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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.

WeightControl.com Interview with:
Tricia Rodriguez, PhD, MPH
Ty Gluckman, MD, MHA, FACC, FAHA, FASPC
Nick Stucky, MD, PhD
Three of the authors of the JAMA Internal Medicine study

WeightControl.com: 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

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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.

WeightControl.com Interview with:
Rong Fan, MS (she/her/hers)
PhD Candidate
University of Massachusetts Amherst
Amherst, Massachusetts

WeightControl.com: 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.

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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.

WeightControl.com 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

WeightControl.com: 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.

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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.

WeightControl.com Interview with:
Donna H. Ryan, MD
Professor Emerita
Pennington Biomedical Research Center
New Orleans, LA 70130

WeightControl.com: 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.

WeightControl.com: What are the main findings?

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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.

WeightControl.com Interview with:
Clifford R. Weiss, MD
Professor of Radiology
Director, the Johns Hopkins HHT Center of ExcellenceRadiological Science and Biomedical Engineering
Johns Hopkins University

WeightControl.com: 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.

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Patients Who Stopped Tirzepatide (Mounjaro™) For Weight Control Gradually Regained Most of Lost Weight

Obesity is a chronic disease, like diabetes and hypertension. If treatment is discontinued, it will relapse, though gradually.

WeightControl.com Interview with:
Louis J Aronne M.D.
Sanford I. Weill Professor of Metabolic Research
Department of Medicine
Weill Cornell Medicine

WeightControl.com: What is the background for this study? What are the main findings?

Response: The SURMOUNT -4 trial demonstrates that patients who discontinued tirzepatide after losing 20.9% over 36 weeks regained about half the weight in one year to an average 9.5% weight loss following discontinuation while those who continued lost an additional 5%.

The metabolic parameters which had improved with weight loss returned towards their starting point, but did not completely regress.

Penn Researchers Identify Brain Circuits That Increase Risk for Obesity

These findings underscore that some individual’s brains can be fundamentally different in regions that increase the risk for obesity.

WeightControl.com Interview with:

Casey H. Halpern, MD
Division Head, Functional and Stereotactic Neurosurgery
Associate Professor of Neurosurgery
University of Pennsylvania

WeightControl.com: What is the background for this study?

Response: The dorsolateral hippocampus (dlHPC) is located in the region of the brain that processes memory, and the lateral hypothalamus (LH) is in the region of the brain that is responsible for keeping the body in a stable state, called homeostasis. Previous research has found an association with loss of function in the human hippocampus in individuals with obesity and related disordered eating, like BED. However, outside of imaging techniques such as magnetic resonance imaging (MRI), the role of the hippocampus has been difficult to study in humans with obesity and related eating disorders.

Even Small Reductions in Weight Can Reduce Obesity-Related Chronic Diseases

Given the health benefits of clinically meaningful weight reduction at any level of excess weight, 5% or greater weight loss can be a reasonable target for obesity management efforts.

WeightControl.com Interview with:

Dr. Lyudmyla Kompaniyets, PhD
Division of Nutrition, Physical Activity and Obesity
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention, Atlanta, Georgia

WeightControl.com: What is the background for this study?

Response: Overweight and obesity affect more than 70% of US adults and are risk factors for other chronic diseases, including type 2 diabetes, cardiovascular disease, and many cancers. This is one of the only papers to assess the probability of a 5% weight loss or reducing BMI to healthy weight among US adults with overweight and obesity.

This study focused on the probability of weight loss in a healthcare seeking population with overweight or obesity regardless of any individual’s intention to lose weight.

Heart Benefits of Wegovy (semaglutide) Extend Beyond Weight Loss

This trial found that among the participants taking Wegovy the incidence of MACE was 20% lower than those with usual care.

WeightControl.com Interview with:
Shauna Levy MD, MS, FACS. FASMBS, DABOM
Assistant Professor
Department of Surgery
Division of Bariatric and Minimally Invasive Surgery
Director of Bariatric Surgery
American Board of Obesity Medicine, Diplomate
Instagram @tulane_bariatric_center
Tulaneweightloss.com

WeightControl.com: What is the background for this study?

Response: The SELECT trial evaluated over 17,000 patients with a history of overweight or obesity and cardiovascular disease. They randomized patients to usual care versus Wegovy (semaglutide), which is an anti-obesity medication. It is important to note that none of the participants had diabetes.

They evaluated the incidence of Major Adverse Cardiaovascular Events (MACE) for up to 5 years for all participants.

Intermittent Fasting Without Counting Calories for Weight Loss

We found that participants who engaged in time-restricted eating ate 425 fewer calories per day than the control group and lost about 10 more pounds than the control group after one year

WeightControl.com Interview with:
Krista Varady, PhD
Professor, Kinesiology and Nutrition
University of Illinois, Chicago

WeightControl.com: What is the background for this study?

Response: Obesity is a major health issue. Many traditional weight loss diets involve counting calories, which can be cumbersome and difficult to do well. Time-restricted eating, without calorie counting, has become a popular weight loss strategy because it is simple to do. Whether it’s effective in producing weight loss, especially beyond the short term, is unclear.