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  • Writer's pictureDr. Harold Pierre

Mounjaro vs. Ozempic: Which Is Better for Weight Loss?

Updated: Nov 29, 2023

Mounjaro vs. Ozempic vs. Wegovy: Which Is Better for Weight Loss?

Ozempic and Mounjaro are two popular diabetes medications that have also shown promise for weight loss. Their generic names are Semaglutide for Ozempic and Tirzepatide for Mounjaro. Wegovy has the same exact ingredient as Ozempic. However, it received Food and Drug Administration approval as a weight loss drug. It also comes in a higher maximum dose. So, moving forward, I will refer to just Mounjaro and Ozempic. But what's the difference between these two drugs? And which one is more effective for losing weight? This in-depth guide examines the key distinctions between Ozempic and Mounjaro to help you determine which may be the better option for managing your weight.

Woman preparing to inject Ozempic to her belly

An Introduction to Ozempic and Mounjaro

Ozempic (semaglutide) and Mounjaro (tirzepatide) belong to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists. They are used in people with type 2 diabetes. Here's a quick rundown of how these drugs work:

  • Ozempic is a once-weekly injectable prescription medication approved by the FDA for treating type 2 diabetes. It helps lower blood sugar levels by stimulating the release of insulin when blood sugar is high. Ozempic also suppresses appetite, leading to decreased food intake and potential weight loss.

  • Mounjaro is another once-weekly injection that was FDA approved in 2022 for managing type 2 diabetes. Like Ozempic, it works by controlling blood sugar and appetite. Mounjaro is a "twincretin" drug, meaning it activates two hormone pathways—GLP-1 and glucose-dependent insulinotropic polypeptide (GIP)—that regulate blood sugar and hunger.

  • In addition to type 2 diabetes, both Ozempic and Mounjaro are also prescribed off-label by some doctors to promote weight loss in patients who are overweight or obese.

Key Differences Between Ozempic and Mounjaro

Although Ozempic and Mounjaro share some similarities, there are a few key differences to note:

  • Weight loss effects: In clinical trials, Mounjaro has shown greater weight loss potential compared to Ozempic. At the highest doses, Mounjaro led to about 20% body weight reduction on average while Ozempic led to around 15% weight loss.

  • FDA approval status for weight loss: Neither Mounjaro or Ozempic are approved for weight loss. However, Ozempic's active ingredient semaglutide is approved for weight loss under the name Wegovy.

  • Mechanism of action: Ozempic activates GLP-1 receptors only. Mounjaro is the first FDA approved dual agonist, meaning it activates both GLP-1 and GIP hormone pathways, which may confer additional weight lowering benefits. Both treat diabetes and both reduce body weight.

  • Dosing: The maximum approved dose of Ozempic is 2 mg, while Mounjaro can be titrated up to 15 mg. Higher Mounjaro and Ozempic doses are associated with increased weight loss effects.

  • Cost: Mounjaro is more expensive than Ozempic. The retail monthly cost for Ozempic is around $900 while Mounjaro costs over $1,300. However, compounded generic versions of these drugs cost less than $500 for the same doses.

Comparing Mounjaro and Ozempic Weight Loss Results

Clinical trial data directly comparing Mounjaro vs. Ozempic head-to-head for weight loss do not yet exist. But they are both effective weight loss drugs. However, studies evaluating the two drugs individually provide insights on their potential efficacy:

Mounjaro Clinical Trial Findings

  • In the SURMOUNT-1 trial, participants with obesity or who were overweight took Mounjaro for 72 weeks. Those who took the highest 15 mg dose lost 22.5% of their body weight compared to just 2.4% for placebo.

  • Over 90% of those on the 15 mg Mounjaro dose lost at least 5% body weight and 57% lost 20% or more.

  • Common side effects included gastrointestinal issues like nausea, diarrhea and constipation. Most were mild to moderate.

Wegovy (Semaglutide) Clinical Trial Findings

  • The STEP 1 trial evaluated Wegovy (2.4 mg weekly) versus placebo for 68 weeks in people with obesity/overweight.

  • Average weight loss was 16.9% with Wegovy versus 5.7% for placebo.

  • About 62% of Ozempic patients lost at least 5% body weight and 34% lost 15% or more.

  • As with Mounjaro, gastrointestinal side effects were the most common but generally mild.

Indirect Comparison Results

  • An indirect treatment comparison using matching-adjusted analysis suggests greater weight loss with Mounjaro 15 mg versus Wegovy (semaglutide) 2.4 mg.

  • Average additional weight reduction was about 6% more with Mounjaro.

