A Simple Guide To Understand Weight Loss Medication
So many confusing terms …
Table of Contents
Some certain diabetes medications have established themselves almost as “miracle cures” for rapid weight loss and are therefore used by both diabetics and non-diabetics for weight reduction.
Have you also been gripped by curiosity? Once you get into the subject, you often come across names like Ozempic and Wegovy or other diabetes or weight loss medications. You may wonder what a drug class is and how it relates to GLP-1 receptor agonists, and why that should even matter to you.
With all these different terms, it is often difficult to understand the connections between them and most importantly the effects of these medicines on your own body.
But no worries – it’s actually not that difficult.
What makes these terms so confusing?
Even after having some basic knowledge, it’s often difficult to understand how these terms are connected to one another.
You might have to look up almost every phrase to understand them, which often might make you give up on your search.
We would like to answer all these questions and explain the meaning of each term so that you don’t feel lost in this jungle of words.
Classes of drugs for diabetes management/ weight loss
Let’s Simplify the Terms You Encounter Every Day.
What is a drug class?
A class of drugs is a group of medicines that are alike. They work in the same way, have a similar chemical structure, and treat the same conditions. For diabetes management and weight loss, various classes of drugs are being used. Among the most common are GLP-1 receptor agonists, SGLT2 inhibitors, and DPP-4 inhibitors.
Drug class: GLP-1 receptor agonists
Or in simple terms: Gut hormone imitation with an “I’ve already eaten” signal
GLP-1 receptor agonists are a type of medicine that is currently getting a lot of attention in the news. This drug lowers blood sugar and reduces appetite by mimicking the natural hormone GLP-1, which is released by the gut after eating.
GLP-1 receptor agonists are a group of medicines currently receiving a lot of media attention. These drugs lower blood sugar levels and reduce appetite by mimicking the natural hormone GLP-1, which is released in the gut after eating.
The receptors for this hormone, GLP-1, are located in the brain. The hormone binds to these receptors in order to exert its effects in the body.
An agonist is a substance that binds to a cell’s receptor and sends signals. These signals are transmitted into the interior of the cell. Such an agonist can be a natural hormone or a synthetic version like the mimicked GLP-1 hormone. And the signal sent by the GLP-1 hormone can be, for example: “I’ve already eaten.”
The medication “tells” your brain that you’ve eaten — even if you haven’t. Since you don’t feel hungry, you end up eating less overall. And just like that, you lose weight.
Medicines Belonging to GLP-1 receptor agonists
Ozempic
Semaglutide
Wegovy
Semaglutide
Mounjaro
Tirzepatide
Saxenda
Liraglutide
Drug class: SGLT2 inhibitors
Or in simple terms: Super-filter in the kidneys with a stop signal — “You, sugar, are getting flushed out of the body.”
Sodium-glucose cotransporter-2 inhibitors = SGLT2 inhibitors are a type of pill.
They are not an appetite suppressant, but a way for the kidneys to stop the release of sugar back into the blood. This means that the extra sugar is passed out of the body in the urine, which lowers the blood sugar level.
This medicine can also help you lose weight and lower your blood pressure
A more detailed explanation:
Sodium-glucose co-transporter 2 inhibitors (SGLT2 inhibitors) are not appetite suppressants, but rather medications that lower blood sugar levels. Normally, sugar and other useful substances are reabsorbed by the kidneys and returned to the bloodstream, while waste products are excreted through the urine. SGLT2 inhibitors act like a filter, sending a stop signal to the body that blocks the reabsorption of sugar into the blood. Instead, the sugar is excreted in the urine. This lowers blood sugar levels.
However, since the body still needs energy and relies on blood sugar for it, it has to retrieve sugar (glucose) from its energy reserves — glycogen and fat. Fat is broken down in the process, which leads to weight loss.
In simpler terms:
You can think of the effect of SGLT2 inhibitors as similar to a microscopic filter:
Imagine you have a container filled with sugar water. In our example, you pour the sugar water through the filter, and the filter only lets the water through, while the sugar stays behind in the container and is then discarded.
SGLT2 inhibitors work like this filter in our body, ensuring that most of the sugar is excreted through the urine and doesn’t re-enter the bloodstream.
Drug class: DPP-4 inhibitors
Or in simple terms: Enzyme blocker that allows natural GLP-1 to be produced.
