Zepbound® Beats Wegovy® in A Head-To-Head Weight Loss Study

Recent data from Lilly’s SURMOUNT-5 phase 3b study, announced in early December, shows that Zepbound® / tirzepatide, the weight loss version of Mounjaro, outperforms Wegovy® / semaglutide, the weight loss version of Ozempic®, by quite a margin. Patients on Zepbound lost over 20% body weight on average versus just under 14% for Wegovy. While we have anecdotal evidence of this result, a head-to-head study was a long time coming. That said, even now, most patients opt for any available medication because we’ve had significant shortages.

What Does This Mean, and Is the Difference Significant to Our Health and Lives?

First and foremost, the short answer is that the difference between the weight loss provided by the two drugs is relative to the total weight loss desired. Someone looking to lose relatively less weight may choose the drug with the fewest side effects rather than the one with the most weight loss potential. High BMI patients (over 40 or so), on the other hand, may use either drug to lose some weight, but ultimately, bariatric surgery may be the solution.

Second, with shortages as they are (though Zepbound seems to have eased), at least for the near future, some patients may have to take what’s available.

Third, it’s important to remember that most patients do not lose the maximum weight observed during the preliminary clinical studies. Between 30 and 50% of patients might reach the maximum weight loss potential, but most will fall significantly lower. Once again, without a comprehensive approach to weight loss that may include lifestyle changes, diet and exercise, medication, and even surgery, many patients cannot realize their full weight loss potential.

Fourth, it’s essential to remember that while both drugs are founded on the weight loss success of GLP–1 receptor agonist medication, Zepbound also includes a GIP, which may offer greater effectiveness. Because of these differences, they may have varying side effect profiles. What works for one may not work for another, so some patients may need to switch.

Last but certainly not least, it’s essential to understand that these medications are only a tool. What patients do with their newfound weight loss and, consequently, newfound energy and determination make a big difference. We do not want you to assume that you’ll stay on these drugs forever. We don’t know the long-term effects or if we will see a rebound in weight over the long term as the body becomes accustomed to the drug. We do see a significant number of patients regain weight after stopping the drug. So, preparing yourself for a future where you can sustain your weight loss without the use of these drugs is critical.

Lastly, your BMI will go a long way toward determining exactly how effective weight loss drugs can and will be. Most patients with a BMI over 40 will likely not receive enough of a benefit from weight loss drugs alone and may be more suited to bariatric surgery. While the drugs may reduce the symptoms of some of the comorbidities associated with excess weight, most patients at these BMIs will not lose enough weight to drop below the obesity threshold, at least according to their BMI.

The Bottom Line

What does this all mean? Ultimately, we see that both GLP-1 receptor agonist drugs can be excellent tools for patients to make a dent in any excess weight-related issues. However, we want patients to quickly return to basics with a long-term lifestyle change that includes improved diet and exercise. No matter what weight loss modality is chosen or how successful it might be, long-term success requires psychological and physical hard work, which cannot be substituted for any drug or surgery.

If you’re considering weight loss drugs or surgery, we encourage you to visit us and learn more about our programs. With medical and surgical weight loss expertise, we can offer patients a solution that meets them where they are. We look forward to seeing your weight loss journey and the success that you achieve.