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Which GLP-1 Has the Least Side Effects
Beginning a journey to manage diabetes or pursue weight loss can feel overwhelming, especially with the wide range of treatment options available. GLP-1 agonists have gained attention as effective tools, helping many people achieve better blood sugar control and weight loss. Yet, it’s entirely natural to feel some hesitation about the potential side effects of these medications. You may have heard about side effects like nausea, vomiting, or diarrhoea, which might raise concerns as you consider your treatment plan. Remember, each person’s body responds differently to medications, and what may suit one individual may not work as well for another. This is why understanding the possible side effects of different GLP-1 agonists is so essential in finding the right fit for you.
In this blog, we will delve into the various GLP-1 medications available, compare their side effects, and discuss strategies for minimising discomfort. Our goal is to provide you with empathetic guidance empowering you to make informed decisions about your health. You are not alone on this path; together, we will explore ways to optimise your treatment while prioritising your comfort and well-being.
Comparing Side Effects of Different GLP-1s
1. Semaglutide (Ozempic, Wegovy)
What it is: Semaglutide, marketed as Ozempic for diabetes management and Wegovy for weight loss, has gained prominence due to its efficacy and positive impact on weight management.
Side Effects:
Common Side Effects
1. Gastrointestinal (GI)
- Nausea (most common, especially during the first few weeks).
- Vomiting, diarrhea, constipation, abdominal bloating, and gas.
- Loss of appetite, making it easier for patients to stick to calorie-restricted diets.
2. Fatigue and headache in the early phase of treatment.
Serious but Less Common Side Effects:
- Pancreatitis: Rare, but a known risk. Pancreatitis (inflammation of the pancreas) can occur in some users.
- Gallbladder Disease: Increased risk of gallstones, especially in individuals with existing gallbladder problems.
- Kidney Issues: There have been reports of acute kidney injury (AKI), particularly in patients who are dehydrated.
- Thyroid Tumors: Animal studies have shown a potential risk of thyroid cancer, although there is no definitive evidence in humans. However, semaglutide is contraindicated in individuals with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia type 2 (MEN2).
Scientific Data:
- GI Side Effects: A large phase 3 study found that semaglutide had a lower incidence of severe gastrointestinal side effects compared to liraglutide. However, nausea remains the most commonly reported side effect, especially in the initial stages.
- Tolerability: According to a study, semaglutide was associated with a lower rate of discontinuation due to side effects compared to other GLP-1 medications like liraglutide, making it better tolerated over the long term.
2. Liraglutide (Victoza, Saxenda)
What it is: Liraglutide, sold under the brand names Victoza for diabetes and Saxenda for weight loss, has been on the market longer than semaglutide.
Side effects:
Common Side Effects:
1. Gastrointestinal (GI):
- Nausea is the most common side effect and tends to be dose-dependent.
- Vomiting, diarrhea, and constipation may also occur.
- Abdominal pain and bloating.
2. Headache and fatigue are common, particularly during the first few weeks.
Serious but Less Common Side Effects:
- Pancreatitis: Rare but noted in some studies. Symptoms include persistent stomach pain, nausea, and vomiting.
- Thyroid Cancer: Studies in rodents have shown a potential link to thyroid tumors (particularly medullary thyroid cancer), but no direct correlation has been established in humans.
- Kidney Issues: Kidney problems, including acute kidney injury, have been reported in a small number of patients, particularly those with pre-existing kidney conditions.
Scientific Data:
- Nausea and GI Side Effects: A study reported that 40% of people on liraglutide experienced nausea during the first few weeks. However, this side effect typically improves after several weeks of use.
- Weight Loss vs. Semaglutide: A study compared liraglutide and semaglutide in terms of efficacy and side effects. The results showed that while both medications led to weight loss, semaglutide was more effective and had a lower frequency of side effects compared to liraglutide, particularly nausea and vomiting.
3. Exenatide (Byetta, Bydureon)
What It Is: Exenatide is a GLP-1 receptor agonist with both short-acting (Byetta) and long-acting (Bydureon) formulations available.
