If you have overweight, obesity, or weight concerns, you may wonder about a newer type of weight loss medication. Several once-weekly injections can promote weight loss, but doctors prescribe them for different purposes. You’ll need to consider your overall health, risk of other conditions, and cost in determining which is best for you.
Glucagon-like peptide-1 (GLP-1) agonists are gaining significant media attention as celebrities and social media personalities popularize these injections.
But can GLP-1 agonists like Ozempic and Wegovy really help you lose weight? What about other types of injections?Read on to learn about these injections, who can get them, whether or not they work, and how they work.
Understanding Weight Loss Injections
Weight loss injections are medications-typically injected weekly-that help regulate appetite, metabolism, and blood sugar levels. Many of the most effective ones were originally developed to treat type 2 diabetes but are now FDA-approved (or prescribed off-label) for weight loss.These medications mimic hormones like GLP-1, helping you feel fuller longer, eat less, and lose weight gradually over time.
Types of Weight Loss Injections
Several types of weight loss injections are available, each with its own mechanism of action and target population. Here's a detailed look at some of the most common options:
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Semaglutide (Wegovy, Ozempic)
Semaglutide is a medication that mimics the role of hormones in your gut called incretins. It helps stimulate your pancreas to increase the amount of insulin you produce. Insulin is a hormone that tells your cells to absorb sugar from your blood and use it for energy. Semaglutide is the active ingredient in Ozempic and Wegovy. It works as a GLP-1 receptor agonist to treat type 2 diabetes. People also use it to help them lose weight.
Semaglutide also helps to decrease your appetite, which may lead to weight loss.
Semaglutide injections are available under the brand names Wegovy and Ozempic.
Wegovy
Wegovy is a once-weekly stomach injection approved by the Food and Drug Administration (FDA) in 2021. Doctors may prescribe it for chronic weight management in adults and teens, for weight loss in people with obesity, meaning they have a body mass index (BMI) of 30 or higher. Doctors may also prescribe it for people with a BMI of 27 or higher if they have at least one related comorbidity, like diabetes or hypertension.
A doctor will prescribe Wegovy in addition to lifestyle changes, including a reduced-calorie diet and increased physical activity. Wegovy is approved for use if:
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- Your BMI is 30 or more, which indicates that you have obesity.
- You have overweight with a BMI of at least 27 along with at least one other weight-related health condition.
- Kids between ages 12 and 18 can take Wegovy if their BMI puts them into the 95th percentile or higher based on their age and sex.
Ozempic
Doctors prescribe Ozempic as a once-weekly injection for people with type 2 diabetes at risk of cardiovascular problems. It helps manage blood sugar levels and makes people feel less hungry. It may also help prevent stroke. Ozempic is approved to lower blood sugar when you have type 2 diabetes. You can also use it to lower your risks of a heart attack or stroke if you have diabetes and heart disease.
You don’t use Ozempic in place of insulin. It’s also not FDA approved for weight loss, although some doctors prescribe it off label for this purpose. Ozempic is approved for people with type 2 diabetes. But it’s sometimes used off-label for weight loss since it’s the same drug as Wegovy. The only difference is that you take Ozempic at a lower dose.
Ozempic vs. Wegovy: Dosage
Ozempic and Wegovy are really the same drug, but you will take them in different doses. You take Wegovy as an injection in your belly, thigh, or upper arm once a week at the same time. You’ll start with a lower dose and work your way up to 2.4 mg each week. If you’re taking Ozempic for diabetes, sometimes you may need to increase the dose to 1 milligram per week if the lower dose isn’t enough to get your blood sugar under control.
Semaglutide: Benefits and Considerations
- Benefits: Wegovy lowered the risk of death from heart attack in people with diabetes plus overweight or obesity. Nonfatal heart attack and nonfatal stroke rates also decreased in the study.
- Considerations:
- Wegovy is approved for weight loss, but only if you are above a certain weight. Ozempic isn’t approved for weight loss, but doctors sometimes use it off-label for this purpose. The main difference between the two is the dose, since they are the same drug (semaglutide) and you take them in the same way.
- Health insurance coverage can differ between Ozempic and Wegovy. This will depend on whether you’re taking them for an approved use or not. To take Ozempic for weight loss, you will likely have to pay for it out-of-pocket unless your doctor lists your diagnosis as diabetes. To take Wegovy for weight loss, you will need to be above a certain weight or have another weight-related health condition.
