Mounjaro: know the medicine used to lose weight – 04/14/2023 – Equilíbrio

In the last year, the injectable diabetes drug Ozempic has taken over TikTok, talk shows and newspapers, and people have been touting the good results of its off-label weight loss use. More recently, interest in Wegovy, a similar drug, but approved by [no Brasil e nos Estados Unidos] for weight control.

Another antidiabetic, Mounjaro, is now gaining attention and is being used by many people in the US off-label (ie, for an off-label purpose) to lose weight.

Some research has concluded that Mounjaro may be even more powerful than Ozempic or Wegovy in weight loss. A large study comparing these drugs found that using tirzepatide, its active ingredient, led to greater reductions in blood sugar levels and greater weight loss than other products.

But that study compared different doses of semaglutide and tirzepatide, making comparison difficult, says Dean Schillinger, professor of medicine and diabetes specialist at the University of California San Francisco. In addition, the study was sponsored by Eli Lilly, the drug’s manufacturer.

Mounjaro is currently FDA-approved for the treatment of type 2 diabetes only.

“Mounjaro is not a weight-loss drug,” reads the product’s official website, under a headline written in large purple letters and proclaiming that users have lost up to 25 pounds. But there is speculation that the FDA may soon authorize its use for weight management. Eli Lilly announced in October that the agency is accelerating the study and approval process for tirzepatide for obese or overweight adults.

Demand is already increasing: After a two-month shortage in US drugstores, Mounjaro is now back in stock, although many diabetic patients are still having difficulty getting hold of the product, says Andrew Kraftson, clinical professor in the division of metabolism, endocrinology and diabetes from Michigan Medicine.

He says he advises patients to call several pharmacies and that he has already been forced to adjust some doses to make the drug last longer.

“It’s frustrating for patients and it’s work for doctors”, he comments. As more people turn to Mounjaro for weight loss, the drug could overtake Ozempic in terms of sales and the attention it receives in the media.

“It wouldn’t be an exaggeration to say it’s a roaring success,” says Kraftson.

How does Mounjaro work?

Tirzepatide mimics the action of two hormones produced naturally in the body: glucagon-like peptide 1, or GLP-1, and glucose-dependent insulinotropic peptide.

Ozempic and Wegovy only mimic GLP-1, while tirzepatide mimics both hormones. Researchers believe that the reason tirzepatide is so effective at lowering blood glucose levels and inducing weight loss is that the two hormones it mimics work synergistically.

Like semaglutide, tirzepatide slows stomach emptying, making people feel fuller for longer, says Janice Hin Hwang, director of the division of endocrinology and metabolism at the University of North Carolina School of Medicine. Tirzepatide also inhibits hunger signals from the brain, suppressing appetite.

A paper presented at the American Diabetes Association conference in the summer of 2022 indicated that study participants who took tirzepatide and did not have diabetes lost up to 22.5% of their body weight after 72 weeks. For Robert Gabbay, scientific and medical director of the association, it is an expressive weight reduction, almost as effective as bariatric surgery.

It remains unclear, however, what the long-term effects of Monjauro might be. This is an urgent question, given that the drug needs to be taken continuously to get continuous results, says Akshaya Srikanth Bhagavathula, a postdoctoral fellow at the University of Arkansas who has studied tirzepatide.

Can Mounjaro be used safely to lose weight?

According to Bhagavathula, the use of Monjauro can cause more serious side effects than Ozempic or Wegovy, in addition to more significant weight loss. People who use the medicine often experience nausea, vomiting, diarrhea, and abdominal pain. In rare cases, use of the drug can result in kidney failure, pancreatitis, hypoglycemia and gastrointestinal bleeding, he says.

There is no robust research on how tirzepatide might affect people who don’t have diabetes or obesity. “We just don’t have enough data to inform people about the risk,” Schillinger points out.

According to Kraftson, Monjauro should be taken under close medical supervision, in part because there is a risk that extreme loss of appetite could lead to malnutrition and disordered eating. “We don’t want to make people anorexic,” she points out. “The goal is not to eliminate hunger completely.”

A representative for Eli Lilly said in a statement: “Monjauro is only approved for the treatment of type 2 diabetes in conjunction with diet and exercise.” Also according to him, “Lilly does not promote or encourage the off-label use of any of our medications.”

But experts warned that as more drugs like Monjauro and Ozempic continue to gain popularity for their weight-loss effects, the more diabetic patients will be affected by shortages of the drugs they need.

“We’re probably going to watch this same movie again,” says Gabbay.

Translated by Clara Allain