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Chances are you've probably seen advertisements for drugs like Ozempic or Wegovy for weight loss. In fact, you probably even know someone who is taking one of them. So you may be wondering: what are they? Are they safe? And, perhaps more importantly, do they actually even work? Well, let’s get into it!
All these medications belong to a class of drugs called “GLP-1 receptor agonists” because they stimulate the Glucagon-Like Peptide-1 (GLP-1) receptor in the pancreas, which is a crucially important organ for regulating an individual’s blood sugar levels. Somewhat amusingly, these GLP-1 agonists were originally developed as a treatment for type 2 diabetes, since they stimulate an increase in insulin secretion (a hormone that lowers blood sugar) and a decrease in glucagon secretion (a hormone that counteracts insulin and raises blood sugar). However --and very serendipitously for the pharmaceutical companies-- it was subsequently discovered that one of the side effects of GLP-1 receptor agonists was weight loss! The pharmaceutical companies accidentally hit upon the proverbial jackpot.
Perhaps surprisingly, this type of accidental discovery happens all the time in pharmacology. A drug initially being developed for one purpose is found to have a “side effect” that may actually be more desirable than the original effect for which it was being developed. For example, sildenafil and minoxidil (better known by their brand names Viagra and Rogaine, respectively) both began their now-vaunted lives as failed blood pressure medications. So, too, with GLP-1 agonists.
While diabetes affects roughly 12% of the American population (certainly nothing to snub one’s nose at from a market opportunity perspective), the combined number of people who are either overweight or obese represent approximately 70+% of the American population -- and that is an almost irresistible siren call to the pharmaceutical companies to quickly repurpose those drugs as treatments for weight loss before the 20-year life of their patents expire!
In fact, the two brand name medications mentioned in the opening of this blog (Ozempic and Wegovy) are actually molecularly the exact same drug: semaglutide. It merely started being marketed to the general public as “Wegovy” once it received FDA approval to be sold as a weight loss drug versus an antidiabetic drug. Now, we must be clear: there is nothing necessarily wrong or untoward about marketing the same drug under a different brand name for treating different ailments (just check the variants of Excedrin!). One could even make the argument that it may be useful to help reduce potential confusion amongst consumers. Nevertheless, it is also useful for the informed consumer to know when the exact same thing is being marketed to them very differently under two different brand names intended to suggest the understanding that they are completely different products.
So, why even bring this up? The reason why it is important to understand this background information is because there are actually three prominent GLP-1 receptor agonist drugs currently on the market, and they all behave roughly in a similar manner: similar mechanism of action, similar effects, similar benefits, and similar undesirable side effects. These three drugs are liraglutide (name brands Victoza and Saxenda), semaglutide (name brands Ozempic, Rybelsus, and Wegovy), and tirzepatide (name brands Mounjaro and Zepbound). So far, only liraglutide and semaglutide have been approved by the FDA for weight loss, but tirzepatide’s FDA approval is likely only a matter of time. What’s notable at the present time is that liraglutide’s patent is set to expire in June of 2024, meaning that we can likely expect a much less expensive generic version to hit the market shortly thereafter.
Consequently, to be an informed consumer, it is worth considering how these three drugs stack up against each other to know which is the best optimization of costs to benefits. And, if one of them is about to considerably drop in price this year, how should that affect our decision matrix? So let’s compare these three GLP-1 receptor agonists!
