Mounjaro for Weight Loss

Are you curious to learn more about the medication Mounjaro for Weight Loss? If so, scroll down and learn more about Mounjaro!

What is Mounjaro?

Mounjaro is a novel medication created by Eli Lilly and Company that has been FDA-approved for the treatment of Type 2 Diabetes. It is a GLP-1 and GIP dual-agonist medication which makes it similar to but slightly different than other GLP-1 agonist medications, such as semaglutide (Wegovy, Ozempic, Rybelsus), liraglutide (Victoza, Saxenda), or dulaglutide (Trulicity). It was FDA-approved for the indication of Type 2 Diabetes in 2022. It is now gaining popularity for its off-label uses for weight loss. Following the SURMOUNT-1 Trial, there are increased efforts to get Mounjaro (Tirzepatide) approved by the FDA for obesity. It is a once-weekly pen injection that starts at a low dose that can be increased over time.

How Does Mounjaro Work?

Mounjaro works by mimicking two hormones naturally produced by the gut: GLP-1 and GIP.

GLP-1 stands for “Glucagon-like-peptide.” GLP-1 plays an important role in regulating blood sugar levels and appetite by stimulating the release of insulin from the pancreas, slowing down the rate at which food is absorbed from the gut, and reducing the production of glucose by the liver. GLP-1 also has a number of other beneficial effects on the body, including reducing inflammation, improving insulin sensitivity, and promoting the growth and survival of the cells in the pancreas that make insulin.

GIP stands for "glucose-dependent insulinotropic peptide," a hormone produced in the gut and secreted with GLP-1 when eating. For the most part, GIP increases the effect of GLP-1 on insulin secretion and blood sugar control when eating.

By mimicking these two hormones at the same time, they synergistically lead to the weight loss effects seen with taking Mounjaro. It decreases appetite and food cravings, improves insulin sensitivity, and lowers blood sugar levels.

Mounjaro also appears to have a significant anti-inflammatory effect on the body. There are GLP-1 receptors in a multitude of organs. When activated, they lead to a decrease in the amount of pro-inflammatory receptors as well as an increase of anti-inflammatory cells in the body. This anti-inflammatory effect is why Mounjaro is being studied for other inflammatory conditions, like Polycystic Ovarian Syndrome and Psoriasis.

Who Qualifies for Mounjaro?

The FDA has approved Mounjaro for the management of type 2 diabetes. Any patient with a diagnosis of type 2 diabetes may be eligible to start taking Mounjaro. Along with diabetes, Mounjaro has shown promise for patients with a few other conditions due to its anti-inflammatory effects of Mounjaro:

Mounjaro is currently being investigated for patients with nonalcoholic fatty liver disease (NAFLD/NASH), which may yield results that lead to FDA approval. A study published in 2020 looked at the effects of tirzepatide (Mounjaro) and dulaglutide (Trulicity) on liver enzyme levels for NASH in diabetic patients. They found that Mounjaro led to a significant decrease in liver enzymes compared to the placebo group (1)

Mounjaro may also have a benefit for people with Polycystic Ovarian Syndrome (PCOS). Though there are no clinical trials published on the use of Mounjaro in PCOS, scientists believe that the weight loss benefits, improvements in insulin sensitivity, and anti-inflammatory effects of Mounjaro may show us that it can benefit these patients as well.

Lastly, Mounjaro is also being studied for its use in treating Obstructive Sleep Apnea (OSA). A review article published in 2022 examined the potential benefits of GLP-1 agonist medications, like Mounjaro, for patients with OSA and other conditions. The article mentions that the benefit of GLP-1 medications on OSA is most likely due to the weight loss effects (2).

Mounjaro can also be used off-label for weight loss in patients who struggle with obesity. It must be noted that the best weight loss results are seen when Mounjaro is taken in conjunction with a calorie-restricted diet and regular exercise. If you have a BMI > 30 or a BMI > 27 with at least one weight-related comorbid condition (diabetes, high blood pressure, high cholesterol, or pre-diabetes), then you may be eligible for Mounjaro.