  • Patients also had 2.6 to 2.8 times better odds of losing at least 5% body weight with Mounjaro compared to Ozempic.

So while head-to-head data are lacking, current evidence indicates Mounjaro may provide better weight lowering at the maximum prescribed doses.

Who Should Take Mounjaro or Ozempic for Weight Loss?

Woman's body before and after weight loss. Diet concept

When considering either medication for weight management, there are some factors to keep in mind:

  • For diabetes: Ozempic is FDA approved and widely used for treating type 2 diabetes. Mounjaro is newer to the market but also used to treat type 2 diabetes.

  • For weight loss alone: Mounjaro wins over Ozempic for weight loss. Some providers do prescribe both off-label.

  • Cost concerns: The more affordable name brand option is Ozempic. Those with prescription coverage can discuss options with their provider.

  • Side effect risks: Both drugs lead to similar gastrointestinal side effects. People more prone to these issues may wish to start on lower doses.

  • Need for weight loss: Those with more weight to lose may derive greater benefits from Mounjaro based on its higher weight reduction potential at maximum doses. Remember, both Ozempic and Mounjaro work and can both help achieve weight loss goals.

As with any medication, work with your healthcare provider to decide if Ozempic or Mounjaro is the right fit based on your health history, needs and treatment goals.

Mounjaro vs. Ozempic for Weight Loss

Both Ozempic and Mounjaro are injected under the skin once weekly. The dosing schedule is gradually increased over time. However, the doses of Mounjaro and Ozempic are very different. Ozempic is more potent than Mounjaro:

Ozempic Dosing

  • The starting dose of Ozempic is 0.25 mg once per week.

  • It is increased to 0.5 mg after 4 weeks if needed.

  • The maintenance dosage for diabetes and maximum approved dose is 2 mg.

  • Maximum dose for Wegovy (semaglutide) is 2.4 mg

Mounjaro Dosing

  • The starting dose of Mounjaro is 2.5 mg once weekly.

  • It increases by 2.5 to 5 mg every 4 weeks.

  • The maximum dose for weight management is 15 mg once per week.

Following the schedule allows the body to adjust and may reduce side effects. Doses can also be tailored down based on individual tolerability.

What to Expect with Ozempic or Mounjaro Treatment

When used for weight loss, here's an overview of what you can expect with either medication:

  • Gradual weight loss: The weight comes off slowly over months. It may take 16-20 weeks to reach maximum effect. Patience is needed.

  • Diet and exercise still required: The drugs work best combined with lifestyle changes. You'll need to focus on healthy eating, calorie deficit, and regular physical activity.

  • Appetite reduction: Most people notice decreased hunger and feeling fuller sooner while eating. This leads to eating less without consciously trying to diet.

  • Gastrointestinal effects: Upset stomach, nausea, vomiting, diarrhea and constipation are common, especially at first. Starting slowly reduces risks.

  • Possible other side effects: Dizziness, headache, fatigue, gallbladder disease and increased heart rate may occur as well.

  • Weekly injections: Theshots are small and simple but still need to be incorporated into your routine. Some bruising or irritation can occur.

  • Medical monitoring: Your provider will monitor your health on the medication through regular weight checks, lab tests, and follow-up.

Who Should Not Take These Medications?

Ozempic and Mounjaro may not be appropriate choices for:

  • Those with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2.

  • People with severe gastrointestinal disease like gastroparesis or chronic pancreatitis.

  • Pregnant or breastfeeding women.

  • Those taking other weight loss medications.

  • Anyone with a severe allergy or hypersensitivity to semaglutide or tirzepatide.

Talk to your doctor about any medical conditions or conflicts to see if Ozempic or Mounjaro may be contraindicated.

Combination Treatment for Enhanced Weight Loss

Some weight loss clinics and bariatric practices are combining Ozempic or Mounjaro with other medications for an enhanced effect:

  • Phentermine: This appetite suppressant is sometimes prescribed short-term along with Ozempic or Mounjaro for greater initial weight reduction.

  • Metformin: This diabetes drug can be added to increase insulin sensitivity and further increase weight loss.

  • Anti-seizure drugs: Medications like topiramate may be paired with GLP-1 drugs for their appetite reducing qualities.

  • Contrave: Combining this naltrexone/bupropion medication with Ozempic or Mounjaro may have a synergistic impact.

Evidence is still limited on these off-label combination therapies for obesity treatment, and additional side effects are possible. But the approach shows promise for those needing added weight loss.

Diet and Lifestyle Recommendations

Woman with measure tape. Healthy lifestyle.jpg

To get the most out of Ozempic or Mounjaro treatment, the following diet and lifestyle changes are recommended:

  • Calorie deficit: Aim for a 500-750 calorie daily deficit through portion control and food substitutions. Veggies, fruits, lean proteins should be diet staples.

