Semaglutide (aka Ozempic® and Wegovy®), a GLP-1 agonist, and tripeptide (aka Mounjaro® and Zepbound®), a combined GLP-1 and GIP agent, are the latest rage in weight loss medications approved by the FDA. They were originally developed for the management of type-2 diabetes. Since being approved for weight loss, there has been a huge demand for these medications, so much so that the pharmaceutical companies have not been able to meet the medical needs of the public. In the interest of public health and meeting patient demands, FDA has allowed these patented medications to be produced by designated sterile compounding pharmacies as discussed below. Both semaglutide, better known as Ozempic® and Wegovy®, and tirzepatide, marketed as Mounjaro® and Zepbound®, in many cases facilitate weight loss without effort.
Efficacy and Concerns for Compounded Semaglutide and Tirzepatide
The fact that the use of these drugs can be effective and mindless is both a blessing and a curse. Both semaglutide and tirzepatide are effective in facilitating weight loss by cutting hunger and cravings plus promoting a variety of favorable metabolic and physiologic changes in the body. They also target and burn belly fat, which is extremely desirable for both esthetic and health reasons.
Challenges in Maintaining Long-Term Benefits
A major problem with their use is that once the medications are stopped, both the cravings and the weight come back unless sustainable changes in day-to-day food selections and lifestyle have been implemented. Taking semaglutide or tirzepatide without instituting the changes that actually address the root cause of why people gain weight in the first place is like putting air in a flat tire that’s deflated because it has a nail in it. You can pump it up but unless you fix it, it will not hold air for the long term.
The Root Causes of Weight Gain
The root cause of why most people gain weight is a direct consequence of the everyday food choices they make. These choices are in effect the spark that ignites a cascade of physiologic changes and behaviors that trigger overeating and progressive weight gain. It is the weight gain or more accurately put, increase in body fat (the most dangerous being belly or visceral fat), that provokes a condition known as insulin resistance, causing insulin levels to rise in an attempt for the body to control blood sugar. Increasing insulin levels impairs our ability to burn fat while increasing fat production and storage, making it increasingly more difficult to lose weight and reverse the health consequences of being overweight.
Eligibility and Precautions for Using Compounded Semaglutide and Tirzepatide
Semaglutide and tirzepatide are excellent choices for many to help facilitate weight loss if deemed appropriate by an experienced medical practitioner. FDA guidelines are clear; in order to be eligible to take either medication you must have a Body Mass Index (BMI) of 30 or more, or alternatively have a BMI of 27 to 29.9 plus have a cardiometabolic risk factor such as hypertension, type-2 diabetes, high triglycerides or significantly increased abdominal girth to name a few.
Risks and Limitations of Compounded Medications
Unfortunately, because of public demand, many people who have a bona fide medical need for semaglutide or tirzepatide are unable to get them from their local pharmacy. Currently, both medications are on FDA’s national shortage list. This enables physicians and other licensed medical practitioners to prescribe and dispense them when they are produced and provided by sterile compounding pharmacies.
Navigating the Compounded Medication Landscape
Not all compounding pharmacies and practitioners follow current standards of care and best practices as recommended by FDA, CDC, World Health Organization and the Florida Board of Medicine. Many uninformed and way too often unscrupulous medical practitioners, weight loss centers and compounding pharmacies have taken advantage of the huge demand for semaglutide and tirzepatide and have been selling them as a commodity without following the guidelines set by FDA, CDC and the Florida Board of Medicine. As a consumer, it is nearly impossible to become aware of these recommended best practices, let alone evaluate who’s compliant and who’s not. Consequently, many people who fall victim to these unscrupulous practices are unnecessarily putting themselves at risk.
Practical Tips for Considering Compounded Medications
When considering compounded semaglutide or tirzepatide, exercise caution and consider the following: Get a full medical evaluation from a bona fide medical practitioner, preferably someone who specializes in medical weight loss or endocrinology.
Conclusion and Alternative Options
In summary, it’s best to select a trusted medical provider experienced in using these medications and ask lots of questions so you can make an informed decision about what is best for you.