Can Mounjaro Be Used For Weight Loss?

Mounjaro has been gaining a lot of attention due to the weight loss side effects. This has led providers to start offering Mounjaro as an off-label prescription medication for those struggling with obesity. Mounjaro is being offered to diabetics and nondiabetics. But just how effective is Mounjaro for weight loss?

The SURMOUNT-1 trial was a significant clinical trial published in 2022 with over 2500 participants that looked at how effective Mounjaro (tirzepatide) was at managing obesity for non-diabetic patients (3). Mounjaro was given at different doses for a period of 72 weeks to groups of non-diabetic participants who were struggling with obesity. The participants were also enrolled in a calorie restriction diet (500 kcal/day), did 150 minutes of exercise per week, and had regularly scheduled with a dietician.

They found that after 72 weeks, each group taking Mounjaro showed significant weight loss compared to the placebo group. Participants saw a  15-20% change in weight from the start of the trial, with higher doses showing a greater change! This was compared to the placebo group, which only experienced a 3% change in weight. This showed us that the use of Mounjaro in combination with diet and exercise is very effective at treating obesity.

This trial opened a new horizon for Mounjaro. More and more studies are being done on Mounjaro for its use as a weight loss medication, so expect to see new data in the near future! You can learn more about Mounjaro for weight loss at our website at Mochi Health

Mounjaro vs Other GLP-1 agonists for Weight Loss

Mounjaro vs Wegovy/Ozempic/Rybelsus

Wegovy, Ozempic, and Rybelsus are diabetic medications that use the same component: semaglutide. They are both used for the management of diabetes and off-label use for obesity. Wegovy is FDA approved for the management of obesity, while the others are indicated for diabetes. Also, Rybelsus is an oral medication, while Ozempic and Wegovy are weekly injections.

How does Mounjaro compare to the semaglutide medications? A study comparing Mounjaro to Ozempic showed that Mounjaro had a more significant body weight reduction (3). Based on the study results, Mounjaro may have a more substantial effect on weight loss compared to the semaglutide medications. More studies that directly compare these excellent medications are needed to say for sure.  

Mounjaro vs Saxenda/Victoza

Saxenda and Victoza are both antidiabetic medications that use the component liraglutide. They also belong to the GLP-1 agonist family of medications for diabetics. Both medications are taken as daily injections.

For Mounjaro, the SURMOUNT trial was a big study that showed that Mounjaro can be used for weight loss in non-diabetics. For Saxenda and Victoza, another big trial called the SCALE trial published in 2015, showed that liraglutide, the component in Saxenda and Victoza, was also effective for weight loss.

When comparing the results of the SURMOUNT-1 trial for Mounjaro and the SCALE trial for Saxenda that were mentioned above, there appear to be some differences. Mounjaro has a more significant effect on weight loss when compared to Saxenda. Saxenda is also a daily injection, while Mounjaro is a weekly injection. In addition, a larger portion of the participants experienced a 5% or more significant change in body weight when taking Mounjaro compared to Saxenda. Again, it should be noted that the best results for both of these trials were seen when participants were also dieting and exercising regularly.

Mounjaro Side Effects

The most common side effects of Mounjaro reported in clinical trials include gastrointestinal symptoms such as nausea (25%), vomiting (8%), and diarrhea (18%) (3). These symptoms are more common in higher doses of Mounjaro; however, these side effects are often mild to moderate and usually resolved within a few days. You may also experience decreased appetite or food cravings, which assists with weight loss. If you begin to experience severe stomach problems with Mounjaro, then notify your provider as soon as possible.

If you are taking birth control medication, Mounjaro may affect the effectiveness of your birth control, so let your provider know if you are taking these medications. Not enough data suggests possible harm when taking Mounjaro while pregnant. Some animal studies may suggest it causes fetal harm, so Mounjaro should only be used if the benefits outweigh the harm of the condition it is intended to treat. You should not take Mounjaro while pregnant solely for weight loss since the weight loss side effects will not likely benefit you and have the potential to harm the fetus. If you are pregnant or plan on becoming pregnant, please discuss this with your provider before starting or continuing with Mounjaro.