Side Effects:
Common Side Effects
- Nausea, vomiting, diarrhea, abdominal discomfort, and constipation.
- Injection site reactions are more common with Bydureon due to the long-acting formulation.
- Headache and fatigue are common, particularly with the short-acting (Byetta) version.
Serious but Less Common Side Effects:
- Pancreatitis: There is a risk of pancreatitis (inflammation of the pancreas), which is typically associated with a history of pancreatic disorders.
- Kidney Issues: Kidney damage or acute kidney injury has been reported in rare cases.
- Thyroid Cancer: Similar to other GLP-1 drugs, exenatide may have a potential risk for thyroid cancer (particularly medullary thyroid carcinoma), though this has not been definitively proven in humans.
Scientific Data:
A study found that Byetta was associated with more frequent nausea compared to other GLP-1 medications. The long-acting Bydureon was linked to fewer gastrointestinal issues but had an increased incidence of injection site reactions.
4. Tirzepatide (Mounjaro)
What It Is: Tirzepatide is a GLP-1/GIP receptor agonist that combines the effects of GLP-1 (glucagon-like peptide) and GIP (gastric inhibitory peptide). It is a newer medication available in the UK for managing type 2 diabetes and weight loss.
Side Effects:
Common Side Effects:
- Nausea, vomiting, diarrhea, abdominal pain, and bloating are common, especially at higher doses.
- Some patients report loss of appetite.
- Fatigue and headache.
2. Serious but Less Common Side Effects:
- Pancreatitis: Although rare, there is a risk of acute pancreatitis in some individuals.
- Kidney Issues: There have been reports of kidney-related problems, including acute kidney injury (especially in patients who are dehydrated).
- Thyroid Cancer: Tirzepatide may carry a theoretical risk for thyroid tumors, though this is based on animal studies and has not been confirmed in humans.
Scientific Data:
In the SURPASS trials, tirzepatide showed higher rates of gastrointestinal side effects compared to semaglutide, but these were generally temporary and resolved as treatment continued. Despite this, tirzepatide's weight loss results were remarkable, making it a promising treatment for those focused on both weight loss and glucose control.
Factors Affecting Side Effect Profile
The side effect profile of GLP-1 agonists can vary significantly among individuals due to several factors:
- Individual Variations: Sensitivity to medications can differ widely among patients due to genetic, metabolic, or health factors. For example, individuals with pre-existing gastrointestinal issues may experience heightened nausea.
- Underlying Health Conditions: Pre-existing conditions, such as a history of pancreatitis or thyroid disorders, may increase the risk of serious side effects. Patients with these conditions should discuss their medical history with their healthcare providers before starting GLP-1 therapy.
- Dosage and Administration: The starting dose and titration schedule can significantly impact side effects. For example, initiating treatment at a lower dose and gradually increasing it can help reduce gastrointestinal symptoms. Many providers recommend a titration schedule that allows the body to adjust to the medication, potentially improving tolerance.
Minimising Side Effects
Implementing strategies to manage side effects effectively can enhance the treatment experience for patients using GLP-1 agonists. Here are some practical approaches:
- Gradual Dose Escalation: Starting with a lower dose and gradually increasing can help mitigate side effects. For instance, beginning semaglutide at a low dose (0.25 mg) and gradually adjusting to a higher therapeutic dose can significantly minimise nausea.
- Dietary Adjustments: Patients may benefit from dietary modifications, such as eating smaller, more frequent meals to avoid overwhelming the digestive system. Avoiding high-fat, spicy, or heavy meals can also help prevent gastrointestinal discomfort.
- Hydration: Maintaining proper hydration is crucial, especially for patients experiencing nausea or constipation. Drinking adequate amounts of water can help alleviate symptoms and support overall digestive health.
- Lifestyle Modifications: Incorporating lifestyle changes, such as managing stress through mindfulness practices and ensuring adequate sleep, can improve well-being and potentially reduce side effects. Regular physical activity can also contribute to digestive health and overall wellness.
