The Skinny on Tirzepatide & Semaglutide

The Skinny on Tirzepatide & Semaglutide:

What is Medical Weight Loss?

Medical weight loss, or medically supervised weight loss, is a specialized weight loss program designed and overseen by healthcare providers. It typically involves a combination of dietary changes, physical activity, and medication.

Step 1: Our clinicians analyze every aspect of a patient’s health, including their medical history, symptoms and exercise/nutritional habits. (*while we do not require blood work for these consultations, we can discuss the need for ordering this and trending your metabolic markers if interested!)
Step 2: While not mandatory, it’s highly recommended each patient work with our Registered Dietitian to create an individualized plan with dietary recommendations and exercise suggestions to promote healthy lifestyle options for better, more sustainable results.

Which Interventions Help with Weight Loss?

Losing weight involves leading a healthy lifestyle, including eating healthy and working out regularly. However, sometimes these methods are not enough, and that’s where medications come in to give that extra push. Medications can be an effective aid in the battle against unwanted weight gain and chronic inflammation that can reduce longevity. They give you an added boost to help shed those extra pounds and increase your chances of success, especially if you’ve hit a weight-loss plateau. Here at Advanced Vitality HRT, we are pleased to offer the following options to help you live a happier, healthier and longer life:

Tirzepatide: A ‘first-in-class’ medication, this innovative medical option works by lowering glycemic levels, improving insulin sensitivity, reducing body weight by over 20% and enhancing lipid metabolism. Tirzepatide is a dual-receptor agonist that targets two hormones, GLP-1 and GIP, which play critical roles in regulating glucose and blood sugar levels. Tirzepatide’s success in achieving medical weight loss comes from its ability to suppress appetite and regulate blood sugar levels. It works by targeting two specific receptors in the body, which triggers the body to produce insulin and glucagon-like peptide 1 (GLP-1). GLP-1 hormones work by slowing down digestion and making people feel full for longer, leading to an overall reduction in calorie intake. Studies have shown that Tirzepatide can significantly improve weight loss. Additionally, the medication has been shown to improve other aspects of metabolic health, such as controlling blood sugar and reducing inflammation.

Semaglutide: Works by mimicking the effects of a hormone in the body that regulates blood sugar levels and appetite. This means that when Semaglutide is taken, it can help reduce feelings of hunger, leading to less food intake and weight loss. It has been shown to be particularly helpful for those who have struggled with losing weight through other methods, as well as those who suffer from health issues associated with weight gain and inflammation, such as diabetes and heart disease. Semaglutide works by targeting the GLP-1 receptors in the pancreas, brain and stomach. When these receptors are stimulated, they reduce appetite and slow down digestion. As a result, individuals snack and overeat less, which ultimately contributes to weight loss. Delayed digestion can also have additional benefits, such as improved blood sugar control, which is essential in managing diabetes. Semaglutide has also shown potential in reducing the risk of several health complications including heart disease, stroke, and even certain types of cancer. By promoting weight loss, Semaglutide can lead to better health outcomes and reduce the burden of chronic disease.

Peptides: Peptides are small chains of amino acids found naturally in the body. They play an essential role in various bodily functions, including growth and repair. When used in combination with a healthy diet and exercise program, peptide therapy can aid in fat loss, muscle growth and metabolism regulation. Peptides work by stimulating the release of human growth hormone, which helps speed up weight loss and improve body composition. Additionally, peptide therapy has been found to increase energy levels and reduce appetite, making it easier for patients to stick to a healthy lifestyle. Advanced Vitality HRT is pleased to offer multiple peptides.

Nutritional consulting: This form of consulting primarily focuses on creating a personalized nutrition plan that caters to the individual’s body type, medical history and lifestyle. A registered dietitian crafts a specialized meal plan that will help them achieve their weight loss goals while also ensuring they receive optimal nutrition. Nutritional consulting provides a holistic approach to weight loss that considers all facets of a patient’s health, making it an effective method for anyone looking to shed pounds in a safe and sustainable way.

How do side effects compare between Tirzepatide and Semaglutide?

Side effects are similar between tirzepatide and semaglutide, because they work in a similar manner. Stomach side effects like nausea, vomiting, and diarrhea are most common for both tirzepatide and semaglutide and can occur in over 50% of all patients.

