Over the past year, the injectable diabetes medication
Ozempic steamrolled through TikTok, talk shows and tabloids as people raved
about using it off-label to lose weight. Then the hype intensified in the fall
around Wegovy, a similar medication approved for weight management.
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Another diabetes drug, called Mounjaro, is now gaining
attention, with many people using it off-label to lose weight. Some research
has found that Mounjaro may be even more powerful than either Ozempic or
Wegovy. One major study comparing these drugs found that taking tirzepatide,
the active ingredient in Mounjaro, led to sharper reductions in blood sugar
levels and greater weight loss than the other drugs.
However, that study compared different doses of semaglutide
and tirzepatide, making it tricky to determine how these medications stack up
head-to-head, said Dr. Dean Schillinger, a professor of medicine and a diabetes
expert at the University of California, San Francisco. It was also sponsored by
Eli Lilly, the company that manufactures Mounjaro.
Mounjaro is approved by the US Food and Drug Administration
to treat only Type 2 diabetes. “Mounjaro is not a weight loss drug,” the
official website for the medication reads, under larger, bold purple letters
proclaiming that people taking it have lost up to 25 pounds. But there is some
speculation that the US FDA could authorize the medication for weight
management soon; Eli Lilly announced in October that the US FDA had
fast-tracked its process of examining and approving tirzepatide for adults who
are obese or overweight.
“The FDA generally cannot confirm, deny or comment on a
pending/potential product application,” a representative of the agency wrote in
an email.
Demand is mounting: After a two-month shortage, Mounjaro is
largely back in stock, although many diabetes patients are struggling to access
it, said Dr. Andrew Kraftson, a clinical associate professor in the division of
metabolism, endocrinology and diabetes at Michigan Medicine. Kraftson
frequently urges patients looking for Mounjaro to try calling different
pharmacies, he said, adding that he has had to adjust some doses to stretch out
the medication.
“It’s definitely frustrating for patients and also
burdensome for physicians,” he said. And as more people turn to the medication
for weight management, Mounjaro could potentially surpass Ozempic in media
attention and sales.
“I don’t think blockbuster would be underselling it,”
Kraftson said.
How does Mounjaro work?Tirzepatide mimics two hormones naturally produced in the
body: glucagon-like peptide-1, or GLP-1, and glucose-dependent insulinotropic
polypeptide.
Ozempic and Wegovy simulate only GLP-1, whereas tirzepatide
imitates both hormones. Researchers believe tirzepatide may be so effective at
lowering blood sugar levels and inducing weight loss because the two hormones
it imitates work in a synergistic way.
Like semaglutide, tirzepatide slows the emptying of the
stomach, making people feel full for longer, said Dr. Janice Jin Hwang, the
division chief of endocrinology and metabolism at the University of North
Carolina School of Medicine. Tirzepatide also inhibits the brain’s hunger
signals, suppressing appetite.
Research presented at an American Diabetes Association
conference this past last summer showed that study participants, who did not
have diabetes, taking tirzepatide lost up to 22.5 percent of their body weight
after 72 weeks — a dramatic reduction that’s nearly as effective as weight loss
surgery, said Dr. Robert Gabbay, the chief scientific and medical officer of
the association.
But it’s not yet clear what the long-term effects of taking
Mounjaro might be — a pressing issue, given that people need to keep taking the
drug for continued results, said Akshaya Srikanth Bhagavathula, a postdoctoral
fellow at the University of Arkansas who has studied tirzepatide.
Is it safe to take Mounjaro for weight loss?Taking Mounjaro may lead to more severe side effects than
Ozempic and Wegovy, as well as more significant weight loss, Bhagavathula said.
People using the medication commonly experience nausea, vomiting, diarrhea and
stomach pain; in rare cases, taking the drug can lead to renal failure,
pancreatitis, hypoglycemia and gastrointestinal bleeding, he added.
There isn’t robust research examining how tirzepatide might
affect people who do not have diabetes or obesity. “We just don’t have enough
information to inform the individual on what gamble they’re making,”
Schillinger said.
Those who do take the medication need to be under close
medical supervision, Kraftson said, partly because there is a risk that extreme
lack of appetite could lead to malnourishment and disordered eating. “We do not
want to make people anorexic,” he said. “The goal is not to get rid of all
hunger.”
In a statement, a representative from Eli Lilly said that
“Mounjaro is only approved for the treatment of Type 2 diabetes as an adjunct
with diet and exercise,” adding, “Lilly does not promote or encourage the
off-label use of any of our medicines.”
But experts warned that the more drugs like Mounjaro and
Ozempic continue to gain popularity for their weight loss effects, the more
patients with diabetes may be left scrambling.
“We’re going to probably watch this movie again,” Gabbay
said.
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