Consulting with a Healthcare Professional
Patients considering or currently using GLP-1 agonists should seek personalised guidance from healthcare professionals. A thorough discussion about potential side effects and management strategies can significantly impact treatment experiences.
Healthcare providers can tailor a treatment plan that considers individual factors, including medical history, concurrent medications, and lifestyle. This personalised approach ensures that patients maximise the benefits of GLP-1 therapy while minimising adverse effects.
Conclusion
While GLP-1 agonists such as semaglutide and tirzepatide offer substantial benefits for weight management and diabetes treatment, they also present potential side effects. Understanding the common and less common side effects associated with each medication is crucial for patients to make informed choices.
Consulting with a healthcare provider is essential to determine the most suitable GLP-1 medication for individual needs and effectively manage potential side effects. By prioritising health and making informed decisions, patients can navigate their treatment journeys successfully, achieving their weight management and diabetes treatment goals effectively.
If you are looking for personalised guidance, don’t hesitate to book a consultation with us at SheMed. We can help tailor a plan just for you.
References
- DeFronzo, R. A., & Triplitt, C. L. (2020). GLP-1 receptor agonists: A clinical perspective on glycemic control, cardiovascular benefits, and weight loss. American Journal of Medicine, 133(11S), S12-S22. https://pubmed.ncbi.nlm.nih.gov/33068776/
- Davies, M. J., Bergenstal, R., Bode, B., Kushner, R. F., Lewin, A., Skjøth, T. V., Andreasen, A. H., Jensen, C. B., & DeFronzo, R. A. (2015). Efficacy of liraglutide for weight loss among patients with type 2 diabetes: https://pubmed.ncbi.nlm.nih.gov/26371721/
- National Center for Biotechnology Information. (2022). GLP-1 receptor agonists in diabetes management. In StatPearls [Internet]. StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK603723/
- Frias, J. P., Davies, M. J., Rosenstock, J., Pérez Manghi, F. C., Fernández Landó, L., Bergman, B. K., ... & Cox, D. A. (2021). Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes. New England Journal of Medicine, 385(6), 503-515. https://pubmed.ncbi.nlm.nih.gov/34305810/.
- Pratley, R. E., Aroda, V. R., Lingvay, I., Ludemann, J., Andreassen, C., Navarria, A., & Viljoen, A. (2017). Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): https://pubmed.ncbi.nlm.nih.gov/28392927/
- Steinberg, W. M., Nauck, M. A., Zinman, B., Kwan, A. Y. M., Li, Y., & Schmitt, C. (2021). LEADER Trial Investigators. Liraglutide and the Risk of Acute Gallbladder or Biliary Disease in Patients With Type 2 Diabetes: https://pmc.ncbi.nlm.nih.gov/articles/PMC8017323/#:~:text=Liraglutide%20is%20associated%20with%20an,acute%20gallbladder%20or%20biliary%20disease.
- Nissen, S. E., Wolski, K., Feng, Q., Gyongyosi, M., Lüscher, T. F., Ruschitzka, F., & Muller-Wieland, D. (2016). https://pubmed.ncbi.nlm.nih.gov/27488824/
- Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., ... & le Roux, C. W. (2021). https://pubmed.ncbi.nlm.nih.gov/33397768/
- Kumar, S., & Tiwari, S. (2023). The safety and efficacy of GLP-1 receptor agonists for the treatment of obesity: a systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/36251836/
- Reynolds, J. J., Stowasser, M., & Thomas, C. J. (2023). Safety and efficacy of GLP-1 receptor agonists in patients with obesity and diabetes: https://pubmed.ncbi.nlm.nih.gov/37904345/
Mounjaro is a new medication developed by Eli Lilly that contains the active ingredient tirzepatide. It was originally designed to help people with type 2 diabetes manage their blood sugar levels. Mounjaro is administered as a once-weekly injection using a self-injection pen, typically into the abdomen, thigh, or upper arm. In the UK, tirzepatide (Mounjaro) has been approved for use by the Medicines and Healthcare products Regulatory Agency (MHRA).
