Real World Study Compares Weight Loss with Semaglutide vs Tirzepatide

While tirzepatide (Mounjaro) was significantly more effective than semaglutide (Ozempic), patients on both medications experienced substantial weight loss and we observed no difference in the risk of GI adverse events. Interview with:
Tricia Rodriguez, PhD, MPH

Nick Stucky, MD, PhD
Three of the authors of the JAMA Internal Medicine study  What is the background for this study? What are the main findings?

Response: With over 70% of US adults having overweight or obesity, GLP-1s have the potential to be used by a huge number of people. We’ve seen dramatic increases in use by patients with and without type 2 diabetes in the past year, yet little real-world data exist to compare the effectiveness of two of the most common medications, semaglutide (Ozempic) and tirzepatide (Mounjaro). Head-to-head trials for patients with overweight or obesity are still months away, and even then, it remains unclear how weight loss observed in these randomized controlled trials will generalize to real-world populations. There has been evidence that these medications are effective for weight loss, but it hadn’t been clear just how effective they are, particularly in relation to each other.

While clinical trials don’t always generalize to the real-world, our findings were broadly consistent with placebo-controlled clinical trials, finding that the majority of patients on both medications experience clinically meaningful weight loss within a year on treatment. However, patients on tirzepatide (Mounjaro) were over 2 times more likely to experience 10% weight loss and 3 times more likely to experience 15% weight loss within a year, compared to patients on semaglutide (Ozempic).  Our study also found that, in general, patients without type 2 diabetes experienced greater weight loss than patients with type 2 diabetes, but tirzepatide (Mounjaro) was more effective than semaglutide (Ozempic) in both groups.

The study also found a high rate of discontinuation – 55.9% of patients on tirzepatide (Mounjaro), and 52.5% of patients on semaglutide (Ozempic) within 12 months.

Gastrointestinal side effects of these medications have been widely reported as well, but we didn’t find a difference in the rates of moderate to severe gastrointestinal adverse events between the two medications.

— Tricia Rodriguez, PhD, MPH principal applied scientist, Truveta Research, and lead author on the paper

Daily Heat Treatments May Reduce Risk of Obesity in Menopausal Women

Daily 30-minute heat treatment is safe and reduces aging-mediated tissue damage. It is a promising and effective therapeutic strategy to boost metabolism and reduce the risk of obesity and metabolic dysfunction. Interview with:
Rong Fan, MS (she/her/hers)
PhD Candidate
University of Massachusetts Amherst
Amherst, Massachusetts  What is the background for this study? 

Response: As we age, our metabolism and energy expenditure decline.

Studies have shown that in women, age-related metabolic changes begin around ages 45-50 with a sharp increase, overlapping with the menopause period. This mid-life aging window is crucial and highlights the need for effective and accessible intervention strategies.

Daily whole-body heat treatment (104-113°F) for 30 minutes is a promising strategy to partially mimic the metabolic benefits and physiological response of aerobic exercise.

Increased BMI in Teens Whose Parents were Obese in Adolescence

Knowing that offsprings of parents with obesity are at a greater risk than other children for being overweight at adolescence, the question remains what are the epigenetic factors that affect obesity. Interview with:
Gilad Twig, MD, MPH,  PhD
Head of the Population Health Research Center
Sheba Medical Center, Ramat Gan, Israel.
Associate Professor, Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine
Tel-Aviv University, Tel-Aviv, Israel  What is the background for this study? 


Response: Heritability of obesity has been widely investigated, but when parental and children’s body weights are compared it is difficult to distinguish between genetic relationship and shared lifestyle. In this study we compared parents and their children’s body weights all measured at age 17.

Two Faulty Copies of SMIM1 Gene Associated with Obesity

The vast majority of people who are struggling with their weight will not have two faulty copies of the gene and their GP should be their first port of call. Interview with:
Dr. Mattia Frontini, Sr BHF Fellow
Associate Professor Cellular Biology
Department of Clinical and Biomedical Sciences
University of Exeter Medical School
Faculty of Health and Life Sciences

Dr. Mattia Frontini, Sr BHF Fellow
Associate Professor Cellular Biology
Department of Clinical and Biomedical Sciences
University of Exeter Medical School
Faculty of Health and Life Sciences

RILD Building, Barrack Road, Exeter,  What is the background for this study? What are the main findings?

Response:   The initial discovery of the gene and its faulty copy, ten years ago, was motivated by the need to develop a genetic test for a difficult to type, using traditional methods, blood group known as Vel. After this discovery was made, we discovered also that the differences in these genes that exist in the population are associated to tiny changes in the blood red cell parameters.

When the UK Biobank data became available we analysed these to determine if having the faulty copy of the gene had an effect on health. We found that people with two faulty copies of the gene (about 1 in 5000) are heavier than those who don’t. They have altered lipids in their blood and they use less energy given the same caloric intake. The excess going being stored as fat.

Continue reading “Two Faulty Copies of SMIM1 Gene Associated with Obesity”

Ultraprocessed Plant-Based Foods May Not Be Good for Your Heart

Our findings showed eating a plant-based diet can be beneficial, except when it is based on ultra-processed foods. Interview with:

Fernanda Rauber, PhD
Researcher at the Centre for Epidemiological Research in Nutrition and Health (NUPENS)University of São Paulo (USP) and
Department of Preventive Medicine
School of Medicine at USP, Brazil
Lead author of this study  What is the background for this study? 

