I recently conducted a very informal survey with our staff here at IsraelPharm and asked them a simple question: what healthcare subject are our customers most interested in? 8 out of 10 responded quickly and unequivocally: losing weight, and the medications that can help.
What was once a peripheral sideshow of healthcare has become one of the main attractions in modern medicine. The big stars of this show are Ozempic and Mounjaro, drugs originally designed as treatments for type 2 diabetes but that quite fortuitously turned out to be something quite revolutionary.
Questions about these weight-loss medications and similar products are hot topics on social media platforms like TikTok, Facebook, Twitter, and Instagram. However, in many cases, they present contrary opinions – mainly due to a fundamental lack of understanding about what were diabetes medications and their intended use for weight loss.
So, to help clear the dust, I assembled a short “cheat sheet” summarizing the most essential points about this new and exciting therapy area for your reference. Having an objective and balanced picture based on scientific evidence is so important. The following paragraphs will deal with a few of the most interesting facts about how the weight-loss medication revolution came about and then answer some of the most common questions that most informal networks tend to get wrong.
What kind of drugs are Ozempic and Mounjaro?
Ozempic is marketed by the Danish company Novo Nordisk and is approved by the FDA for the diabetes care (specifically type 2 diabetes – T2D). Its active ingredient is a glucagon-like peptide-1 (GLP-1) receptor agonist with the generic name semaglutide.
Mounjaro is marketed by US company Eli Lilly & Company and is currently approved by the FDA for the treatment of T2D. Its active ingredients combine glucagon-like peptide-1 (GLP-1) receptor agonists and a glucose-dependent insulinotropic polypeptide (GIP). This compound has the generic name tirzepatide.
Tirzepatide was approved by the FDA in November 2023 for weight-loss in people diagnosed as overweight (BMI between 27.0 and 29.9 who have some other health problems such as high blood pressure or diabetes) or are obese (BMI 30.0 or higher). The drug will be marketed under the brand name Zepbound in early 2024.
Interesting facts: Based largely on the success of these two drugs, the companies have outperformed market expectations. The market capitalization of Novo Nordisk now exceeds the GDP of Denmark! According to the Wall Street Journal, Eli Lilly & Company is now “the most valuable standalone pharmaceutical company in the U.S. with a market value of more than $300 billion.”
How do GIP/GLP-1 receptor agonists work?
One of the main effects of GIP/GLP-1RAs is to suppress glucagon secretion. The molecule activates the secretion of GIP and GLP-1 receptors in the lining of the intestines when glucose or nutrients are eaten. These stimulate the secretion of insulin from pancreatic beta cells. They also regulate food intake control centers in the brain, which slows gastric emptying, reduces food intake via appetite reduction, and promotes beta cell proliferation.
In patients with living with type 2 diabetes, GIP/GLP-1 concentrations are lower than normal after oral glucose-load intake, which can mean that glucagon goes into overdrive. GIP/GLP-1 receptor agonists (a receptor agonist blocks the point on a cell’s surface that is programmed to take up a specific molecule) can restore insulin secretory functions, thereby contributing to managing diabetes through improvements in glycemic control for diabetic patients
The shared ingredients in semaglutide and tirzepatide (GIP/GLP-1RAs) are man-made versions of the native human GIP and GLP-1. As a bonus, synthetic GLP-1 is resistant to degradation by the body’s natural enzymes, so it remains active for longer.
Are Mounjaro and Ozempic prescribed weight-loss medications?
Currently, Ozempic has only been approved by the FDA as treatments for type 2 diabetes. Even there, they are regarded as suitable only when the simpler drugs, such as insulin itself or Metformin, together with exercise and diet, are not controlling blood sugar levels.
The FDA now registered Mounjaro as a weight-loss drug to be marketed under the name Zepbound. It’s hoped that it will reach our shelves early in 2024.
Novo Nordisk has taken another route and created a different format of semaglutide, which is marketed as Wegovy. Wegovy is an FDA-approved weight-loss drug and can be prescribed for patients who satisfy the definition of obese or overweight with at least one relevant weight-related medical condition such as diabetes or heart disease. It has the same generic formula as semaglutide, but the strength of the dose goes higher – up to 2.4 mg per dose, whereas for Ozempic, the maximum dose is 1 mg.
Is there a definite amount of weight you can lose each week using Mounjaro or Ozempic weight-loss drugs?
