If you’re considering medication for weight loss, Glucagon-Like Peptide-1 (GLP-1) receptor agonists, such as Wegovy® and Trulicity®, have revolutionized the weight loss landscape. While both belong to the GLP-1 family, they have different primary purposes and effectiveness. Wegovy® is FDA-approved for weight loss, while Trulicity® is approved to treat type 2 diabetes and reduce the risk of major cardiovascular events in people with both type 2 diabetes and heart disease.
Understanding GLP-1 Receptor Agonists
Wegovy® and Trulicity® mimic a hormone your body makes called GLP-1 (glucagon-like peptide-1). This hormone regulates blood sugar, slows digestion, and signals your brain that you’re full, making it easier to eat less. Semaglutide (Wegovy®) and dulaglutide (Trulicity®) are medications that mimic a natural hormone in your body called GLP-1, which helps control blood sugar, slow digestion, and reduce appetite. Semaglutide is a synthetic analog, which means it’s almost identical to the GLP-1 hormone your body naturally makes. Because it’s such a close match, it fits really well into the body’s GLP-1 receptors and stays active for longer. Dulaglutide is a fusion protein, meaning it’s part GLP-1 and part of another protein (from an antibody) that helps it last longer in the body. It still activates GLP-1 receptors, but the way it’s built makes it a bit bulkier and less targeted than semaglutide.
Key Differences: Active Ingredients and Manufacturers
While both Wegovy® and Trulicity® are GLP-1 receptor agonists, they have different active ingredients: semaglutide for Wegovy® and dulaglutide for Trulicity®. Wegovy® is made by Novo Nordisk, while Trulicity® is produced by Eli Lilly-two pharmaceutical companies with long-standing expertise in diabetes care and metabolic health. Novo Nordisk is also behind Ozempic® and Rybelsus®, both of which contain semaglutide, the same active ingredient found in Wegovy®.
FDA Approval and Primary Uses
While both Wegovy® and Trulicity® can be used for weight loss, only Wegovy® is FDA-approved for that purpose. Wegovy® is FDA-approved specifically for weight management in adults who have a BMI of 30 or above or 27 and above with at least one weight-related condition, like high blood pressure or high cholesterol. Trulicity (dulaglutide) is indicated as an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients 10 years of age and older with type 2 diabetes mellitus and to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes mellitus who have established cardiovascular disease or multiple cardiovascular risk factors.
Weight Loss Efficacy
Research shows that semaglutide has a stronger effect on appetite suppression and calorie reduction than dulaglutide. Wegovy achieves greater weight loss (around 15%), while Trulicity provides modest HbA1c reductions (1-1.5%). In comparison, research has shown that dulaglutide leads to weight loss of around 4-5% of body weight after one year. Randomised controlled trials have shown that Wegovy can lead to an average weight loss of around 16% after one year. Clinical studies show people lose around 15% of their body weight in just over a year with Wegovy®. Weight loss with Trulicity® tends to be more modest.
Read also: Choosing Between Trulicity and Victoza
Administration and Dosing
Wegovy® and Trulicity® are both once-weekly injections delivered via a prefilled pen. Like many medications in their class, they follow a step-up dosing schedule, meaning the dose is gradually increased over time.
To take Wegovy®, you’ll inject yourself once per day on the same day each week. Your doctor will start you at the lowest dose (0.25 mg) and will increase it to keep you losing steady weight as tolerated from 0.5 mg, 1 mg, 1.7 mg, to 2.4 mg. To take Trulicity®, you’ll inject yourself once a week on the same day each week, just like Wegovy®. Trulicity® comes in several doses: 0.75 mg, 1.5 mg, 3 mg, and 4.5 mg.
Common and Serious Side Effects
Since Wegovy® and Trulicity® are both GLP-1 receptor agonists, they share many of the same side effects. The most common ones are related to how these medications slow down digestion, which can cause symptoms like nausea or bloating. Most people experience mild to moderate side effects when they begin taking Wegovy® or Trulicity® or when adjusting to a higher dose. Nausea, diarrhea, and other digestive issues are common when starting either medication. These side effects usually get better as your body adjusts to treatment.
Both Wegovy® and Trulicity® have an FDA-boxed warning about a potential risk of thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). This risk has only been observed in animal studies, and it is unclear if it applies to humans. Pancreatitis - Symptoms include severe abdominal pain that may spread to your back, with or without vomiting. Low blood sugar (hypoglycemia) - Symptoms include dizziness, shakiness, blurred vision, rapid heartbeat, and feeling jittery. This is more common in people taking additional diabetes medications. Kidney problems - Dehydration from diarrhea, nausea, or vomiting can worsen kidney function. Allergic reactions - Swelling of the face, lips, tongue, or throat, difficulty breathing or swallowing, or a rapid heartbeat could indicate a severe allergic reaction.
Costs and Insurance Coverage
The costs of these medications can differ depending on factors like list price, pharmacy choice, and your insurance coverage. Understanding how much Trulicity® or Wegovy® might cost is an important step in choosing the right medication for your health journey.
Read also: Using Trulicity for Weight Management
Trulicity® (dulaglutide): The list price is around $987 per month, regardless of dose. It’s possible it will be covered for type 2 diabetes, but it’s rarely covered for weight loss. Wegovy® (semaglutide): The list price is about $1,349 per month, and coverage can vary significantly. If you don’t have insurance coverage, you can get it through the NovoCare® Pharmacy program for $499 per month.
Switching Between Medications
Yes, you can switch between Wegovy® and Trulicity®-but you’ll need to work closely with your healthcare provider to make sure the transition is safe and effective. When you’re switching medications, it’s totally normal to notice your body reacting a bit differently. Maybe your energy shifts, your appetite changes, or you feel full more quickly than usual. Some people need a little time to settle into a new routine. Your doctor will work with you to come up with a plan that makes sense for your health, your goals, and your past experience with these medications.
Considerations When Discontinuing Medication
When you stop taking them, the effects of appetite suppression and blood sugar regulation go away, and weight regain is common. Weight regain can happen: People tend to regain a portion of the weight they lost. Side effects: Some might experience side effects that are tough to manage, like persistent nausea or digestive issues. Reached their goal weight: Those who have reached their goal weight might also be considering stopping. To help maintain all the progress you’ve made, be sure to work with your doctor to taper off the medication slowly. Cost is too high: Others may face insurance or affordability challenges, especially if they’re taking the drug off-label for weight loss. If cost is an issue, be sure to check for any manufacturer discounts or savings programs.
GLP-1 medications aren’t just about the number on the scale-they support long-term metabolic health, and stopping abruptly can make it harder to maintain the progress you’ve worked so hard for. That’s why pairing medication with a sustainable approach to nutrition and behavior change is so important.
Contraindications and Warnings
Both medications carry a boxed warning for an increased risk of thyroid cancer. Animal studies showed that these medications could lead to thyroid tumors, including medullary thyroid carcinoma (MTC). Both medications have also been linked to acute pancreatitis. If pancreatitis is suspected, treatment should be stopped. In addition, both drugs can cause kidney problems, so it’s important to monitor kidney function regularly, especially in those with existing kidney issues.
Read also: The Truth About Trulicity for Weight Loss
The Role of Lifestyle Changes
Weight loss is primarily influenced by eating foods that are lower in calories along with exercising regularly. It’s true that weight loss medications can help your body burn extra calories; however, they can also cause some side effects. As a consequence, these medications are typically used in conjunction with other weight loss behaviors rather than as a sole weight loss technique.