DPP-4 inhibitors are pills that lower blood sugar for people with type 2 diabetes.
Those are also no hunger suppression pills. They block (hence the name “inhibitor”) an enzyme called DPP-4, which breaks down special hormones called incretins.
These incretins aid the body in producing more insulin and reduce blood sugar levels after meals.
A more detailed explanation:
Or in simple terms: enzyme blockers that allow natural GLP-1 to be produced.
DPP-4 inhibitors are medications that lower blood sugar in people with type 2 diabetes. These medications only indirectly suppress hunger.
Inhibitor means: blocker/inhibitor/preventer.
DPP-4 is an enzyme that normally breaks down GLP-1 — and another hormone called GIP.
DPP-4 is found in the endothelium (the thin layer lining the inside of blood vessels) of many organs, as well as in the blood, and is also connected to T-lymphocytes of the immune system.
So, DPP-4 inhibitors block the enzyme called DPP-4, allowing the body to produce more of its own natural GLP-1. As we remember: one of the signals of the GLP-1 hormone might be, “I’ve already eaten.”
DPP-4 inhibitors only increase the body’s own gut hormones GLP-1 and GIP — and, as a result, insulin secretion in the pancreas — when carbohydrates have been consumed beforehand. Since more insulin is then released to reduce blood sugar, blood sugar levels decrease accordingly.
Interesting for (Pre-)Diabetics
Sugar that is not used in the blood — for example, for muscle activity or other energy needs — remains in the bloodstream. Normally, excess sugar is taken up by the body’s cells and either stored long-term as fat with the help of insulin, or short-term as glycogen in the liver and muscles. However, if too much sugar remains in the blood over time, it can have harmful effects on the body.
In people with type 2 diabetes, insulin regulation often doesn’t work properly. Due to insulin resistance, sugar stays in the blood instead of entering the cells. This leads to high blood sugar levels, which over time can damage blood vessels, nerves, and organs.
Active ingredients – the part of the medicine that actually works:
Now that we know about different drug classes for diabetes medication or weight control medication, let’s talk about active ingredients.
The active ingredient is the chemical in a medicine that makes it work. It interacts with the body to give the medicine its effects.
Popular weight control medicines like Ozempic, Wegovy, Mounjaro, and Saxenda use three different types of active ingredients.
Active ingredients belonging to GLP-1 receptor agonists: Semaglutide
Active ingredients belonging to GLP-1 receptor agonists: Tirzepatide
Active ingredients belonging to GLP-1 receptor agonists:Liraglutide
Let’s have a closer look at these three active ingredients – Semaglutide, Tirzepatide and Liraglutide
Tirzepatide, Semaglutide, and Liraglutide are popular active ingredients which are used for type 2 diabetes and sometimes for weight loss.
They belong to the class of drugs known as GLP-1 receptor agonists, but Tirzepatide also targets GIP receptors. GIP is gastric inhibitory peptide. GIP binds to GIP receptors on the cell membrane of the so-called beta cells of the pancreas and thus promotes the release of insulin.
Some general facts about the different actives
Semaglutide
Class: GLP-1 receptor agonist
Mechanism: Semaglutide mimics the effects of (GLP-1) hormone. It enhances insulin secretion, reduces glucagon secretion, slows gastric emptying, and curbs appetite.
Administration: Available as a once-weekly subcutaneous injection or as an oral tablet taken daily. The weekly form is more common for weight loss and diabetes management.
Uses: Primarily used for the management of type 2 diabetes and weight management in adults with obesity or overweight.
Efficacy:
Semaglutide is highly effective in reducing HbA1c levels, often comparable to or slightly less effective than Tirzepatide but more effective than Liraglutide.
Semaglutide also promotes significant weight loss, with patients typically losing around 15% of their body weight.
Additional benefits: Has demonstrated significant cardiovascular benefits in reducing major adverse cardiovascular events in patients with type 2 diabetes.
Side Effects: Known for its strong efficacy but also associated with gastrointestinal side effects, particularly when starting the medication. Nausea, vomiting, diarrhea, and constipation are frequent complaints after using the drug. Serious side effects can include pancreatitis and diabetic retinopathy.