It depends on a lot of different factors. Results will differ from person to person based on their weight, medical history, and lifestyle. Requirements for optimizing weight loss with Mounjaro and Ozempic include adherence to healthy eating and regular exercise – so weekly weight loss will vary from person to person.
Do I have to use weight-loss medications long-term?
The answer to this question is not yet known for certain. Studies on weight-loss trials for both Mounjaro and Wegovy did show that coming to the end of the trials when subjects no longer received the weight-loss medication, there was a pattern of weight being regained, but not to the extent that the whole benefit was lost. It’s impossible to derive a complete answer to this question because external factors also play a part. For example, if people stayed on a controlled diet and exercised, they tended to keep off most of the lost weight. At the opposite end of the scale, some people failed to lose much weight even while on weight-loss medication, largely because they kept eating the wrong foods in the wrong quantities and failed to exercise.
Researchers are currently studying how well Mounjaro helps maintain weight in an ongoing clinical trial that looks beyond two years and whether weight loss is maintained after the drug is stopped. Doctors will be able to decide whether Mounjaro should be used long-term with the results of this trial.
Can I afford Ozempic or Mounjaro weight-loss medications?
The costs of Ozempic and Mounjaro are based on individual factors, mostly from a patient’s prescribed treatment regimen, their insurance plan, the pharmacy use as the supplier, and their State of residence.
Until Mounjaro becomes an FDA-approved weight-loss medication, it has to be prescribed off-label. The same thing goes for Ozempic for weight loss. Although the alternative already available (Wegovy) is FDA-approved for weight loss, most health insurance plans still do not cover it.
Comparing off-label prices from US retail pharmacies with IsraelPharm has made purchasing Ozempic from us a popular choice. It’s sold at US retail pharmacies for between $1050 (Ozempic) and $1400 (Wegovy) per 4-shot pen (with no health insurance payback). By contrast, at IsraelPharm, we supply Ozempic at a far lower price – $550 for the four-week dose. Our lower pricing is thanks to the capping of pharmaceutical prices in our government-mandated universal health care system.
How to get Mounjaro for weight loss from IsraelPharm.
It is important to be very careful when sourcing Mounjaro through internet platforms, especially those that do not insist on providing a valid prescription. Getting your doctor’s consent via prescription for Mounjaro is essential. There has been an outbreak of bogus pharmacies all over the world that offer to sell Ozempic, Wegovy, and Mounjaro, often at much cheaper prices than they can be obtained from either at retail US pharmacies or from reputable online pharmacies.
During the COVID-19 pandemic, supply chains of many medications were disrupted, and unscrupulous businesses jumped in to fill the gaps, often providing fake medications, or at the least non-standard and highly suspect formulations that had not been approved either by the FDA or by the regulatory authorities in their own countries.
A better way to obtain Mounjaro from a compounding pharmacy is by using our reputable and supervised service. Here at IsraelPharm, we only ship drugs if a valid prescription was provided – the license of our pharmacist depends on compliance with this law.
We are also here to provide the guidance and support you need to get the best results.
How are Mounjaro and Ozempic administered?
When prescribed off-label for weight loss, it’s necessary to follow the dosage and instructions given by the prescribing doctor. In most typical cases, the weekly dosages start low and are adjusted gradually until they reach the right amount that yields the desired result. The usual starting dosage is 2.5 milligrams once weekly for the first pen, lasting four weeks. After that, the doctor normally will increase the dose by 2.5 mg for each pen until the maximum dosage of 15 mg is determined as the long-term dose of Mounjaro.
Mounjaro and Ozempic are approved by the FDA for other uses. The leaflet and online dosage information may differ from the prescribing doctor’s decision, and in all cases, the doctor’s recommendation takes precedence over any other dosage notes.
Both drugs come in a four-dose pen for self-administered subcutaneous injection. It is generally advised to inject under the skin of the abdomen or thigh. It’s also advisable to rotate each subsequent week’s dose onto a different portion of the body, ensuring not to inject twice in consecutive weeks at the same spot. If under the care of another person, they should give the injection under the skin of your upper arm, switching between arms each week.
The drugs can be injected at any time of day. It’s advisable to try to inject it on the same day each week so that doses are not missed or duplicated.
Who qualifies for a prescription of Mounjaro or Ozempic off-label for weight-loss medications?
