This is one of the questions I get asked frequently and here is a video that gives reasons why you may not lose weight in the first couple months on any of these meds (and also why the medication may not work at all, even at a higher dose). kzfaq.info/get/bejne/qdOamtyr1tG4p4k.htmlsi=mvMqx6a6stP_oVkD In this case, I recommend that you stay on Ozempic and increase to 1mg. Here are the reasons: It is too soon to know if you Ozempic will work for you because even 0.5mg is a low dose. Many people actually won’t see weight loss until they get to 1mg or higher. It’s true that Zepbound / Mounjaro has shown better results, but as of the time I am replying to you, they are on a nationwide shortage and its very difficult to find at a pharmacy.

I didn't loose a pound as well.

Hang in there! It can take some time.

Do you have fatigue? I was on ozempic 9 weeks. No gastric issues whatsoever but the fatigue was brutal. I stopped after 9 weeks.. 10 lbs lost but I felt like garbage. I stopped taking it and I am no longer fatigued, feel 100% better off it.

​@@Mexicanita1904 I'm on my 6th week and also extremely fatigued. Though could also be my fibromyalgia.

Thank you!

Thank you and Welcome! Best of luck to you! You are fortunate to be on the most effective one!

First off, congratulations on being down 55 pounds! I’m sorry to hear about the vomiting -sounds awful. The GI side effects like nausea and vomiting with Wegovy (and Zepbound too) are from delayed stomach emptying. Unfortunately, alcohol consumption can also result in delayed stomach emptying so the results can be additive. Many people taking Wegovy do better by avoiding alcohol and also by having smaller meal portions. It is possible that you may find Zepbound more tolerable, but no guarantees. While Zepbound does appear to more effective, the side effects are similar. The nice thing about Zepbound is that the titration is slower. People often find that going from 0.5mg of Wegovy to 1mg is too abrubt. Zepbound adds an additional titration dose. If you continue to have severe side effects with Wegovy 1mg, then you can discuss with your doctor to either go back down to the 0.5mg or try Zepbound. Best of luck to you and thank you for sharing your story with everyone. Many others may benefit from hearing about it.

This approach seems reasonable given the high cost of these medications. In the US, the medications are approved by our FDA to use as maintenance and obesity is considered a chronic condition. Unfortunately, studies show that people gain about 2/3 of their weight back 1 year after stopping the medication if they do not make lifestyle changes. A recent study showed that people who exercised 4 days a week were much more likely to keep weight off after stopping their medication. I am glad to hear that the UK approach focuses on lifestyle change from the beginning.

Yes as it should be cause they are used as tolls to help people learn how to eat not for life or long term!

While I have personally used oral and topical medication from Mexico pharmacies, my honest opinion is that I would not purchase an injectable medication from Mexico. While the majority of prescription medication at Mexican pharmacies are legitimate, there has been a few reports of imitation medications at some pharmacies. When it comes to an injectable medication that must be sterile, I would not feel comfortable taking that risk. The Rybelsus I showed at the Mexico pharmacy was actually the oral form of Semaglutide. I want you to be aware of another weight loss medication that is much less expensive (although not quite as effective). It is, Qsymia, and as of right now, it is $98 per month using the manufacturer’s home delivery pharmacy. Best of luck to you!

Yes, this is correct. Wegovy (weight loss) dose goes higher than Ozempic (T2 Diabetes). But I think max dose of Wegovy vs max dose of Zepbound is fair to compare. They are both FDA approved for weight loss.

Yes! You are correct! It will be many years before a generic will be allowed on the market. In the pharmacy world we refer to the active ingredient name as the generic name. Now I see how that can cause confusion. Thank you!

Yes, Qsymia is effective and people lose almost 10% body weight on average at max dose. The best thing about Qsymia is the price. If you are doing well on Qsymia, stay on it. If not, then your insurance may cover either Zepbound or Wegovy with a "prior auth" from your doctor. Yes to your other question too -your doctor can try to prescribe mounjaro but it probably won't be covered by your insurance unless you have Type 2 Diabetes.

Thank you!@@veena-usa

I’m on mounjaro if my insurance covers it will they cover Zepbound as well ? And is 5 mg of Moujaro the same as 5 mg of zepbound ? Are they the same with lost lost or no ?