Mounjaro Dosage and Administration

Mounjaro is a once-weekly injection that starts at a low dose of 2.5mg over four weeks. After four weeks, the dose may be increased to 5 mg, 7.5mg, 10 mg, 12.5mg, or 15 mg. If a dose is missed, try to take the missed dose within four days after the day you were supposed to take that dose.  

Mounjaro can be taken with or without food. It can be injected in the thighs, upper arms, or abdomen. It is important to switch injection sites after each dose.

Mounjaro Costs and Coverage

As of now, Mounjaro is only approved for use in type 2 diabetic populations, which can make it difficult to find coverage through insurance. You can call your insurance provider to see if Mounjaro is covered under your plan.

The average cost for a month's supply of Mounjaro can range from $900-$1000. Depending on your insurance plan, you may also be eligible for a savings card from the manufacturer, allowing you to pay as little as $25 per month for Mounjaro. Sometimes, your insurance plan may also request a prior authorization form. This will be faxed to your provider’s office, or if you are a member of Mochi Health, the Mochi Prior Authorization Team will handle the prior authorization request and keep you updated throughout the process.

There are also compound forms of Mounjaro that you can get at a lower monthly price. At Mochi Health, we send prescriptions to 3 compounding pharmacies we trust to ensure that all 3 have enough supply for our patients and cover as many of our states as possible for compounding. All of our pharmacies source bulk products from FDA-approved sources and are approved by the state board of pharmacy for compounding under 503A guidelines and sterile compounding (CGMP/USP797). Our pharmacy has a third-party test for efficacy, potency, stability (expiration dates), and contamination for every batch of samples. The FDA has ever sanctioned None of our pharmacies or any other government organization overseeing the safety of sterile compounding– and it was quite a selection process to find these!

We've been working with these pharmacies for a while and have a good relationship with them. For early patients on these medications between June and December, we ran a cohort study comparing the side effect rates and efficacy to brand-name commercially available versions. (ie. Compounded Tirzepatide vs Mounjaro)– Because we have a large population on these versions, we can continuously pull anonymized data from our EMR and compare outcomes to ensure the medications are the same. This is another reason we're partnered with multiple pharmacies– this affords us the ability to seamlessly switch patients from one pharmacy to the other based on supply chain issues

If you would like to know more about compound options for Mounjaro, check out our website at Mochi Health.

Mounjaro Contraindications and Warnings

Mounjaro should be avoided in certain populations at high risk of severe adverse reactions. These serious adverse reactions associated with Mounjaro therapy include:

Pancreatitis

Pancreatitis occurs when the pancreas becomes inflamed. This is a very rare but potential side effect of Mounjaro. If you have a history of pancreatitis, please let your provider know before starting Mounjaro.

Hypoglycemia (Low Blood Sugar)

Since Mounjaro is an antidiabetic medication that leads to an increase in insulin secretion, there is a risk that your blood sugar can be lowered to dangerous levels. This is known as hypoglycemia. If you have a history of hypoglycemia or are currently using insulin, you must inform your provider before starting Mounjaro.

Serious Allergic Reaction

There is a chance that you may experience a severe allergic reaction to Mounjaro when first taking it. Signs of a severe allergic reaction include swelling of your face, lips, tongue, or throat, problems breathing or swallowing, severe rash or itching, fainting or feeling dizzy, and very rapid heartbeat. Let your provider know immediately if you have experienced this with other GLP-1 medications or are currently experiencing this when taking Mounjaro.

Kidney Disease

Though Mounjaro is safe for people with kidney disease, the stomach problems associated with Mounjaro may lead to fluid loss by vomiting, nausea, or vomiting. If you do have kidney problems, it is very important to stay hydrated while on Mounjaro. If the gastrointestinal side effects of Mounjaro are preventing you from adequately staying hydrated, then let your provider know immediately.

