with overweight or obesity:
  • Patients were 1.76 times more likely to achieve ≥5% weight loss
  • 2.54 times more likely to achieve ≥10% weight loss
  • 3.24 times more likely to achieve ≥15% weight loss compared to semaglutide

Semaglutide:

• Effective for weight loss, but generally less so than tirzepatide
• Approved for chronic weight management in adults with obesity or overweight with at least one weight-related condition

Effectiveness for Type 2 Diabetes​

Both medications are effective in treating type 2 diabetes, but tirzepatide has shown superior results:Tirzepatide:

• In a 40-week trial, tirzepatide at doses of 5 mg, 10 mg, or 15 mg was superior to semaglutide 1 mg in reducing glycated hemoglobin levels
• 82-86% of patients reached the target glycated hemoglobin level of <7.0%

Semaglutide:

• Effective in lowering blood sugar levels in adults with type 2 diabetes
• 79% of patients reached the target glycated hemoglobin level of <7.0% in the same trial

Dosage and Administration​

Tirzepatide (Zepbound):

• Weekly subcutaneous injection
• Dosage increased over 4-20 weeks to target doses of 5 mg, 10 mg, or 15 mg

Semaglutide (Wegovy):

• Weekly subcutaneous injection
• Typical dose for weight loss is 2.4 mg

Side Effects​

Both medications have similar side effect profiles, with gastrointestinal issues being the most common:

• Nausea
• Diarrhea
• Vomiting
• Constipation
• Abdominal discomfort

Considerations​

• Tirzepatide is a newer medication, approved by the FDA in November 2023 for chronic weight management
• Semaglutide has been in use longer and has more established safety data
• Both medications should be used in conjunction with diet and exercise for optimal results
• Neither medication is recommended for patients with a history of medullary thyroid cancer or Multiple Endocrine Neoplasia syndrome type 2

In conclusion, while both tirzepatide and semaglutide are effective medications for weight loss and type 2 diabetes management, current evidence suggests that tirzepatide may be more effective in achieving weight loss and glycemic control. However, the choice between the two should be made in consultation with a healthcare provider, considering individual patient factors, medical history, and treatment goals.

Citations:
[1] Semaglutide vs Tirzepatide for Weight Loss in Adults With Overweight or Obesity
[2] FDA Approves New Medication for Chronic Weight Management
[3] Medications Containing Semaglutide
[4] https://www.nejm.org/doi/full/10.1056/NEJMoa2107519
[5] Tirzepatide (Subcutaneous Route) Description and Brand Names - Mayo Clinic
[6] Semaglutide, also known as Ozempic, for weight loss - what you need to know

 

[KevinS]

I just started Tirzepatide today - will let you know how it goes.

 

[mrblonde01]

I just started Tirzepatide today - will let you know how it goes.

What coincidence, me and my wife did too. We started with 1mg each 5 days, this is to lose just a moderate amount of weight. Let's see how it goes!

 

[SteveCleves]

Theres an abundance of information out there on these.

 

[KevinS]

What coincidence, me and my wife did too. We started with 1mg each 5 days, this is to lose just a moderate amount of weight. Let's see how it goes!

Good luck!

I am starting with a 2.5mg dose - the providers normal protocol is to in crease it to 5mg after 4 weeks or when you plateaued for 2 weeks.

A friend is getting good results, she lost 25 pounds in about 3 months and she is at the 5mg dose.

I am looking for ways to make sure I am getting enough protein, and will continue working out in the gym 3-4 days a week.

 

[DixieWrecked]

From my understanding these drugs could have some pretty nasty problms after a while including a black box warning indicating an increased risk of various cancers. The longer a person takes it the greater chance of cancer they have. There are plenty of other problems too. It's basically a synthesized version of venom from the Gila Monster, which is some type of lizard.

The marketing seems to have that 'too good to be true' feel to it. Anybody worried about these concerns or is it just fear mongering?