- At about $1,000 per month, either of these drugs can be costly if you have to pay for them yourself.
Liraglutide (Saxenda, Victoza)
Like semaglutide, liraglutide (Saxenda) stimulates your pancreas to make insulin when blood sugar levels are high. It also suppresses appetite and slows digestion. You can use it to manage blood sugar and to promote weight loss. Liraglutide is a daily injectable medication that acts on hormones that send signals from the gut to the brain to make the patient feel full quicker and decrease hunger signals. Doses start at 0.6 mg to 3 mg a day. Some patients may lose 5-10% of body weight, especially with the higher dose of liraglutide.
Along with a diet and exercise plan, liraglutide can help promote weight loss in people ages 12 and older with overweight or obesity. It also helps them avoid regaining it.
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A 2022 Belgian study looked at the effects of liraglutide in 115 people with a median BMI of 34.8. After 4 months, the group’s median body weight had decreased by 9.2%. A 2017 literature review also found that liraglutide was effective in helping people lose weight and had the added benefit of blood sugar management.
Liraglutide is also available under the brand name Victoza. But Victoza isn’t FDA approved to help with weight loss. It helps people 10 years and older manage type 2 diabetes. Liraglutide is also approved for Type 2 Diabetes, under the brand name Victoza.
Tirzepatide (Mounjaro, Zepbound)
Tirzepatide is the active ingredient in Mounjaro and Zepbound, which also can treat type 2 diabetes and encourage weight loss. Tirzepatide is a GLP-1 receptor agonist, too. But it also works in a second way, as what’s known as a GIP receptor agonist. GIP, short for glucose-dependent insulinotropic polypeptide, is another hormone your body makes after you eat. Tirzepatide differs from other GLP-1 agonists in that it’s also a glucose-dependent insulinotropic polypeptide (GIP) agonist. This dual role allows it to be even more effective. Early studies showed some people losing more than 20% of their weight after 72 weeks (about 18 months).
The FDA has approved Mounjaro to help people with diabetes manage their blood sugar. Some doctors may prescribe it off label for weight loss when other methods don’t work. Further clinical trials have recently concluded, and the manufacturers expect FDA approval by late 2023.
You inject tirzepatide once a week. It can slow down your digestion, making you feel fuller for longer. Appetite suppression combined with diet and exercise can lead to weight loss.
Mounjaro vs. Ozempic
Mounjaro and Ozempic are different drugs, although they work in a similar way. Mounjaro is a GLP-1 and GIP receptor agonist. Ozempic acts only on GLP-1. They’re both approved to lower blood sugar in people with type 2 diabetes in combination with a healthy diet and exercise. While both Mounjaro and Ozempic are really diabetes drugs, they also can help you lose weight.
Compared to Ozempic, Mounjaro might work even better for weight loss. One study showed that a 15 milligram-dose of this drug taken every week led people to lose more than 20% of their body weight. Ozempic can help you lose 15%-20% of your weight on average. But many people might lose closer to 10% of their body weight. You’ll most likely have to keep taking them to keep the weight off.
Mounjaro vs. Zepbound
Mounjaro and Zepbound are brand names for the same drug, tirzepatide. While Mounjaro is approved for type 2 diabetes, Zepbound is approved for weight management in adults with a BMI of 30 or more. It’s also approved if you’re overweight and have another health condition including:
- High blood pressure
- High cholesterol
- Type 2 diabetes
- Obstructive sleep apnea
- Heart disease
You’ll take Mounjaro and Zepbound in similar doses. The maximum dose is 15 milligrams per week. You will start at a dose of 2.5 milligrams and adjust it over time to reach the desired effects. In addition to considering how it’s working, you’ll have to take any side effects into account.
Other Weight Loss Injections
Botulinum Toxin (Botox)
Unlike the others, botulinum toxin (Botox) isn’t a GLP-1 agonist. It’s a strong neurotoxin made by the bacteria Clostridium botulinum.
People use Botox cosmetically and therapeutically to treat facial wrinkles, migraine, spastic disorders, and other medical conditions. It works by temporarily paralyzing muscles.
People with obesity sometimes use it to help promote weight loss. But research on its effectiveness has been mixed.
A 2017 review of six clinical trials concluded that Botox didn’t help people with obesity lose weight.
A 2022 review of trials found the opposite - that people with obesity did lose weight after Botox injections in certain conditions. For example, diet management was an important factor. But the researchers noted that the trials were all relatively small.