Severe Stomach Problems

The most common side effect of Mounjaro is gastrointestinal upset, which includes stomach ache, nausea, diarrhea, vomiting, and loss of appetite. If these symptoms become so severe that they significantly affect your daily life or ability to eat regularly, then let your provider know.

Changes in Vision

For patients with a history of diabetic retinopathy, there is a chance that your vision can worsen when taking Mounjaro. If you do have a history of diabetic retinopathy, then let your provider know before starting Mounjaro.

Gallbladder Disease

Along with the other gastrointestinal side effects, Mounjaro can also cause some gallbladder issues. Since Mounjaro decreases the movement of food through the gastrointestinal system, it also reduces the function of the gallbladder. This can lead to gallstone formation, which can block the release of bile, leading to the inflammation of the gallbladder. If you have a history of gallstones or cholecystitis (inflammation of the gallbladder), then let your provider know before starting Mounjaro. If you have had your gallbladder removed in the past, then you can still take Mounjaro.

Thyroid Cancer or Family History of MEN-2

Though very rare, there is a risk of developing a specific type of thyroid cancer when taking Mounjaro, called Medullary Thyroid Cancer. If you have a history of medullary thyroid cancer or a family history of Multiple Endocrine Neoplasia Cancer Syndrome Type 2 (MEN-2), then let your provider know before starting Mounjaro. MEN-2 is a genetic cancer syndrome that puts a patient at risk for developing Medullary Thyroid Cancer, which is why patients with this syndrome should avoid taking Mounjaro.

Where Can I Get Mounjaro?

If you would like to learn more about GLP-1 medications or want to see if you might be eligible for medication-assisted weight loss, check out Mochi Health, where board-certified obesity medicine physicians can offer expertise in this realm!

Mochi Health is a virtual obesity medicine practice that connects you with medical providers, like licensed physicians and nurse practitioners, to help you optimize your weight loss journey. We provide monthly video chats with actual medical providers to provide guidance about weight management and to get you started on prescription weight loss medications to supplement your weight loss plan.

Frequently Asked Questions?

Check out our Mochi Health Blogs to learn about different topics on weight loss medications

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‍‍What is the best diet while taking Mounjaro?

‍‍Can Mounjaro lower my blood sugar?

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References

1. Hartman ML, Sanyal AJ, Loomba R, et al. Effects of Novel Dual GIP and GLP-1 Receptor Agonist Tirzepatide on Biomarkers of Nonalcoholic Steatohepatitis in Patients With Type 2 Diabetes. Diabetes Care. 2020;43(6):1352-1355. doi:10.2337/dc19-1892
2. Sultana R, Sissoho F, Kaushik VP, Raji MA. The Case for Early Use of Glucagon-like Peptide-1 Receptor Agonists in Obstructive Sleep Apnea Patients with Comorbid Diabetes and Metabolic Syndrome. Life (Basel). 2022 Aug 12;12(8):1222. doi: 10.3390/life12081222. PMID: 36013401; PMCID: PMC9410036.
3. Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, Kiyosue A, Zhang S, Liu B, Bunck MC, Stefanski A; SURMOUNT-1 Investigators. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022 Jul 21;387(3):205-216. doi: 10.1056/NEJMoa2206038. Epub 2022 Jun 4. PMID: 35658024.
4. Frías JP, Davies MJ, Rosenstock J, Pérez Manghi FC, Fernández Landó L, Bergman BK, Liu B, Cui X, Brown K; SURPASS-2 Investigators. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. N Engl J Med. 2021 Aug 5;385(6):503-515. doi: 10.1056/NEJMoa2107519. Epub 2021 Jun 25. PMID: 34170647.
5. Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, Lau DC, le Roux CW, Violante Ortiz R, Jensen CB, Wilding JP; SCALE Obesity and Prediabetes NN8022-1839 Study Group. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med. 2015 Jul 2;373(1):11-22. doi: 10.1056/NEJMoa1411892. PMID: 26132939.