Semaglutide Vs. Zepbound: Weight Loss Differences, Side Effects & Dosage

The CDC reported that 19.7% of children and adults are obese. Obese patients are at more risk of coming with complications such as hypertension, type two diabetes, raised serum cholesterol levels, stroke, and some types of cancer.

AOMs known as anti-obesity medications, can be recommended as an additional therapy for a patient who does not achieve the goal of losing weight with a comprehensive weight loss program, such as losing 5% of the initial weight during 3-6 months. In the United States, about thirty-five million people, or 53.5% of persons are eligible for weight loss medication.

AOM is approved to make weight loss easier if taken along with a low-calorie diet and physical exercise in patients with a BMI ranges from 30 kg/m2 and above and those with a BMI of 25 kg/m2 and above (overweight).

Among these drugs, Semaglutide and Zepbound are the most famous for weight management.

What is Semaglutide?

Semaglutide which has a FDA approval is the GLP-1 receptor agonist, another anti-obesity medication currently available for long-term use for weight loss.

Semaglutide among Type 2 diabetes patients had the target dose of 1.0 mg granted permission by FDA in 2017 and EMA in 2018. Oral Semaglutide for Type 2 diabetes was approved by the FDA in 2019 with an up to 14mg dose. Specifically for weight loss, the preferential dosage is 2.4 mcg/week that has to be injected subcutaneously.

What is Zepbound?

Zepbound is a weight loss supplement that contains tirzepatide, a medicine to imitates hormones that control hunger and the reactions of insulin. Although initially intended for type 2 diabetes, tirzepatide trials have evidenced considerable weight loss impact because the drug triggers both GLP-1 and GIP receptors that reduce hunger and control blood sugar.

Tirzepatide (Zepbound) was another drug assessed in a study conducted in New England Journal of Medicine for weight loss in individuals with obesity. The tirzepatide participants who received the drug once a week shed 15-20 percent of their body weight on average over 72 weeks, compared to the placebo group. This weight reduction was obtained with hormones that decrease appetite and stimulate insulin sensitivity, making tirzepatide the best in obesity treatment.

Key Differences Between Semaglutide and Zepbound

While Semaglutide and Zepbound are both used for weight loss and metabolic health, they have distinct differences in their mechanisms, dosing, patient populations, and accessibility.

1. Mechanism of Action

Semaglutide is in the class of GLP-1 receptor agonist and is a peak analog of human native GLP-1. First of all, GLP-1 affects human hunger, appetite, and energy intake reducing even the energy quantity. Stimulation of GLP1 receptors in the human brain is involved in appetite and the reward center of food.

Zepbound, on the other hand, acts as both a GLP-1 and a GIP receptor agonist. These receptors are crucial for controlling blood sugar and hunger. Zepbound increases insulin release from the pancreas, reduces glucagon, improves blood sugar control, slows down stomach emptying, and helps with feeling full (satiety).

2. Dosing and Duration

When starting Zepbound or Semaglutide, your dosage is slowly raised at 4-week intervals to help manage side effects and find the right dose. However, each medication’s dosage schedule looks a bit different. For example, it may take longer to reach your target Semaglutide dose compared with Zepbound.

For Semaglutide the initial dose is 0.25 mg weekly for the initial month or four weeks of therapy. In the next step, the dosing frequency is stepped up to 0.5, then to 1 then to 1.7 mg every four weeks. If this is tolerated then the dose is stepped up to 2.4 mg weekly, which is the maintenance (and maximum) dose.

For Zepbound, the once-weekly starting dosage is 2.5 mg for 4 weeks. After that, the dosage is increased to 5 mg once weekly. Some people may continue the 5 mg dose long term. If needed, the dosage may be increased at 4-week intervals to 10 mg or 15 mg weekly.

3. Cost and Accessibility

With a manufacturer copay card, you could pay as little as $25 for Zepbound if you have a commercial insurance plan that covers the medication. However, if this is not covered under your plan, Zepbound can be bought for $650 for a 30 day supply.

Wegovy formerly known as Semaglutide has a list price of $1,349.02/package You can get a 28-day supply for up to 13 fills at $0 with the Savings Offer if your insurance is accepted or $650 for an uncapped 28-day supply if you’re uninsured or paying cash for the prescription.

Efficacy Comparison: Which is More Effective?

The literature review has confirmed that both Semaglutide and Zepbound are well-suited to be used as weight reducing agents.

Semaglutide group patients taking the maintenance dose of 2.4 mg achieved weight loss of 14.99% of initial body weight over the 68-week clinical trial.

According to the open data of the patients, over half of those in the Semaglutide group shed 15% or more of their body weight.

In a 72-week clinical trial, those patients who took the highest dose of Zepbound (15 mg) had, on average, a weight reduction of 20.99%.

Cardiac Health Benefits

Both Zepbound and Semaglutide have been authorized for chronic weight management.

However, in March 2024, Semaglutide has also been demonstrated to reduce the cardiovascular death opportunity, non-fatal myocardial infarction, or nonfatal stroke risk in diabetic mellitus type II patients who are at high cardiovascular risk by 20 percent.

Side Effects

Semaglutide carries adverse possible risks including;

• Hypoglycemia
• Increased heart rate
• Potential pancreatitis
• Gallbladder issues
• Acute kidney injury
• Risk of thyroid tumors

It is recommended that patients be monitored for these risks, especially those with a history of thyroid disease.

While Zepbound adverse side effects are:

• Risk of Thyroid Tumors
• Gastrointestinal Disease
• Gallbladder Disease
• Acute Pancreatitis
• Hypersensitivity Reactions
• Hypoglycemia

Considerations for Choosing Between Semaglutide and Zepbound

1. Lifestyle and Health Goals: For individuals aiming for blood sugar control along with weight loss, Semaglutide’s action on insulin regulation and appetite suppression makes it highly effective. Zepbound may be better suited for those focused solely on weight loss without a diabetes diagnosis.
2. Medical History: A patient’s medical history, such as thyroid or cardiovascular issues, can guide the choice between Semaglutide and Zepbound. Semaglutide is beneficial for patients at risk of cardiovascular events, while Zepbound may be preferable for those avoiding thyroid-related risks.
3. Cost and Accessibility: Cost can also play a crucial role, especially if insurance does not cover one of the drugs. Semaglutide’s wider insurance coverage for diabetes may offer an economic advantage over Zepbound, which is newer and may not be as readily covered for weight loss alone.

Conclusion

Both Semaglutide and Zepbound offer unique benefits in managing obesity and weight-related health issues, with individual patient factors often guiding the choice between them. Semaglutide is highly effective for individuals needing both blood sugar control and weight management, with the added benefit of cardiovascular protection. Zepbound, while newer, shows promise as a targeted weight-loss solution with potentially fewer gastrointestinal side effects, making it an option for those focused on weight loss alone. Ultimately, consulting a healthcare provider is essential to determine the best choice based on individual health conditions, goals, and access.