  • Lower glycemic index foods: Focus on foods that produce slower blood sugar spikes and crashes to maintain energy. Choose whole grains, nuts, non-starchy veggies.

  • Protein intake: Eating adequate protein is key to preserving lean muscle mass when losing weight. Target 0.5-1 grams of protein per pound of body weight daily.

  • Reduce snacking: Excessive snacking interferes with the medications' appetite suppression effects. Limit yourself to two to three modest snacks at most.

  • Limit liquid calories: Juices, soda, frappes, and alcohol are high in empty calories. Slash these and drink more water, unsweetened coffee/tea.

  • Exercise: Include a mix of cardiovascular exercise and strength training in your fitness routine. Work up to 150-300 minutes of moderate activity weekly.

Making dietary changes and increasing activity will help maximize weight loss success on these medications.

Potential Future Obesity Medications

With obesity reaching epidemic proportions globally, pharmaceutical companies are racing to develop new anti-obesity drugs. Some future medications that may compete with Ozempic and Mounjaro include:

  • Cagrilintide: This experimental drug showed an average 15% weight reduction in early trials. It mimics a hormone that suppresses appetite and reduces food intake.

  • Tirzepatide: Already sold as Mounjaro, studies are testing a higher 20 mg dose which may lead to 25% or greater weight loss.

  • LY3298176: An investigational dual GLP-1/GIP drug similar to tirzepatide that's being studied at higher doses for treating obesity.

  • AMG133: This modified glucagon/GLP-1 combination medication led to up to 28% weight loss in initial clinical studies.

  • GDF15 analogs: Pharmaceutical companies are developing synthetic versions of the natural hormone GDF15 which may have weight loss effects.

While still undergoing testing, these emerging medications could expand future pharmaceutical options for weight management beyond today's GLP-1 drugs.

Which Is Better: Ozempic vs Mounjaro for Weight Loss?

Based on a review of current evidence and clinical trial results, Mounjaro appears to have an edge over Ozempic with more significant weight loss:

Key advantages of Mounjaro may include:

  • Significantly greater weight loss (up to 20-25% body weight) at the maximum prescribed dose

  • Recently approved by the FDA for chronic weight management

  • Dual mechanism of action targeting GLP-1 and GIP hormone pathways

  • Higher maximum dosage providing enhanced weight lowering effects

Ozempic benefits for weight loss may include:

  • More time on the market and extensive real-world use in patients

  • Weight reductions up to 15% demonstrated in clinical studies

  • Lower cost and greater insurance coverage expected

  • Positive effects on blood sugar and diabetes management

For those seeking pharmaceutical help losing excess weight who are willing to self-inject weekly, Mounjaro offers the most potent weight loss effects based on studies so far. But Ozempic remains an effective alternative, especially for people also needing type 2 diabetes treatment.

In summary, Ozempic and Mounjaro give us exciting new medical options for managing obesity. But consult your doctor to decide if one of these GLP-1 drugs may be appropriate for helping you successfully shed pounds and improve your health.

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Key Takeaways

  • Ozempic (semaglutide) and Mounjaro (tirzepatide) are GLP-1 receptor agonist drugs used for type 2 diabetes mellitus that also promote weight loss.

  • Mounjaro has shown greater weight reduction ability (up to 22% loss) compared to Ozempic (up to 16% loss) at maximum prescribed doses.

  • Wegovy, which is the same drug as Ozempic, gained FDA approval for weight loss while Mounjaro remains off-label for weight loss.

  • These injectable medications work by controlling blood sugar levels, suppressing appetite, and enhancing feelings of fullness.

  • Gastrointestinal side effects are common initially but usually mild. More serious risks are rare.

  • Common side effects of Mounjaro are similar to Ozempic.

  • Mounjaro is available as the compounded generic tirzepatide.

  • Ozempic is available as a compounded generic semaglutide.

  • Mounjaro or Ozempic together with other weight loss drugs may increase the amount of weight loss.

  • For optimal results, healthy eating, calorie deficits, adequate-protein, and exercise should accompany the medications.

  • Talk to your doctor to decide if Ozempic or Mounjaro is the right option for you based on effectiveness, side effects, costs, and insurance coverage.

About the author:

Dr. Harold Pierre is a board-certified anesthesiologist and addiction medicine specialist with over 20 years of experience. He is board-certified by the American Board of Anesthesiology and the American Board of Preventive Medicine.

This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician or another qualified medical professional. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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