Besides helping with blood sugar, Mounjaro has also been found to be very effective at helping people lose weight. This is why you might have heard it called a "weight loss jab" in the media.
- How you take it: You inject Mounjaro once a week. Your doctor will usually start you on a small dose and slowly increase it over time. This helps your body get used to the medicine and can lower the chance of you feeling sick.
How it Works:
Mounjaro is like a "twin hormone" medicine. It acts like two natural gut hormones, GLP-1 and GIP. These hormones help control blood sugar and appetite.
- It helps your body release more insulin when needed and lowers sugar from your liver, improving blood sugar control.
- It makes you feel fuller sooner and for longer, helping you eat less.
- Working on both GLP-1 and GIP is thought to be why it can lead to greater weight loss than medicines that only use GLP-1 (like Semaglutide in Ozempic/Wegovy).
What is it Used For?
- Type 2 Diabetes: Mounjaro lowers blood sugar effectively, often helping patients reach better levels (lower HbA1c). It's used alongside diet and exercise, sometimes with other diabetes medicines, typically when standard treatments aren't enough, especially if weight loss would help.
- Weight Management: In studies, people using Mounjaro lost a significant amount of weight, often averaging 15-20% of their body weight over about 1 to 1.5 years. It's approved for adults with obesity (high BMI) or those with a lower BMI and a weight-related health problem.
Access in the UK:
- NHS: Mounjaro is available on the NHS for type 2 diabetes if you meet certain criteria. For weight loss, NHS access is starting gradually through specialist clinics for adults with a very high BMI and multiple weight related health issues.
- Private: You can also access Mounjaro privately through weight loss clinics, pharmacies or online services like ours if you meet the medical criteria. SheMed operates a weight management programme specifically tailored for women, which includes the potential prescription of GLP-1 medications such as Mounjaro and Wegovy, provided the individual meets their medical criteria.
Mounjaro vs. Semaglutide (Ozempic/Wegovy):
Both are effective weekly injections. Semaglutide works on GLP-1 while Mounjaro works on both GLP-1 and GIP. Studies suggest Mounjaro may lead to slightly more weight loss on average. But choice of drug depends on a number of factors and is very individual.
Side Effects and Safety:
Common side effects are usually mild stomach issues (nausea, vomiting, etc.) that often improve over time. Because it affects appetite, you'll feel less hungry. If you take other diabetes medicines, your doctor might adjust doses to prevent low blood sugar.
Serious side effects are rare, but contact a doctor immediately for severe tummy pain, persistent vomiting, allergic reactions, or worrying mood changes.
Important Note: Mounjaro works best with healthy eating and exercise. If you stop Mounjaro, appetite and weight can return if lifestyle changes aren't maintained.
Check our healthcare support page to see if Mounjaro could be a suitable option for you based on your health needs and the latest criteria.
FAQs
1. How is Mounjaro administered?
Mounjaro is given as a once-weekly injection. Your healthcare provider will guide you on the correct dosage and administration technique.
2. Can I use Mounjaro if I’m pregnant or breastfeeding?
No, tirzepatide is not recommended during pregnancy or breastfeeding, as its safety in these situations has not been established. If you are planning to conceive or are breastfeeding, discuss alternative options with your doctor.
3. How long does it take to see results with Mounjaro?
While individual results vary, many users begin noticing changes within a few weeks. Maximum benefits are typically observed after several months of consistent use, alongside dietary and lifestyle adjustments.