Conclusion
Semaglutide is highly effective, especially for weight loss, and has an oral form (tablet), which can be more convenient for some patients.
Liraglutide
Class: GLP-1 receptor agonist
Mechanism: Liraglutide works similarly to Semaglutide by imitating GLP-1 to enhance insulin secretion, suppress glucagon, slow gastric emptying, and reduce appetite.
Administration: Available as a daily subcutaneous injection. Typically, treatment begins with a lower dose that is gradually increased to minimize gastrointestinal side effects.
Uses: It is used to manage type 2 diabetes, help with weight loss, and reduce heart disease risk in patients with type 2 diabetes.
Efficacy:
Liraglutide effectively lowers HbA1c levels but generally to a lesser extent than both Tirzepatide and Semaglutide. It is also effective for weight loss, though typically less so than Semaglutide and Tirzepatide. Patients often experience around 5-10% weight loss.
Side Effects Nausea, vomiting, diarrhea, and constipation are frequent complaints after using the drug. Serious side effects can include pancreatitis and gallbladder disease. Similar side effect profile but might cause fewer gastrointestinal issues compared to the higher doses of Semaglutide and Tirzepatide.
Conclusion:
Liraglutide is effective but generally not as strong as the other two options. However, it may have slightly fewer gastrointestinal side effects. Even though it causes less weight loss, it also has milder side effects, which makes it a popular choice.
Tirzepatide
Class: Dual GLP-1/GIP receptor agonist
Mechanism: Tirzepatide acts on both GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptors, enhancing insulin secretion, reducing glucagon levels, slowing gastric emptying, and decreasing appetite.
Administration: Available as a once-weekly subcutaneous injection.
Uses: Primarily used for the management of type 2 diabetes and weight management in adults with obesity or overweight.
Efficacy: Shown to significantly reduce HbA1c levels and promote substantial weight loss, often greater than that achieved with GLP-1 receptor agonists alone. Tirzepatide has demonstrated greater weight loss effects than both Semaglutide and Liraglutide, with some studies showing average weight loss of up to 22.5%.
Additional Benefits: Tirzepatide shows promising cardiovascular benefits, but long-term studies are still ongoing.
Side Effects: Generally well-tolerated, but can cause more significant gastrointestinal discomfort at higher doses. Nausea, vomiting, diarrhea, and constipation are frequent complaints after using the drug. Serious side effects can include pancreatitis and gallbladder disease.
Conclusion:
Tirzepatide is very effective for both blood sugar control and weight loss, often better than Semaglutide and Liraglutide, but it might cause more gastrointestinal issues.
Understanding different medicines
Now that we understand how these terms are connected, let’s take a closer look at different medicines which are used as diabetes medication and weight control medicines. Understanding the correct proper storage conditions can help you maximize the benefits of the treatments, because the medicine maintains its efficacy. Additionally, it can minimize side effects, which are detailed in the PMI (patient medication information).
Medicines belonging to the class GLP-1 receptor agonists
GLP-1 receptor agonists lower blood sugar and reduce appetite by mimicking the natural hormone GLP-1 released after eating. (“I have already eaten“ -signal)
- Helps lower blood sugar levels
- Effective for weight loss
- Reduces cardiovascular risks.
Frequency
Once weekly
Storage
Unused Ozempic pens must be refrigerated.
Once opened, they can be refrigerated or stored at room temperature (between 59°F to 86°F or 15°C to 30°C) for 56 days.
- Effective for weight loss
- Reduces cardiovascular risks.
Frequency
- once-a-week given under the skin.
Storage
Wegovy can be stored at room temperature (46°F to 86°F) for up to 28 days in an unopened carton.
After opening, store it below 30°C (86°F).
- Effective for weight loss.
Frequency
- Once per day, at the same time.
Storage
Keep your unused pen(s) in the refrigerator at 36° to 46° F (2°C to 8°C). The pen you currently use can be kept at room temperature (up to 59° to 86°F) (15°C to 30°C) for up to 30 days.
- Lower blood sugar levels in people with type 2 diabetes.
Frequency
- Once a week (gradually increases)
Storage
Store between 36 F to 46 F (2 C to 8 C).
Mounjaro can be exposed to temperatures up to 86 F (30 C), for no more than 21 days.