Diabetes medications will usually only be prescribed off-label as weight-loss medications for adults who have not yet gone on to develop type 2 diabetes, but with the following conditions:
- Body mass index (BMI) of 30 or higher
- BMI higher than 27 but lower than 30 when at least one health condition related to weight, such as high cholesterol, high blood pressure, or sleep apnea.
The prescribing doctor decides whether using Mounjaro or Ozempic off-label for weight loss is safe and that the benefits from a reduction of associated health problems such as heart disease, stroke, or kidney disease outweigh any risk factors. Along with these medications, patients must undertake careful diets and regular physical activity.
The FDA approves Wegovy as a weight-loss medication, and it can even be prescribed for teenagers aged 12 and older who are dealing with obesity.
How do Mounjaro, Wegovy, and Ozempic work as weight-loss medications?
Wegovy and Ozempic contain a glucagon-like peptide-1 (GLP-1) receptor agonist. Mounjaro also contains a GLP-1 receptor agonist and a glucose-dependent insulinotropic polypeptide (GIP).
Mounjaro works by mimicking the activity of the hormones GIP and GLP-1, while Wegovy and Ozempic only affect GLP-1. These regulate blood glucose levels, slow food movement through the stomach, and reduce appetite. Both can help reduce caloric intake and may result in weight loss. As a side benefit, in people who have lot substantial weight, this can prevent type 2 diabetes from developing later on.
How well do weight-loss medications work?
Mounjaro, Ozempic, and Wegovy have all been found to be very effective for weight loss. There has yet to be any specific trial that compares the three, and because Ozempic and Moujaro are still only registered for the treatment of T2D, the information about how they promote weight loss comes mainly from trials on that patient group, not from the general population. So far, the clinical trials for treating type 2 diabetes have produced statistics on the drug’s effect on body weight. Many people with T2D who used the drugs did lose weight.
So far, the only clinical trial that looked at the use of Mounjaro for weight loss in people without diabetes has published preliminary results. SURMOUNT-2 trial included adults who met the specification for off-label prescription with either obesity with a BMI of 30 or greater or overweight with a BMI above 27 and at least one health condition related to obesity. Two streams received either 10 mg or 15 mg of tirzepatide. They were compared with a similar group receiving a placebo medication. The preliminary results published in June 2023 showed that those on 10 mg lost 13.4%of starting body weight (30 pounds or 13.5 kilos), and those on 15 mg lost 15.7% of starting body weight (34 pounds or 15.5 kilos). This compared to 3.3% of body weight (7 pounds or 3.2 kilos) on placebo
What are the common side effects of Mounjaro and Ozempic?
This is one of the most contentious issues in the whole subject of weight-loss medications. It’s important to remember that all drugs (without exception) produce some adverse effects. So, perhaps a better question is whether the expected side effects are more or less serious than the consequences of not treating the condition for which they are being prescribed.
Ultimately, the answer needs to be discussed between you and your trusted healthcare provider. Your doctor should know more about you than strangers on the internet, so no matter what you have heard or read, this kind of conversation should be held face-to-face with your provider.
One subject that comes up in most discussions about serious side effects is the elevated risk of thyroid cancer in Mounjaro. It carries a boxed warning for this side effect, which is the most serious warning from the FDA. Animal trials have shown an increased risk of thyroid cancer from using tirzepatide. Due to this risk, doctors usually hesitate to prescribe Mounjaro for anyone with a personal or family history of a type of thyroid cancer known as medullary thyroid carcinoma (MTC) or with a rare genetic condition called multiple endocrine neoplasia syndrome type 2 (MEN2) that may lead to thyroid cancer. It’s worth repeating that so far the threat has only shown up in animal trials, and there’s no evidence that the drug represents the same risk for humans.
How long does it take for weight-loss medications to start working?
A study conducted by Novo Nordisk of Ozempic vs. a placebo showed that within twelve weeks of the start, people on Ozempic on average, had lost around 8% of their starting body weight (against losses of roughly 2% for those on placebo). The losses continued in a more-or-less straight line for the Ozempic group, reaching 12% at week 28 and 17% at the end of the trial (week 68). By comparison, the placebo group showed very little further weight loss.
The Eli Lilly direct trial results for weight loss are still under wraps but appear to be showing even greater losses than Ozempic was producing.