References
- MotherToBaby. (2024). Tirzepatide (Mounjaro®, Zepbound®) - Mother To Baby | Fact Sheets. https://www.ncbi.nlm.nih.gov/books/NBK605070/
- Watanabe, M., & Hasegawa, Y. (2021). Tirzepatide in adults with obesity and type 2 diabetes. New England Journal of Medicine, 385(11), 1046-1056. https://doi.org/10.1056/NEJMoa2107519
- Kahn, S. E., & Florez, J. C. (2023). Tirzepatide: A dual GLP-1 and GIP receptor agonist for type 2 diabetes management. PMC, 11543192. https://pmc.ncbi.nlm.nih.gov/articles/PMC11543192/
- Kahn, S. E., & Florez, J. C. (2023). Tirzepatide once weekly for the treatment of obesity. New England Journal of Medicine. https://pubmed.ncbi.nlm.nih.gov/36751934/
- Nauck, M. A., & Quast, D. R. (2020). Glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide: A review of their roles in obesity and type 2 diabetes. Endocrine Reviews, 41(3), 1-24. https://pubmed.ncbi.nlm.nih.gov/32459834/
- Kahn, S. E., & Florez, J. C. (2020). Tirzepatide: A novel dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist for type 2 diabetes management. Endocrine Society. https://www.ncbi.nlm.nih.gov/books/NBK605070/
A groundbreaking clinical trial has revealed that Mounjaro (tirzepatide) leads to greater weight loss than its rival Wegovy (semaglutide), offering new hope for people struggling with obesity.
Head-to-Head Results: Mounjaro vs Wegovy
The study, presented at the European Congress on Obesity and published in the New England Journal of Medicine, compared the two most talked-about weight-loss injections. Over 72 weeks, participants taking Mounjaro lost an average of 20% of their body weight, compared to 14% for those on Wegovy. That’s a significant difference, especially for those with a lot of weight to lose.
Key Findings:
- 32% of Mounjaro users lost at least a quarter of their body weight, compared to 16% on Wegovy.
- Waistlines shrank more: Mounjaro users lost an average of 18cm from their waists, while Wegovy users lost 13cm.
- Health improvements: Mounjaro also led to better blood pressure, blood sugar, and cholesterol results.
- Similar side-effect profiles for both drugs.
- Women tended to lose more weight than men on both medications.
How Do These Medications Work?
Both Mounjaro and Wegovy help people feel full, reducing appetite and encouraging the body to burn stored fat. The key difference is that Wegovy mimics one appetite-control hormone, while Mounjaro targets two, which may explain its superior results.
Mounjaro and Wegovy: Availability and Eligibility in the UK
Both Mounjaro and Wegovy are available for weight management in the UK through both the NHS and private clinics. Here’s what you need to know about who can access them and how.
NHS Eligibility Criteria
Both medications are available on the NHS, but only for people who meet specific criteria:
- Adults with a BMI of 35 or above and at least one weight-related health condition (such as high blood pressure, cardiovascular disease, or osteoarthritis).
- Adults with a BMI of 30 or above who qualify for referral to a Specialist Weight Management Service (SWMS) and have not succeeded with other weight loss methods.
- Some groups, such as certain minority ethnic backgrounds or those with cardiovascular disease, may qualify with a BMI as low as 27.5.
Private Prescription Criteria
For those seeking treatment privately, the requirements are less strict:
- BMI of 30 or above, or BMI of 27 or above with a weight-related health condition or from certain ethnic backgrounds.
- Patients must complete an online or in-person consultation, including questions on weight, medical history, and current medications.
- New regulations require verification of identity and medical suitability, often with GP input or supporting records.
Estimated Monthly Costs
Customers seeking access to weight loss treatments like Mounjaro and Wegovy can conveniently receive private prescriptions through online clinics such as SheMed Healthcare. SheMed specializes in providing healthcare services tailored for women, including a dedicated weight loss programme.
Here is a breakdown of the programme's pricing:
- Starting Price: £99 for the initial dose.
- Includes: This initial cost covers a health screening, which involves a blood test to ensure the treatment is safe and appropriate.
- Subsequent Doses: Later doses are priced at £159 each.
Conclusion
This major trial confirms Mounjaro's significant edge over Wegovy, demonstrating superior weight loss and better health outcomes for individuals with obesity. Both medications represent powerful advancements in weight management and are available in the UK via NHS and private pathways, offering promising new options for those seeking effective medical treatment. If you have any questions about these medications or weight loss options, please visit the SheMed Support website for more information.