Friday Q&A: Mounjaro vs. Ozempic; forgetfulness; the snoring bed partner; & COVID testing

A cornucopia of subscriber questions! 🍁

ICYMI 👉

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• How to Manage Health Anxiety

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Question #1 (about Mounjaro) is free for everyone. Questions #2-4 (on forgetfulness, the snoring bed partner, & COVID testing) are for paid subscribers only.

Click here to submit your questions (about anything) for future Q&A posts!

Disclaimer: The views expressed here are entirely my own. They do not reflect those of my employer, nor are they a substitute for advice from your personal physician.

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QUESTION #1: MOUNJARO VS. OZEMPIC

What are your thoughts on Mounjaro? -Gail

Hi Gail,

Mounjaro is the trade name for tirzepatide. It is a weekly injection that, like Ozempic, is FDA-approved as a treatment for type 2 diabetes. Mounjaro contains two active ingredients: 1) a glucagon-like peptide-1 (GLP-1) that is similar to the active ingredient in Ozempic and Wegovy, and 2) a glucose-dependent insulinotropic polypeptide (GIP) receptor agonist, an intestinal hormone that stimulates insulin secretion and helps the body recognize and use circulating insulin.

Recall that insulin is a hormone that tells our cells to take up glucose (sugar) from the blood. Type 2 diabetes is a condition that occurs when this process does not work properly (i.e. “insulin resistance”), which leads to an increase in blood sugar.

Note that Mounjaro’s first cousin, called Zepbound, is FDA-approved for treating obesity without diabetes as of November 8, 2023.

On the other hand, Ozempic and Wegovy are trade names for semaglutide. Semaglutide is in a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists. Ozempic is FDA-approved for the treatment of type 2 diabetes. Wegovy is FDA-approved as a treatment for obesity without diabetes. 

The GLP-1 of semaglutide is a hormone that stimulates insulin secretion from the pancreas after consuming carbohydrates. GLP-1 receptor agonists also have other effects, including promoting satiety (feeling full), leading to less eating and weight loss. A groundbreaking new study (the SELECT trial) showed that weekly semaglutide helps reduce the risk of stroke, heart attack, or death in adults who have risk factors for heart disease. This is big news.

The upshot? All four drugs (Ozempic, Wegovy, Mounjaro, Zepbound) improve insulin sensitivity, reduce blood sugar and hemoglobin A1C levels, and promote weight loss. The side effects are similar and, if they occur, tend to be mostly gastrointestinal (e.g., nausea, indigestion, constipation, etc.). What are the key differences? Mounjaro and Zepbound generally are more effective than Ozempic and Wegovy (which are also highly effective, especially when used appropriately and under medical supervision), however the side effects of Mounjaro and Zepbound tend to be more significant. 

These drugs are very sophisticated but are not a panacea. In my experience, the patients who do best with these medications are the patients who 1) pair the medication with a high-protein, high-fiber diet, 2) hydrate well, 3) get regular movement/exercise, specifically strength training, 4) don’t fall into the trap of not eating regularly or enough, and 5) have managed expectations of what a medication can and cannot do for complex medical problems like obesity and diabetes.

There is so much misinformation about these drugs it can be difficult to know who to trust! So, for more information and individualized guidance, I suggest seeing your physician. I hope that helps!

Photo by Eric Tompkins on Unsplash

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QUESTION #2: FORGETFULNESS

I blank on the names of very familiar things (a flower, a bird, a street name) maybe once or twice a day and then remember it an hour or a day later.  Is this anything I should be concerned about—the start of dementia—or normal aging? My memory otherwise is fine. But I worry. -Suzen