Medicines belonging to the class SGLT2 inhibitors
Super-filter in the kidneys with a stop signal — “You, sugar, are getting flushed out of the body.”
- Helps in treatment of type 2 diabetes.
- Helps discharge glucose through urine.
- Can also be used to reduce cardiovascular risks.
Frequency
Once daily (10mg)
May increase up to 25mg daily
Storage
Store JARDIANCE at room temperature between (20°C to 25°C)
- Similar to Jardiance, promotes glucose emission via the urine.
- Can also be used in heart failure and chronic kidney disease.
Frequency
- Once daily (5mg) (gradually increases)
Storage
- Store FARXIGA at room temperature between (20°C to 25°C).
Medicines belonging to the class DPP-4 inhibitors
Enzyme blocker that allows natural GLP-1 to be produced.
- Increases insulin production and reduces glucagon release after meals.
- To be taken orally.
- Controls blood sugar in type 2 diabetes.
Frequency
Once daily (100mg)
Storage
- Store at 20-25°C, tours permitted to 15-30°C
- Similar to Januvia, increases insulin secretion and reduces glucagon release.
- Oral intake.
- Used for type 2 diabetes.
Frequency
- Once daily (5mg)
Storage
- Store TRADJENTA at (15°C to 30°C).
Medicines commonly used for combination therapy
- Combination of basal insulin and a GLP-1 agonist.
- Used to enhance blood sugar control in type 2 diabetes.
Frequency
- Injection once a day.
Storage
- Store between (15°C – 30°C) or refrigerate at (2°C – 8°C).
- Combination of basal insulin and a GLP-1 agonist.
- Supports blood sugar control and promotes weight loss.
Frequency
- Once daily (5mg)
Storage
- Store your new pen at (2°C to 8°C)
- After first use, store below (30°C)
Ozempic: The Most Famous weight control medicine
Research shows that about 30% of people using semaglutide for weight loss are non-diabetic. They take it under brand names like Wegovy and Ozempic, which are mainly for diabetes but are now also used to treat obesity.
Ozempic is one of the most talked-about drugs today. The reason is: it was originally created to help people manage diabetes. This means it helps control blood sugar levels for people with type 2 diabetes.
Ozempic alternatives
Ozempic is viewed as one of the most popular weight loss medications available. However, there are also several alternatives to Ozempic that offer similar benefits.
We want to provide you with information about these alternatives so you can make an informed decision together with your doctor about which medication might best meet your needs.
Ozempic alternatives for diabetes
Rybelsus: Rybelsus is a pill approved by the FDA that contains Semaglutide. Unlike other diabetes drugs that need to be injected, Rybelsus is taken as a tablet. This makes it easier for people who don’t want injections. It’s active ingredient Semaglutide helps control blood sugar and aids in weight loss by acting like GLP-1 receptor agonists.
Ozempic alternatives for Weight loss
Wegovy
Wegovy is the first drug approved by the FDA for long-term weight management. It is given as an injection under the skin.Wegovy works by mimicking GLP-1 receptor agonists, which target the parts of the brain that control appetite and food intake. This helps people feel less hungry and eat less, making it easier to manage their weight.
GLP-1 Drugs: Usage Trend Development
Originally developed as a diabetes medication
GLP-1 receptor agonists (GLP-1 RAs) were first made to help people with type 2 diabetes. These medicines help control blood sugar by making the body release more insulin and reduce glucagon that raises blood sugar.
Emergence of Weight Loss Benefits
Over time, clinical studies and patient reports began to highlight an additional benefit of these drugs: significant weight loss. Because of this, more people started using them for weight loss, even though they weren't originally meant for that.
Growing Popularity
As the effectiveness of GLP-1 receptor agonists in weight loss became more widely recognized, their off-label use for this purpose has increased. Media coverage and celebrity endorsements have further enhanced interest and use.
Weight loss drugs usage trends
01
Global trend
According to The Lancet, over a billion people worldwide are dealing with obesity. As more people realize that obesity can lead to serious health issues, they are increasingly seeking effective weight loss drugs. This growing concern, especially in developed countries, is rapidly expanding the market for these medications. Initially, anti-obesity drugs weren’t widely used in medical practices. But now, their popularity is rising, with the U.S. leading the way. In 2022, Ozempic alone generated $8.5 billion in sales, with 65% coming from the U.S. Experts predict that the global market for obesity drugs could grow more than 15 times by 2030.
