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Thank you for listening to The Peptide Podcast. If you enjoyed the show and want to support what we do, head over to our Partners Page. You'll find some amazing brands we trust—and by checking them out, you're helping us keep the podcast going. Today we’re diving into a topic that’s been everywhere lately: GLP-1 medications like semaglutide and tirzepatide for weight loss. You may know them by names like Wegovy, Ozempic, Mounjaro, or Zepbound. I want to give you a clear, realistic picture of what to expect—because while the media loves to highlight the dramatic before-and-after photos, the real journey can be slower and more nuanced for some. So in this episode, we’re going to talk about the truth—what these medications can do, what they can’t, how long things really take, and what you need to know to set yourself up for success. Not hype, not magic promises—just real, honest insight to help you understand the process. Let’s get into it. How GLP-1 & GIP/GLP-1 Agonists Work So first things first—how do these meds work? Semaglutide is a GLP-1 receptor agonist, and tirzepatide is a dual GIP and GLP-1 receptor agonist. Basically, they mimic natural hormones in your body that help regulate blood sugar, slow digestion, and—most importantly for weight loss—reduce appetite and improve satiety. That means you feel fuller faster and stay full longer. You're not obsessing over food like before. And that’s powerful. But—and this is a big one— these peptides don't magically erase years of weight gain overnight. What they do is help make weight loss easier by reducing hunger and supporting your metabolism—but they don't do all the work for you. It’s important to remember they're a powerful tool, not a replacement for your efforts. You're still in control of your choices, habits, and long-term success. Why We Titrate the Dose—and What "Therapeutic Dose" Means Now, let’s talk about dosing. When you start Wegovy, you don’t start at the highest dose. It’s gradually increased over several weeks to give your body time to adjust and to help reduce side effects like nausea or stomach upset. The usual schedule looks like this: You’ll start with 0.25 mg once a week for the first month. Then it increases every four weeks—0.5 mg, then 1 mg, then 1.7 mg. By week 17, most people reach the full dose of 2.4 mg once a week—that’s the dose shown in studies to lead to the most consistent weight loss, with many people losing around 15% of their total body weight over about a year. But here’s the thing—not everyone follows this path exactly, and that’s okay. Some people need to slow down or stay longer at a lower dose if they’re having side effects. Others may need to increase sooner if they’re not seeing appetite changes and are tolerating the medication well. And even though 2.4 mg is considered the “therapeutic dose,” not everyone needs to reach it. Some people feel great and lose weight at a lower dose—and if that’s you, that’s your sweet spot. The real goal is to find the lowest effective dose that controls your hunger, helps you lose weight at a steady pace, and keeps side effects to a minimum. This isn’t a one-size-fits-all journey, and pushing through side effects just to hit the max dose isn’t necessary—or safe. Your best dose is the one your body handles well and helps you make progress. *How Much Weight Can You Expect to Lose—and How Fast? Let’s take a look at the clinical studies. In large trials, people on semaglutide lost about 15% of their total body weight over 68 weeks. For tirzepatide, it was even higher—20% or more in some cases. But here’s the thing—those results happened over a year to a year and a half. Not 6 weeks. Not 3 months. It’s a marathon, not a sprint. Also, most of the weight loss doesn't happen during the titration phase. You may see some weight loss early on, especially if your appetite plummets. But the bulk of the weight loss happens once you reach and maintain your therapeutic dose. Why Everyone’s Journey Looks Different I can’t stress this enough—everybody’s journey is different. Some people feel zero hunger from their very first injection. Others don’t notice a big change until week 10 or 12. Some drop 10 pounds in the first month. Others lose two pounds and feel discouraged. All of those experiences are normal. Your age, hormones, medications, stress levels, sleep, and past diet history? They all play a role. And let’s be real—gaining 20, 50, or 100 pounds didn’t happen in a few weeks, right? It likely took months or even years of lifestyle habits, hormonal shifts, emotional eating, or underlying conditions. So we have to give ourselves that same grace and patience when we’re trying to take the weight off—even with medical support. Navigating Side...

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The 2 minute update looks at a randomized trial comparing tirzepatide and semaglutide for weight loss. Which one helps patients lose more weight? We don’t see studies like this one often – pharmaceutical companies rarely fund head-to-head trials with competitors’ medications. But the manufacturer of tirzepatide sponsored this study. It’s a randomized open-label trial that included 751 adults, 65% of whom were women. Mean age was about 45, and mean BMI was 39.4. They excluded anyone with diabetes. They were randomized to weekly subcutaneous tirzepatide or semaglutide. The dose was titrated up to the maximum dose, or less depending on side effects. Treatment was for 72 weeks. The primary outcome was total percentage weight loss. Those on tirzepatide lost an average of 20.2% of their starting weight, while those on semaglutide lost 13.7% of their weight. They also evaluated what portion of patients lost a certain percentage of weight, such as 15% or 20%, and more patients on tirzepatide were in every one of those categories. Of course, GLP-1 agonists come with adverse events. Overall, about 78% of patients experienced an adverse event, and the rates were similar in both groups. But only 6.1% of the tirzepatide group and 8.0% of the semaglutide group stopped due to adverse events. Weight loss from semaglutide changed obesity treatment dramatically in recent years, and now the results with tirzepatide are even better. Unfortunately, cost is a big barrier, and it does not appear that prices will come down anytime soon. Reference: Aronne et al. Tirzepatide as compared with semaglutide for the treatment of obesity. NEJM 2025 May 11; Online ahead of print If you would like more updates like this, subscribe to our channel above, or sign up for our email newsletter at https://cmevacations.com/ For more information on future Hospital Medicine or Outpatient Medicine CME conferences, head to www.CMEvacations.com utm_source=YouTube&utm_medium=link&utm_campaign=2min.

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