 

[Guided_by_Voices]

From my understanding these drugs could have some pretty nasty problms after a while including a black box warning indicating an increased risk of various cancers. The longer a person takes it the greater chance of cancer they have. There are plenty of other problems too. It's basically a synthesized version of venom from the Gila Monster, which is some type of lizard.

The marketing seems to have that 'too good to be true' feel to it. Anybody worried about these concerns or is it just fear mongering?

This has puzzled me too since (among other things) these drugs apparently slow down intestinal motility, however I understood slow food passage to be associated with (and likely causative of) colon cancer.

 

[DixieWrecked]

This has puzzled me too since (among other things) these drugs apparently slow down intestinal motility, however I understood slow food passage to be associated with (and likely causative of) colon cancer.

Yeah supposedly it can actually paralyze the digestive system. And once it occurs can be irreversible.

I mean knowing the pharma industry, they have all the payouts from lawsuits already budgeted in.

 

[Wilson7]

Retatrutide will be the next blockbuster when approved. Far less GI sides (lower GLP-1 activity), none at lower doses, and activates the glucagon receptor that enhances fat oxidation. Many of the sides of these drugs are simply bc doctors don't know how to use them and patients expect miracles from an injection with the more is better mentality.

 

[jc2c]

Any thoughts on these meds and sexual side effects? some people report better sex life but I suspect it's due to being fitter. on the other hand, I've read reports that it may be used for addictions including sex addiction so it may reduce libido (in theory).

 

[KevinS]

More than 4 full weeks in, just took the 5th injection. I have lost 12 pounds and dropped my average BP 5 points for the month. Side effects - heartburn, mostly mild, but was nasty after eating fried onion rings. Some mild constipation. Some sudden nausea when eating - all of a sudden, can't eat any more.

Dramatically shut off food noise, some things I was snacking on, and comfort foods I can avoid. Have been able to avoid or responsibly be around Christmas Cookies and Cheese plates. Still at 2.5mg, will up to 5mg when I plateau for a week.
Happy New Years!

 

[Nelson Vergel]

Dramatically shut off food noise, some things I was snacking on, and comfort foods I can avoid. Have been able to avoid or responsibly be around Christmas Cookies and Cheese plates.

Wow! Thanks for the update.

Has your sex drive or porn consumption decreased?

 

[Fernando Almaguer]

Wow! Thanks for the update.

Has your sex drive or porn consumption decreased?

Porn is a tough one to kick. But staying busy and fulfilled. I think relaxing it away when thoughts come up may help.. mindfulness. Interesting to hear folks on trt are on these weight loss drugs. I don't want to risk muscle loss.. hear its a real problem

 

[KevinS]

Wow! Thanks for the update.

Has your sex drive or porn consumption decreased?

Can't say my sex drive is any lower, kind of in a dry spell anyway since I have a lack of regular partners right now. I have noticed a decrease in compulsive type activities - like scrolling porn or social media. seems to give me more 'will power' in general.

 

[KevinS]

Porn is a tough one to kick. But staying busy and fulfilled. I think relaxing it away when thoughts come up may help.. mindfulness. Interesting to hear folks on trt are on these weight loss drugs. I don't want to risk muscle loss.. hear its a real problem

I am trying to make sure I get more protein.

 

[mrblonde01]

I have heard muscle loss isn't much of a problem when you're on TRT. Peptides like CJC1295 and Ipamorelin might help for this as well.

I'm on Tirzepatide 2.5mg for a couple of weeks now, what an amazing compound. I have noticed only mild nausea, not even real nausea, just a feeling of being really full which you feel on the bottom of your neck a little. Also, I've noticed I can still get a little hangry, but not really being aware of being hungry, if that makes any sense.

I went from being 86.6 kilo to 82.3 kilo in just 2 weeks. Took a little break during christmas to fully enjoy the dinners, and I only gained 1 kilo. Back at it right now!