Response: Although we already have substantial evidence of the negative impact of an ultra-processed food-based diet on health, solid public policies to discourage the consumption of these products are still lacking, especially in countries like the United Kingdom. Plant-based foods are recommended in many dietary guidelines, and this area has been explored by the food industry, which uses health claims (vegetarian, vegan, plant-based) to promote its products.

With a growing population adopting plant-based diets, studying the role of food processing in plant-based dietary patterns and its relation to cardiovascular diseases can help refine guidelines to incorporate considerations about food processing in their recommendations.

Pennington Study Demonstrates Long-Term Weight Loss Efficacy of Semaglutide

The long term data is reassuring.  We now have more evidence for semaglutide weight loss efficacy in older, sicker individuals. Interview with:
Donna H. Ryan, MD
Professor Emerita
Pennington Biomedical Research Center
New Orleans, LA 70130  What is the background for this study? 

Response: This is the first of the sub-papers to the landmark SELECT study.  It has been peer review and published in a top-line journal.  While the primary outcome was the observation of 20% reduction in MI, stroke and CV death this new paper looks only at weight.   What are the main findings?

SIR24: Bariatric Arterial Embolization Safely Reduced BMI in Hopkins Study

The procedure resulted in a decrease in the mean BMI of the participants from initially being 43.6 to 41.2 one-year post-procedure. Interview with:
Clifford R. Weiss, MD
Professor of Radiology
Director, the Johns Hopkins HHT Center of ExcellenceRadiological Science and Biomedical Engineering
Johns Hopkins University  What is the background for this study? How would you describe the procedure?

Response: The purpose of this study was to evaluate the safety and efficacy of Bariatric Arterial Embolization (BAE) in patients who have a BMI greater than or equal to 35. BAE is a minimally invasive interventional radiology treatment that reduces the production of the hunger hormone ghrelin as a result of decreasing the blood flow to the stomach.

There were 10 participants recruited in this study. The participants were followed six weeks before BAE and a year following the procedure. After the procedure, the participants were admitted for routine supportive care for up to 48 hours. The participant’s BMI, weight, and body compensation were measured 1,3,6, and 12 months after the surgery.

ECO24: Ideal Weight For Patients with Diabetes May Vary with Age

For older individuals who are moderately overweight , maintaining rather than reducing weight may be a more practical goal. Interview with:
Dr Shaoyong Xu
Xiangyang Central Hospital
Affiliated Hospital of Hubei University of Arts and Science
Xiangyang, China  What is the background for this study? 

Response: In previous studies, the obesity paradox has been observed, where overweight and obese individuals with cardiovascular disease have better outcomes compared to their slim counterparts with the same disease. The global prevalence of diabetes is steadily increasing year by year.

In this era of population growth and aging, the question arises as to whether obesity or overweight can be beneficial in improving survival rates for older individuals with diabetes. This topic holds significant relevance due to the potential implications it has on weight management strategies for older adults. If overweight does not pose an increased risk of cardiovascular mortality, it may suggest that older individuals are not necessarily required to strive for weight loss in order to achieve so-called normal values. Moreover, inappropriate weight loss and being underweight could potentially elevate the risk of cardiovascular events, myocardial infarction, cerebral infarction, and all-cause mortality.

ECO24: Tirzepatide Found Effective for Weight Loss Despite Duration of Obesity

Tirzepatide is a once weekly GIP and GLP-1 receptor agonist while semaglutide was a once weekly GLP-1 receptor agonist Interview with:
Giovanna Muscogiuri, MD, PhD
Assistant Professor
Endocrinology Unit
University Federico II
Naples, Italy  What is the background for this study? 

Response: The study was a subgroup analysis of SURMOUNT 1-4 aiming to investigate if tirzepatide was effective in terms of percent body weight change, proportions achieving weight loss targets of 5, 10, 15, 20, and 25% and change in waist circumference in subjects with different duration of obesity.

Fasting Mimicking Diet: Five Days Per Month Demonstrated Improved Biomarkers for Aging and Disease Risk

The fasting mimicking diet is a five-day long meal program specifically designed to mimic the beneficial effects of fasting while allowing a person to eat and providing the necessary nutrients Interview with:
Valter D. Longo PhD
Edna M. Jones Professor of Gerontology and Biological Sciences
Director, Longevity Institute, Leonard Davis School of Gerontology
University of Southern California, Los Angeles, CA
AIRC Institute of Molecular Oncology
Italian Foundation for Cancer Research Institute of Molecular Oncolog
Milan, Italy

Sebastian Brandhorst PhD
Associate Professor Of Gerontology Co-Director
Aging Murine Phenotyping Core
University of Southern California,  Health Sciences  What is the background for this study? 

Response: In mice, periodic cycles of a fasting mimicking diet (FMD) protect normal cells while killing damaged cells including cancer and autoimmune cells, reduce inflammation, promote multi-system  regeneration, and extend longevity. We previously demonstrated that study participants who consumed the FMD for 5 consecutive days per month for 3 months, but otherwise ate their regular diet had reduced body weight, trunk and total body fat, blood pressure, and a favorable safety profile.