GLP Info Page

Important Quick Facts

• The *average* dose for consistent weight loss with Semaglutide is 1.5mg. The *average* dose for consistent weight loss with Tirzepatide is 7.5mg. That means 50% of people will lose weight at less than the average, and the other  50% of people will need higher doses, so don't be discouraged if you don't lose right away! Everyone's journey is different.

• If you have been on a GLP medication before, it is normal to not have as strong of a response when re-starting, depending on how high of a dose you were on previously and how long you have been off of the medication. Your provider can help you determine if you need to titrate up more quickly if you are unsure. 

• Being successful with weight loss on GLP medications, like anything else, requires diet modification and exercise for your best chance of success. These medications serve as a tool to help you, particularly with diet.

Tirzepatide & Semaglutide

Tirzepatide is a once-weekly injectable dual glucagon-like peptide 1 (GLP-1) receptor and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist. Semaglutide is a once-weekly injectable glucagon-like peptide 1 (GLP-1) receptor agonist. They work by increasing insulin production and lowering glucagon secretion as well as targeting areas in the brain that regulate appetite and food intake. A small change in the molecule allows the drug to last weeks in our bodies rather than the natural version our bodies make, which lasts minutes.

How They Work

• Delays how quickly the stomach digests food, leading to a feeling of fullness and satisfaction with smaller meal sizes.

• Slows intestinal motility so you will feel fuller longer after meals.

• Dual action receptors promote lowered blood sugars, in part by reducing the production of sugar in the liver.

• Stimulates insulin secretion by the pancreas.

• Decreases appetite by stimulating satiety in the hypothalamus.

• For tirzepatide, it is also a GIP receptor agonist. GIP has been show to improve pancreatic beta-cell function and improving insulin secretion after diet-induced weight loss. GIP helps increase energy expenditure, also resulting in weight loss.

Which one is right for me?

There are several factors to consider when choosing between Tirzepatide and Semaglutide:

• Effectiveness: in clinical studies, Tirzepatide has been shown to lead to more weight loss; however, some patients find the GLP agonism alone with Semaglutide is more effective for them (particularly with appetite suppression, although it should happen with both). 

• Side Effects: although the side effects between the two are very similar, some patients experience more side effects with Semaglutide, particularly GI side effects. 

• Cost: cost is certainly a reasonable factor to consider, as Tirzepatide is generally more expensive than Semaglutide, especially if you end up requiring higher doses.

If you are still unsure, your provider can help you decide on which one to choose. You can also switch between the two if needed later with your provider's guidance. 

How much weight will I lose?

The average weight loss is around 15-20% of starting body weight, but this could be less or more depending on several factors.

Who should not use it?

People with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia type 2 should not use the medication due to a possible increased risk of medullary thyroid cancer in this population. People with severe gastrointestinal disease should not use it. Pregnant or lactating women should not use tirzepatide. Women using oral contraceptives to switch to a non-oral contraceptive method or add a barrier method of contraception for 4 weeks after initiation and for 4 weeks after each dose escalation.

What are possible side effects?

The most common side effects include nausea, diarrhea, vomiting, constipation, abdominal pain, dyspepsia, injection site reactions, fatigue, eructation, hair loss, belching and gastroesophageal reflux disease. It can slow stomach emptying. Very rarely people have developed serious problems such as pancreatitis or bowel obstruction. It is important to stop the medication and seek evaluation by a doctor if you develop severe abdominal pain while taking the medication. The medication can increase the risk for low blood sugar in people with type 2 diabetes taking other medications that lower blood glucose.

How long do you stay on it?

People stay on the medication for different lengths of time as determined in discussion with your provider. The medication is safe for long term use. The medication should be held 1-2 weeks before a surgical procedure requiring general anesthesia.

What if I miss a dose?

If you miss a dose, you can typically inject it as soon as you remember. But if it’s been more than 4 days (96 hours) since your dose was due, skip the missed dose and inject your next dose at the usual time. You should not inject two doses at once to make up for a missed dose. Do not inject two doses within 3 days (72 hours) of each other. Doing so could raise your risk of side effects.

Important Resources

Your Self-Injection Guide is your key tool to help guide you with the self-injection process. A link is also included in all confirmation emails when you place your medication order. We encourage you to bookmark it or print it out if you would like.

The Patient Guide is also an important resource that goes over general procedures and information for LSH patients.

Provider Recommended Apps

Happy Scale - track your weight trends and set goals - Happy Scale smooths out your daily scale weights and makes insightful predictions about when you'll hit your goals.

MeThreeSixty - Weight is a one-dimensional number and doesn't give you the whole story. With the MeThreeSixty app you get a three-dimensional scan of your body over time.

Shotsy - This app allows you to log your weekly shots, track side effects, and view estimated concentration levels.

My Fitness Pal - All in one food, calorie, and exercise tracker.