02
USA
According to the CDC, about 42% of U.S. adults are obese. A recent survey by the healthcare research group KFF found that around 12% of American adults have used popular weight loss and diabetes drugs called GLP-1s, with 6% still taking them. About the future consumption of these drugs, there are estimates that it will keep growing and could be worth $100 billion by the end of this decade. Analysts at Goldman Sachs predict that by 2030, almost 15 million U.S. adults will be using obesity medications.
03
Europe
Obesity and weight problems are rising in the EU, with 52.7% of adults being overweight in 2019. The anti obesity medicine market in Europe is growing rapidly. Valued at $2.5 billion in 2023, this market is expected to grow at a rate of 10.7% annually, reaching about $6.3 billion by 2032. In some European countries, the prescription rate for weight loss drugs has increased by over 30% in the last decade. This trend shows that more people are becoming obese and are increasingly open to using medicine to help manage their weight. The company behind popular weight-loss drugs like Wegovy and Ozempic saw record sales in 2023, boosting its market value to $508 billion.
04
Germany
In Germany, 46.6% of women and 60.5% of men are overweight, with 19% of adults classified as obese. Despite 23% of consumers showing interest in prescription weight control medicines, these medicines remain largely inaccessible. This gap presents opportunities for supplement brands to offer alternatives that mimic the effects of weight loss drugs.
05
Canada
Approximately 26.6% of Canadian adults, or about 1 in 4, are living with obesity. Additionally, around one million Canadians are currently using GLP-1 medications such as Ozempic for managing weight loss and Type 2 diabetes. According to a survey from Dalhousie University, 57.2% use it for diabetes, 27.2% for weight loss, and 11.6% for both. It’s estimated that 300,000 to 400,000 Canadians take GLP-1 for weight loss, and this number is expected to grow as much as what we would see in the United States.
06
UK
In England, over one in four adults (26%) is affected by obesity. The UK utilises Orlistat, Mounjaro, Saxenda, and the newly approved Wegovy as weight loss drugs. Ozempic is officially approved for treating type 2 diabetes, but more people are using it off-label for weight loss as well. Currently, NICE (National Institute for Health and Care Excellence) has recommended Wegovy for adults with weight-related health condition. However, due to limited supply and the initial rollout, only around 35,000 people are projected to have access to this medication in the near term (Health Media). Overall, while the exact number of people currently taking weight loss drugs in the UK isn’t specified, the government’s significant investment and the expected increase in availability suggest that usage will likely rise in the coming years (Med Xpress).
07
Austria
Forbes ranks Austria as the 52nd fattest country in the world, with 57.1% of the population being overweight or obese. This means that more than half of the adults in Austria have weight issues, creating a major health concern. Out of this group, around 900,000 people are obese, which is about 10% of the entire population. This high obesity rate is increasing the demand for weight loss treatments, including medication. Popular weight loss drugs in Austria include Orlistat, Liraglutide (Saxenda), and the newly approved Wegovy. Although there is growing popularity of weight loss drugs, it’s important to keep an eye on healthcare policies and market changes to understand how weight loss drug use will change in Austria in the future.
08
Denmark
In Denmark, the usage of weight loss drugs, particularly semaglutide (Ozempic®), has shown a significant upward trend in recent years. Initially, the rate of new users remained stable, with approximately 4 per 1,000 adult person-years between 2019 and 2021. However, this rate accelerated sharply, peaking at 10 per 1,000 in the first quarter of 2023 before experiencing a notable decline. By 2023, the total number of semaglutide users in Denmark had increased to 91,626. Interestingly, the proportion of new semaglutide users with Type 2 diabetes (T2D) changed significantly over time. In 2018, almost all new users (99%) had T2D, but by 2022, this dropped to 67%. It shows the drug was being used more for weight management rather than just for diabetes. However, in 2023, the percentage of T2D patients among new users increased again to 87%, showing that the drug is still mainly used for diabetes treatment. This trend shows how the use of weight loss drugs in Denmark has evolved.
