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Over the last few years, we have seen great progress in medications approved for weight loss. The most recent addition to this class of medications is Zepbound™, a once-weekly injectable medication manufactured by Eli Lilly for the treatment of obesity. This is the most recent approval of a weight loss medication since Wegovy®, which became available for weight loss in June of 2021. In clinical studies, patients using Wegovy for weight loss experienced an average of 15.8% reduction in their body weight. Zepbound clinical trials show patients losing even more. On average patients with obesity experienced a remarkable 26.6% loss in body weight over 82 weeks, results that rival those from bariatric surgery.
Zepbound contains the active ingredient tirzepatide, which is the same active ingredient as Mounjaro®, a medication approved by the FDA to treat type 2 diabetes and prescribed off-label for weight loss. Here’s what you need to know about this promising new weight loss medication.
What is Zepbound?
Tirzepatide is the active ingredient found in both Mounjaro and the recently approved Zepbound. Zepbound is approved for weight loss in adults with obesity (BMI 30+) or overweight (BMI 27+) who also have weight-related medical problems. Zepbound should be used in conjunction with a healthy diet and exercise to promote weight loss and has demonstrated the highest average weight loss seen with a medication to date. In clinical trials, patients with obesity lost at least 5% of their body weight after 3 months with a combination of tirzepatide and intensive lifestyle changes. When these individuals took tirzepatide for up to a year and a half, they lost an average of 26.6% of their body weight. This is compared to a 15.8% reduction in weight seen with semaglutide, branded as Wegovy (a GLP-1 receptor agonist used to treat obesity), over 68 weeks. The amount of weight loss with Zepbound is comparable to that achieved with bariatric surgery, which results in a 30% weight loss within the first year, and 25% in the long term.
Zepbound should not be used along with other GLP-1 receptor agonists. If you have a history of pancreatitis, the safety of using Zepbound is unknown. Similar to other GLP-1 medications, Zepbound should not be used if you are pregnant or have a personal or family history of medullary thyroid cancer. Safety and effectiveness of Zepbound for weight loss have not been established in patients less than 18 years of age and therefore use is not recommended.
How does Zepbound Work for Weight Loss?
Zepbound (tirzepatide) is in a class of its own when it comes to obesity medications. Tirzepatide is a single molecule that has the ability to mimic two naturally occurring hormones in the body that help to lower blood sugar: Glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1). The weight loss effect of Zepbound has to do with the dual action of the drug on both the GIP and GLP-1 receptors found in the appetite center of the brain which reduces cravings and food intake. GLP-1 also slows down stomach emptying, so you feel fuller sooner and longer, while GIP acts on our fat stores in a variety of ways to improve function and insulin sensitivity; all of which promote weight loss. Another notable effect of Zepbound for weight loss found in clinical trials were improvements in weight related conditions such as changes in cholesterol and reductions in blood pressure noted in those with weight loss. However it is important to note that Zepbound is not approved to treat such conditions on its own.
Zepbound Pricing and Availability
It is expected that Zepbound will be available in the US by the end of 2023 in six doses (2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg). Its list price of $1059.87 is 20% less than that of Wegovy ($1303.26), however this does not reflect the out of pocket cost for those accessing the medication through insurance coverage or discounts. Eli Lilly is currently working on a savings card program for patients with commercial insurance that includes coverage for Zepbound to make it more accessible to those who need it.
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What Are the Side Effects of Zepbound?
While there are many beneficial effects of Zepbound, like with any medication, there are potential side effects that need to be taken into consideration. Similar to GLP-1 receptor agonists like Wegovy, the most common side effects of tirzepatide are gastrointestinal symptoms such as nausea, vomiting, diarrhea, constipation, heartburn, and abdominal pain. Headaches, dizziness, and an increase in heart rate can occur as well, though less commonly. Gallbladder disease is another potential side effect, and other rare side effects have also been described. Tolerability of tirzepatide can be improved by starting the medication at a low dose and gradually increasing it. Clinical studies investigating the use of tirzepatide for weight loss employed a monthly dose escalation strategy which is recommended to help to reduce the potential for intolerable side effects.
What are Alternatives to Zepbound?
While Zepbound has shown exciting new weight loss results, there are other FDA-approved medications that are available to help you with weight loss. Saxenda® and Wegovy are both GLP-1 receptor agonists approved by the FDA for weight management that have benefits for both weight loss and improving blood sugar. ContraveⓇ can also be an effective option, especially for patients struggling with cravings. Working with a program like FORM will connect you with healthcare professionals that can help you determine which medication is best for you based on your health history, goals, medication availability, and insurance coverage. The FORM Weight Loss Medication page provides more information on these options.
How FORM Can Help While Taking Zepbound
While medications like Zepbound are a great tool in weight loss, studies show that patients experience greater weight loss success when medication is combined with lifestyle changes, rather than using medication alone. At FORM, patients work 1:1 with a Board Certified weight loss Doctor and a Registered Dietitian who help create a personalized plan just for you. Your plan will address nutrition, physical activity, and mindset shifts and may include a prescription for FDA-approved medication, if appropriate, to help you reach your weight loss and health goals.
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Zepbound™ and Mounjaro® and their delivery device bases are registered trademarks owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates.
WegovyⓇ and SaxendaⓇ are registered trademarks of Novo Nordisk A/S
Contrave® is a registered trademark of Currax Pharmaceutical LLC