Lipotropic, HCG, or B12 Injections
Some clinics promote injections like:
- Lipotropic injections (fat burners with B12 and amino acids)
- HCG injections (used with a very low-calorie diet)
- B12 injections (boost energy and metabolism)
However, these are not FDA-approved for weight loss and lack strong clinical evidence. Be cautious and speak with a qualified medical provider before trying these.
Effectiveness of Weight Loss Injections
The only FDA-approved stomach injections to help with weight management are semaglutide (Wegovy) and liraglutide (Saxenda). Neither has been extensively studied in people who don’t have overweight or obesity.
A 2022 literature review found that Wegovy worked best for weight loss compared with placebo and other antidiabetic medications. People also had greater weight loss with Wegovy than with Saxenda.
But that study didn’t include Mounjaro. Research from 2022 found that the low dose of tirzepatide (5 mg) was as effective as the 2-mg dose of semaglutide, but the higher doses (10 and 15 mg) were more effective.
But the comparison was indirect, as the two drugs weren’t studied head to head. Other researchers have identified a need for a direct comparison.
In the SURMOUNT-1 trial, adults with obesity or overweight (without diabetes) taking tirzepatide achieved up to 22.5% average body weight reduction at 72 weeks. Tirzepatide is a dual GIP and GLP-1 receptor agonist that suppresses appetite, improves satiety, and supports metabolic health. In addition to impressive weight loss, studies show improvements in cardiovascular risk factors and metabolic markers.
Clinical trials have shown that taking either semaglutide or tirzepatide can make you lose weight. But the first studies didn’t compare the two to each other. To look at this, one recent study looked at weight loss and side effects in adults who were overweight or had obesity. Some of them got tirzepatide while others got semaglutide. It turned out that people taking tirzepatide lost more weight than those taking semaglutide. This was true after 3 months and a year.
Side Effects and Risks
Side effects may differ depending on which injection you take.
In general, side effects of GLP-1 agonists include:
- Nausea
- Vomiting
- Diarrhea
- Dizziness
- Increased heart rate
- Headaches
- Stomach upset
- Infection
Botox injections are typically safe and without risk of serious side effects when used for weight loss. You may experience minor side effects like headaches. Rarely, people may have an allergic reaction.
See a healthcare professional right away if:
- You have severe abdominal pain.
- You have an allergic reaction, such as swelling in your eyes, mouth, throat, face, ankles, feet, or legs.
- You have problems breathing or swallowing.
- You have a fever, jaundice, or clay-colored stools.
Cost and Availability
Many things influence the price of weight loss injections, including your insurance plan. Some insurance companies won’t cover them unless prescribed for certain medical conditions. Since there are no generic versions yet, GLP-1 agonist injections can cost upward of $1,000 a month.
As of May 2023, costs for a typical monthly supply are as follows:
- Ozempic - $935
- Mounjaro - $1,023
- Wegovy - $1,349
Talk with a doctor and your insurance providers to see what options you have. Your insurance plan may need to approve the use of the medication before treatment to ensure coverage. Some drug manufacturers may also offer a temporary savings program, depending on your insurance.
Insurance coverage varies and will affect many patients’ choices about going on weight loss medications. GLP-1s are notoriously costly. The Kaiser Family Foundation estimates the annual net price of Wegovy at $13,600.
Who is a Good Candidate?
Weight loss injections are typically recommended for adults with:
- A BMI of 30+
- Or a BMI of 27+ with a related health condition like diabetes, PCOS, or high blood pressure
Your doctor may also suggest injections if you've tried other methods without success and need additional support.
Important Considerations
- Lifestyle Changes: Weight loss injections can help you lose weight, but they aren’t a magic fix. To maximize the benefits of weight loss injections, it’s essential to make healthy lifestyle changes.
- Eating a balanced diet - if you're less hungry and eating less food, you need to make sure your diet still has enough of the protein, vitamins and minerals your body needs. Eat a good balance of fruits, vegetables, wholegrains, lean meat, fish, pulses, and low-fat dairy foods.
- Staying physically active - research shows that weight-loss injections can lead to a loss of muscle mass as well as fat.
- Long-Term Use: GLP-1s are not meant to be stopped and restarted at will. The dosing for some of these includes a long ramp-up period-up to five months-to reach full dosage.
- Potential for Weight Regain: There is a potential to regain the lost weight, but those chances decrease when you work with a healthcare provider to transition off the medication safely.
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