Experts Say This Weight Loss Drug Is Better Tolerated By Patients Than Ozempic
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Zepbound was recently approved by the Food and Drug Administration (FDA) for weight loss in adults with overweight or obesity.
The injectable medication is expected to be available by the end of the year.
It’s not yet clear how much individual health insurance policies will cover.
Weight loss drugs exploded in popularity over the past year and now there’s one more to add to the mix. The Food and Drug Administration (FDA) just approved the injectable drug Zepbound (tirzepatide) for adults who have obesity or overweight. With more and more medications claiming to aid with weight loss coming to market, it’s normal to wonder: What is Zepbound?
Two randomized, double-blind, placebo-controlled trials (per the FDA) of 2,519 adults with obesity or overweight found that those who took Zepbound had a statistically significant reduction in body weight compared to those who took a placebo. The FDA also notes that those who took the highest dose of Zepbound in one trial lost an average of 18% of their body weight during the study. (Patients who had type 2 diabetes lost an average of 12% of their body weight.)
“Obesity and overweight are serious conditions that can be associated with some of the leading causes of death such as heart disease, stroke, and diabetes,” John Sharretts, M.D., director of the Division of Diabetes, Lipid Disorders, and Obesity in the FDA’s Center for Drug Evaluation and Research, said in a statement. “In light of increasing rates of both obesity and overweight in the United States, today’s approval addresses an unmet medical need.”
Meet the experts: Kunal Shah, M.D., an assistant professor in the division of endocrinology at the Rutgers Robert Wood Johnson Medical Center; Michael Russo, M.D., a board-certified bariatric surgeon at MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA; and Steven Batash, M.D., a gastroenterologist and leading physician at the Batash Endoscopic Weight Loss Center.
The approval is “very, very exciting,” says Kunal Shah, M.D., an assistant professor in the division of endocrinology at the Rutgers Robert Wood Johnson Medical Center. “It gives patients more options,” he adds.
Zepbound isn’t an entirely new drug (more on that in a moment), but it’s understandable to have questions about what this is and when people can have access to it. Here’s the deal.
What Is Zepbound and what does it do?
Zepbound contains tirzepatide and it’s an injectable medication that’s designed to be taken once a week to help with weight loss in adults who have obesity or overweight. Tirzepatide targets glucagon-like peptide 1 (GLP-1) agonists which stimulate the body to produce more insulin when blood sugars start to rise, along with something called glucose-dependent insulinotropic polypeptide (GIP) receptors, says Michael Russo, M.D., a board-certified bariatric surgeon at MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA.
Tirzepatide is already FDA-approved under the name Mounjaro, which is designed to help with blood sugar management in people who have type 2 diabetes.
“They’re the same thing,” says Dr. Russo. “Tirzepatide is just branded as Mounjaro for diabetes and Zepbound for weight loss.”
Zepbound is intended to be used along with a reduced-calorie diet and physical exercise for weight loss, the FDA says.
Side effects of Zepbound
All medications come with potential side effects, and Zepbound is no exception. “The medication acts on the gastrointestinal tract, and the side effects are largely gastrointestinal-related,” Dr. Russo says.
According to the FDA, those can include:
Nausea
Diarrhea
Vomiting
Constipation
Stomach discomfort and pain
Injection site reactions
Fatigue
Allergic reactions like fever and rash
Burping
Hair loss
Gastroesophageal reflux disease (GERD)
“Nausea is usually the most common side effect we see,” Dr. Shah says.
The FDA also notes that Zepbound causes thyroid C-cell tumors in rats, with the agency stating that it’s “unknown” if Zepbound causes these tumors in humans. However, the FDA recommends that Zepbound not be used in patients with a personal or family history of medullary thyroid cancer or in patients with Multiple Endocrine Neoplasia syndrome type 2.
But doctors say that patients typically have fewer side effects on tirzepatide than they do on semaglutide medications like Ozempic and Wegovy. “Some people who don’t tolerate Wegovy do much better on Mounjaro/Zepbound,” observes Steven Batash, M.D., a gastroenterologist and leading physician at the Batash Endoscopic Weight Loss Center.
When will Zepbound be available in the US?
Eli Lilly, which makes Zepbound, says the drug will be available in the US by the end of 2o23.
Will Zepbound be covered by insurance?
Eli Lilly has already shared the list price of Zepbound—$1,059.87—which is not cheap, particularly given that the medication is taken weekly. However, the company also said health insurance will typically lower the cost.
With insurance coverage, Eli Lilly estimated that people will pay as low as $25 for a one-month or three-month prescription. Those who have health insurance that doesn’t specifically cover Zepbound may pay $550+ for a one-month prescription, the company said.
If you have health insurance and want to know if Zepbound is covered under it, Dr. Russo recommends calling the number on your insurance card. “They should be able to give you a clear answer,” he says.
Just keep this in mind, per Dr. Shah: “There is usually a lag time from when these medications are FDA-approved and when they’re covered by health insurance.” Meaning, your health insurance company may cover Zepbound eventually, even if they don’t at the moment. Still, “if your insurance covers things like Saxenda or Wegovy, it will probably cover Zepbound,” Dr. Shah says.
Zepbound vs. Ozempic—How do they differ?
Ozempic (semaglutide) has gotten a lot of buzz for its weight loss potential, despite only being approved for the management of type 2 diabetes. (Its sister medication, Wegovy, is approved for weight loss, though.)
Zepbound is similar to Ozempic but has something additional, Dr. Russo says. Ozempic is in a class of medications known as glucagon-like peptide 1 (GLP-1) agonists, he explains. This mimics a protein in your own body called GLP-1 and activates GLP-1 receptors in your body, increasing the production of insulin, a hormone that helps escort blood sugar to your cells where it can be used for energy.
“It’s targeting two hormonal receptors instead of just one,” he says. “The benefit is increased weight loss.”
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