The New Weight Loss Injectables

Ask the Experts | Dr. Arshpreet Saraan

The New Weight Loss Injectables 

Weight loss injectables have been making headlines in the papers and across social media for the past couple of years, but how much do we really know about them?

Ozempic, Wegovy, Mounjaro, and Zepbound are the injectables that have recently gained popularity. What’s the difference between them? Are they all the same? Ozempic and Wegovy are different brand names for the same injectable, semaglutide. While Mounjaro and Zepbound are different brand names for the same injectable, tirzepatide. Ozempic and Mounjaro were approved for management of type 2 diabetes while their counterparts Wegovy and Zepbound are approved for weight management for patients with a BMI greater than 30.

These injectables are administered once weekly and work by increasing satiety and slowing the transit of food in your intestines. You will ultimately feel full quicker and stay full for a longer period of time.  While the injectables originally were meant to be used for adults, given the rise in pediatric obesity they can be used for pediatric patients age >12 with a qualifying BMI. Contraindications for these injectables include personal history of pancreatitis or a personal/family history of medullary thyroid cancer or multiple endocrine neoplasia 2A or 2B. The injectables are also contraindicated during pregnancy.

Weight loss injectables do not come without the risk of side effects. The side effect profile includes but is not limited to increased heart rate, nausea, gastroparesis, pancreatitis, acute kidney injury, gallstones, hypoglycemia/low sugar, and possible small bowel obstruction. There has not been enough research done yet to know what possible long-term side effects these injectables may have on the body. Additionally, there is not enough research yet to know how long patients should be on these injectables. The current practice in medicine is to titrate the dose every four weeks to the most effective dose for a patient to lose weight, and once the patient’s goal weight is reached, begin working towards discontinuing the injectable. This is also time for patients to work on diet and exercise lifestyle modifications to help prevent weight gain post discontinuation of the injectable.

As these injectables continue to gain popularity, insurance approval has been increasingly difficult for obesity. Obtaining the actual medication has also been increasingly difficult given many of them are on national backorder. Despite these obstacles, the injectables continue to rise in popularity and we continue to learn more about them as a community. They are making a huge impact on the way we can tackle the disease of obesity and the Type 2 Diabetes it can cause.

 


Dr. Arshpreet Saraan practices Family Medicine at Corewell Health East-Grosse Pointe. Her interests include Community Medicine, Psychiatry, Behavioral Medicine, and Social Disparities in Healthcare. For more information, please visit: www.corewellhealth.org.