How Much Weight Can You Lose on Semaglutides? Board-Certified Obesity Doctors Explain

You might be familiar with—or even know someone who has seen remarkable weight loss results from—medications like Ozempic, Wegovy, Mounjaro and Zepbound. Perhaps you’ve wondered just how much weight you can lose with these drugs, and whether one is particularly more effective than the others. To understand their effectiveness, knowing how these medications work is essential.

“Weight loss medications (like Ozempic, Wegovy, and Mounjaro) target areas of the brain that regulate appetite and food intake,” explains Dr. Spencer Nadolsky, DO, WeightWatchers medical director and board-certified obesity and lipid doctor. These medications mimic the body’s natural GLP-1 (a hormone that regulates appetite and insulin release), which the body quickly breaks down to produce similar peptides and molecules that have a longer-lasting effect. “In other words, the effects of GLP-1 medications in the gut and brain work together to help the body feel less hungry and feel full faster with the amount of food consumed.”

Reena Bose, MD, a board-certified obesity medicine specialist at the Cleveland Clinic, notes that dual agonist weight loss medications like tirzepatide (Mounjaro and Zepbound) are more potent than single agonist drugs like Ozempic and Wegovy (different names for semaglutide), leading to greater weight loss. It’s called “dual-agonist” because it does everything semaglutides do, but it also works on GIP receptors, which helps patients avoid hypoglycemia (low blood sugar).

However, Dr. Bose also emphasizes the need to improve the “3 A’s” of these drugs: Access, affordability, and availability. Despite their effectiveness, the cost remains prohibitive for many, as most health insurance plans do not cover these medications, often leaving patients to pay out of pocket. “We really need to be our patients’ advocates by improving access and cost of these drugs so it is available to all our patients, across all demographics,” Dr. Bose states.

If you’re curious to learn which medication is the safest, most effective, and best suited to help you reach your goals, continue reading as these obesity medicine experts share their insights and the latest scientific findings and clinical trials.

How much weight can you lose on weight loss drugs like Ozempic?

“The new generation of these GLP-1 medicines can lead to an average of at least 15% weight loss with semaglutide, but can get to over 20% with tirzepatide,” explains Dr. Nadolsky.

Additionally, Dr. Bose points to specific results from the SURMOUNT TRIALS, noting that with Mounjaro and Zepbound, you can expect close to 22% weight loss, and with Wegovy, around 17% weight loss. She emphasizes that these results can be further enhanced when patients adopt healthy lifestyle changes surrounding diet, exercise, sleep, and stress management.

Do certain health conditions influence the choice of weight loss drugs?

Dr. Nadolsky shares the clinical preference for semaglutide in certain cases: “Semaglutide specifically has been shown to reduce major cardiovascular events, so if one has a history of cardiovascular disease, this medicine may be preferred. Tirzepatide is being studied for this but we do not know if it is helpful yet.”

For patients with hypoglycemia, Dr. Bose recommends Zepbound or Mounjaro. These medications are beneficial because they help prevent low-sugar episodes by aiding in releasing glucagon, which can increase blood sugar levels.

Dr. Bose also discusses recent findings: “There are results coming out of the SURMOUNT-OSA trial that Zepbound can help treat moderate to severe obstructive sleep apnea and sleep-related outcomes.”

Overall, both classes of drugs offer substantial benefits for patients looking to manage their chronic diseases through weight reduction and improve their overall quality of life.

Which weight loss drug is the safest?

“Both drugs are very safe. They have been FDA approved following clinical trials demonstrating their safety and efficacy,” says Dr. Bose.

Dr. Nadolsky adds insight into patient experiences, noting, “They have similar tolerability and safety profiles although clinically, we hear patients say they tolerate tirzepatide better. This may be due to the GIP component that has anti-emetic properties.” (Note: “Anti-emetic” refers to a substance that helps prevent vomiting.)

Both doctors acknowledge that the most common side effects include mild nausea, which typically diminishes within a few weeks, and constipation. However, in rare cases, severe nausea and vomiting can occur, leading to dehydration, which can be harmful to the kidneys. Incorporating healthy lifestyle habits such as eating nutrient-rich meals, ensuring adequate hydration, and staying active can help alleviate these potential side effects.

Patients are advised to always discuss these medications’ potential risks and benefits with their healthcare provider—the experts suggest that in some cases, the benefits will outweigh the risks.

Which weight loss drug will help me reach my weight loss goals?

“With the SELECT trial, we now have four years of data showing people tend to keep the weight off after they initially lose it with these medications as long as they keep taking it,” Dr. Nadolsky explains. “Most people who take GLP-1 weight loss medications will stop losing weight between 12 to 15 months. Having said that, some people may continue to lose weight even after 15 months, especially if they start and continue healthful lifestyle changes like increasing exercise.”

So, a really big determining factor in which medication will help you reach your weight loss goals quicker is the habits you incorporate while taking it:

• Change how and what you eat: Choose nutrient-rich foods to aid long-term, healthy weight loss. Adequate protein is key to feeling full, stabilizing blood sugar and keeping muscle. Fiber helps you stay full longer and eases constipation from medications. Lower-fat meals may reduce side effects.
• Add daily movement to your routine: While all exercise is beneficial as long as you avoid injury, strength and resistance training, such as weight lifting, Pilates, yoga and bodyweight exercises, helps preserve muscle during rapid weight loss. Muscle also leads to steadier metabolization of calories even when you’re resting.
• Stay hydrated: It’s crucial to drink enough water daily. This may be worth tracking in a fitness or nutrition app.

Dr. Bose also discusses the benefits of a multidisciplinary approach, where a dedicated team of professionals provides personalized treatment for each patient. This support includes registered dietitians, exercise physiologists and behavioral psychologists who manage various eating disorders, such as binge eating, overeating syndrome and emotional eating. They also collaborate with sleep physicians to enhance sleep quality and treat sleep apnea, helping optimize patient weight loss outcomes.

What to keep in mind

Before diving too deep into which weight loss drug will yield the quickest results or shed the most pounds, Dr. Nadolsky reminds us: “Just like life, your wellness journey isn’t linear—it’s filled with ups and downs, but that doesn’t mean you aren’t making hard-won progress.”

Rather than fixating on the scale, it’s important to acknowledge and celebrate your non-scale victories. He encourages, “Celebrate the healthier choices you make each day, the times you choose to be active and the moments you overcome cravings.”

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