What’s the Skinny on Weight Loss Shots??

by Amanda Spencer, Nurse Practitioner

As always, this is not medical advice. Please consult with your medical team.

You’ve heard about them. Your friend, your mom, their neighbor, and their dog are all on these once weekly shots for weight loss. Even the Kardashians talk about them…so they must be golden, right? Maybe! Let’s take a deeper dive today into understanding these new weight loss medications.

Ozempic/Wegovy (semaglutide) – This is one of the more popular shots on the market. Ozempic is the version for diabetes, and Wegovy is the version for weight loss. They are the exact same drug, but just a tiny dose difference for weight loss. These work in a variety of ways. They slow how fast food moves through your GI tract (gut), they make your body use it’s own insulin more efficiently, they curb hunger, and they can help people lose a lot of weight. The most common side effects include nausea and constipation. People with a history of thyroid cancer, pancreatitis, or multiple endocrine neoplasia type 2 (MENS2) should NOT take these medications.

  • Pros – once a week shot vs daily dosing, generally tolerated with mild side effects that get better over time, reduce cardiovascular risk in patients with diabetes
  • Cons – EXPENSIVE, cash pay price is $900-1300 per month; while they do have discount coupons for commercially insured patients, those must be used in a local retail pharmacy, which have all been out of stock of Wegovy for months; Ozempic has a copay card for $25 per prescription for commercially insured patients (if your insurance approves it and IF you have diabetes)

Mounjaro (tirzepatide) – This medicine works in the same way as semaglutide but has further impact on insulin/glucose effects. It is also a once weekly injection with similar side effect profile to semaglutide. It currently is only FDA approved for diabetes, but should be getting an approval for weight loss any day now (possibly has been approved between the writing of this article and it’s publication…check it out!). Risk profile is similar, so do not take this if you have a history of pancreatitis, thyroid cancer, or MENS2

  • Pros – same as semaglutide but may work better for some individuals, particularly those with diabetes
  • Cons – EXPENSIVE, cash pay price is over $1000 per month; Mounjaro has a $25 copay card for commercially insured patients whose insurance approves the medicine (for diabetes only right now) but supply at the pharmacies can also be short, making it difficult to use

Compounded semaglutide/tirzepatide – This is becoming a more and more popular option for people to be able to get these medications at a reduced cost, although generally still costs $60-100+ per shot depending on dose and what your healthcare provider charges. There are some weight loss clinics using an oral form of semaglutide (similar to Rybelsus) that is also compounded. It can be a little cheaper than the shots, but most places still charge hundreds of dollars a month for the medication.

Overall, these medications are very effective at helping people lose weight, particularly if you have diabetes, prediabetes, or insulin resistance. While no medication is 100% safe, the side effect profile is relatively low compared to other medications. Just like with any medication, not everyone responds the same. What works best for one person may not work for another, so be sure to discuss your options with your trusted healthcare provider. The old way of treating obesity (willpower) DOES. NOT. WORK. and it is past time for us to start treating obesity as the complicated chronic disease that it is.

Amanda Spencer is a nurse practitioner practicing outpatient cardiology in Oklahoma City. She is passionate about integrative healthcare and helping patients feel their best. She has been a nurse since 2009 and a nurse practitioner since 2015. She is married with 2 children, a cat, a bearded dragon, and enjoys spending time with her family and traveling on vacation.

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