09
Switzerland
In Switzerland, the need for weight loss drugs is rising as obesity rates increase. Although Switzerland has lower obesity rates than many other European countries, people are becoming more aware of the health risks of being overweight. Doctors in Switzerland are increasingly prescribing new weight loss drugs like Wegovy, which are popular for their effectiveness. The Swiss market for weight loss drugs is shaped by strict regulations and high standards. It ensures that only safe and effective treatments are available.
10
New Zealand
In New Zealand, about 34.3% of adults are considered obese. This is up from 31.2% in 2019/20. Liraglutide, phentermine, orlistat, and naltrexone + bupropion are drugs permitted to use for weight management in New Zealand. Recent studies show a significant rise in the number of people asking about weight loss medications at Medical Weight Loss Clinics. This demand has surged by 10 to 20 times compared to a few years ago.
11
Australia
In Australia, about 31% of adults are obese. The country has four approved medications for managing obesity: phentermine (Duromine), orlistat (Xenical), and liraglutide (Saxenda), a GLP-1 agonist that regulates appetite and fullness. A fourth GLP-1 agonist, semaglutide (Wegovy) has been approved for weight loss but isn’t yet available in Australia. These drugs, approved by the Therapeutic Goods Administration (TGA), play a key role in the country’s obesity management efforts.However, their accessibility can be limited by cost and availability.
12
The Netherlands
In 2023, 16% of adults aged 20 and older in the Netherlands were classified as obese. Additionally, about 1.1 million people in the Netherlands had diabetes in 2021, with more than 90% having type 2 diabetes. This high rate of diabetes is linked to obesity and has led to greater interest in weight loss treatments. The use of Semaglutide, the active ingredient in Ozempic, grew nine-fold over five years, reaching more than 100,000 users last year. Liraglutide, found in Saxenda, saw a three-fold increase to nearly 40,000 users.
13
Spain
In Spain, 22.9% of people are obese, and 39.4% are overweight. Despite these high numbers, only 32% of doctors think there are good prescription weight loss options, and 37% feel unsure about prescribing them because they lack knowledge. The weight management market in Spain was worth USD 145.57 billion in 2021 and is expected to grow by 9.5% each year, reaching USD 300.87 billion by 2030.
14
South America+ Latin America
In South America and Latin America, obesity is a growing issue, leading to higher demand for weight loss drugs. Although obesity rates are high, many people still have limited access to these medications due to economic and regulatory reasons. The weight management market is expanding as awareness of obesity’s health effects increases. However, access to weight loss drugs is uneven, and many doctors hesitate to prescribe them. To improve this situation, there needs to be more education and better access to effective treatments.
15
Portugal
In Portugal, 23.5% of adult women and 23.2% of adult men are living with obesity. These rates are lower than the regional averages, which are 25.3% for women and 24.9% for men. Despite having lower obesity rates compared to the regional average, there is a growing interest in weight loss drugs in Portugal.
16
Brazil
About 27% of adults in Brazil are obese, which is higher than the average for the region. This high rate of obesity is increasing the demand for weight loss treatments. In 2022, the market for weight loss drugs in Brazil was worth $1.54 billion and is expected to grow to $2.67 billion by 2030. This growth reflects the rising obesity rates and greater awareness of weight loss options. As more people look for effective treatments, the market is set to keep expanding.
17
Pakistan
In Pakistan, where 25% of the population is classified as obese, access to modern weight-loss medications is limited. This scarcity drives patients to seek anecdotal treatments and remedies, which may lack scientific backing. While some weight-loss drugs like Orlistat, Lorcaserin, and Liraglutide are available, many of the more recent and effective medications are not.
18
India
A recent study in The Lancet shows that 70% of people in urban India are obese or overweight, making it a serious obesity crisis. Now, India ranks third globally for the highest number of obese individuals, following the US and China. Right now, the only anti-obesity drug available in India is Novo Nordisk’s Rybelsus, a pill that has the same ingredients as Wegovy and Ozempic, but it’s less effective than these injectables. However, Indians can now also get Tirzepatide, known as Mounjaro and Zepbound in the US, which is used for both weight loss and diabetes.
This website is not meant to provide medical advice, diagnosis, or provide treatment. It is for informational and educational purpose only. We would like to encourage you to seek your primary care provider should you have medical concerns. The information provided on this website is not meant to be a substitute for a visit with a healthcare provider. Any comments made about specific products, medicines or treatment plans are not meant to diagnose, cure or prevent disease.
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