@@nikkiturnup1688 Don't worry - Mounjaro and Zepbound are identical. They just got approved for different purposes and at different times. There is absolutely no difference so just stay on Mounjaro as long as insurance will continue to cover it. I log in every morning to check on orders and there was zero Zepbound available to order for the past several days. All strengths are on back order (I'm in California). If you got switched it would be difficult to find the medication right now.

Semaglutide (Wegovy /Ozempic) has a very low risk of triggering elevated liver enzymes. If it occurs, it is often transient and does not always indicate liver damage. Tirzepatide (Zepbound / Mounjaro) does not seem to cause elevated liver enzymes that I am aware of.

It’s true that if you are taking the medication for weight loss, you will likely be more successful with Mounjaro (or Zepbound). However, I also want you to know that it is very reasonable that you have not lost any weight yet with 5 weeks of Ozempic. You most likely have completed 4 weeks of 0.25mg and only 1 week on 0.5mg. The starter dose of 0.25mg does not cause weight loss (I have had only a couple patients that are the exception). There is only 1 reason that everyone starts at 0.25mg for 4 weeks -to get your body used to the medication. If you started at 1mg or 2mg, you would probably have very bad nausea. Starting at a sub-therapeutic dose allows your body to gradually get used to the medication side effects -but does not provide the benefit. Some people get partial benefit at the 0.5mg dose and some do not. Most people do get benefit from the 1mg and most benefit from 2mg. The bottom line is this: it is too early to know if Ozempic is going to work for you because it takes 3 months to titrate up. That said, you would probably do better on Mounjaro if your insurance covers it and if your doctor is comfortable to make the switch. Best of luck!

Great question, and I agree that its confusing. Both Zepbound and Mounjaro come in the exact same 6 doses which are: 2.5mg, 5mg, 7.5mg, 10mg, 12.5mg and 15mg. Also, Zepbound and Mounjaro are identical medications (active ingredient is tirzepatide). The chart you see only lists 3 doses (5mg, 10mg, 15mg) along with mean weight loss at those doses because those were the only results reported and published in the research study. I could have labeled the chart either "Zepbound" or "Mounjaro" (or both). The reason I labeled it Zepbound is because the FDA approved tirzepatide for weight loss under the name Zepbound and approved tirzepatide for diabetes under the name Mounjaro. However, they both will give the results shown in the chart.

It is confusing to compare Zepbound and Wegovy to each other mg per mg. Each of these is a different chemical compound and has different activity at different mg. The starter dose of Wegovy is 0.25mg and the starter dose for Zepbound is 2.5mg. The starter dose is 10 times higher when looking at mg of Zepbound, but it is considered similar in side effects and effect on the body.

Excellent question! 7.5mg is the only strength that does not have a corresponding dose in Wegovy titration. Wegovy doubles from 0.5mg to 1mg and Mounjaro does a slower titration from 5mg to 7.5mg to 10mg. Wegovy uses 5 steps to reach max dose and Mounjaro uses 6 steps. By the way, so far, there have not been any published equivalency studies so we are estimating and assuming corresponding doses.

The most common side effects are nausea, constipation and diarrhea. They happen more often on days 1 to 3 and less common on days 4 to 7. Many people tolerate the 2.5mg dose very well. The dry mouth is interesting. It’s not actually an official side effect but a few other patients complain about this as well. It can happen if someone is dehydrated due to vomiting or diarrhea, but that does not seem to be the situation for you. Others have found that drinking electrolytes helps with the dry mouth. Best of luck to you!

It’s true that Zepbound has possible side effects, especially nausea and constipation for many (but not all) people. It’s risk vs benefit. If you qualify to use this medication then your doctor determined the health benefits of weight loss outweigh the potential risks. This medication is for those that have been unsuccessful in losing weight despite diet changes and exercise program. If this is you, then I would take the plunge and absolutely continue the diet changes and exercise along with Zepbound. Here’s 2 of my recommendations: 1. Smaller meals can help reduce the nausea- that is feedback from many of my patients. 2. Include weight bearing exercise so that you keep your muscle mass during weight loss and lose fat instead of muscle. I hope you are one who tolerates it. I’m rooting for you!

How awful! Looks like it just isn't for you. If you were trying the medication for weight loss, then there is an alternative you may ask your doctor about. It's called Qsymia. If you are a candidate, it may be better tolerated.

If you are on Wegovy and still eating normal, don’t worry! The starter doses are only meant to get your body used to it. Most of my patients don’t see a change in appetite until they reach the 1mg dose and for some people they must go higher. Best of luck to you!

No kidding?! You are amazing!