Stomach side effects are usually transient and decrease over the first few months of treatment. Roughly 4% to 8% of patients in studies stopped treatment, usually due to stomach side effects like nausea, vomiting, and/or diarrhea.

Most reports of nausea, vomiting, and diarrhea occur when doses are being increased at the start of treatment. Here at Advanced Vitality HRT, our clinicians titrate the dose depending on your individual response, which may help to reduce stomach side effects with tirzepatide or semaglutide. We can also prescribe anti nausea medication which can help while your body is adjusting. Our registered dietitian can help guide food choices which can alleviate many gastrointestinal side effects.

These agents do not usually cause low blood sugar (hypoglycemia) unless they are combined with other medicines that may cause hypoglycemia like the sulfonylureas or insulin. It is important you let your clinician know all your current medications.

Serious Warnings

The labeling for both tirzepatide and semaglutide carry Boxed Warnings, the FDA’s strongest safety warning, for possible an increased risk of thyroid tumors, including cancer, which has been seen in animal studies.

Do not use these products if:

you or your family has a history of medullary thyroid carcinoma (MTC), or
if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Tell your provider if you have a history of pancreatitis, diabetic retinopathy (vision changes), hypoglycemia (low blood sugar), kidney problems, gallbladder disease, or an allergy to any active ingredients in the tirzepatide or semaglutide product.

Both tirzepatide and semaglutide can slow gastric emptying (which is slowed or stopped movement of food through your digestive tract). Tell your healthcare provider if you have a history of gastroparesis (slowed stomach motility).

In 2023, the FDA updated the side effects for tirzepatide and semaglutide to emphasize that an ileus, an intestinal blockage, has been reported as a possible side effect. The FDA cannot reliably determine how often this side effect occurs or if the drug actually caused the ileus due to the voluntary nature of the reports. Speak to your clinician about your risk for this side effect.

Also, tell your healthcare providers if you are scheduled for any procedures or surgeries where you may receive any type of anesthesia. It’s important to note that tirzepatide/semaglutide can slow down digestion, which will delay your stomach from emptying and an increased risk of complications under anesthesia. If you are taking tirzepatide/semaglutide, speak with your anesthesiologist or surgeon before undergoing any procedure that requires the use of anesthesia.

While you are taking these medicines, pay close attention to any changes in your mood, behaviors, feelings, or thoughts and call your healthcare provider right away if you have any changes to your mental health, feelings of depression or thoughts of suicide.

Semaglutide and tirzepatide may decrease the absorption of other oral medicines due to the delayed gastric-emptying effect. Check with your healthcare provider or pharmacist if you take other oral medicines.

The manufacturer of tirzepatide advises females using birth control pills to switch to a non-oral contraceptive method or add a barrier method of contraception (like a condom) for 4 weeks after you start treatment and for 4 weeks after each dose increase.

Potential Pitfalls of Tirzepatide and Semaglutide

LOSS OF LEAN BODY MASS

As weight drops significantly, it’s common to see a decrease in both lean mass (muscle and bone) and fat mass. Individuals using Tirzepatide/Semaglutide may experience some loss of lean muscle mass. However, our clinicians are equipped to explore strategies to minimize this loss. It’s crucial to team up with our registered dietitian to develop a comprehensive plan, incorporating dietary guidance and resistance training. This sets the stage for optimal outcomes. Now, let’s tackle the next potential challenge…

LOWER BASAL METABOLIC RATE

With significant weight loss often comes the assumption of some reduction in lean body mass, leading us to pitfall number two. When individuals stop using these medications, their basal metabolic rate decreases, resulting in fewer calories burned at rest. Despite being at a lower weight, their percentage of body fat and muscle likely declined. As a result, they may experience a resurgence of appetite and food intake, coupled with fewer calories burned at rest, leading to weight regain. Sometimes, this weight regain can surpass previous fat mass levels, making future weight loss even more challenging.

However, there are several antidotes to this pitfall. One option is for Tirzepatide/Semaglutide users to consider staying on the medication at a low dose for weight loss maintenance.

Additionally, focusing on a high-quality diet with sufficient protein intake while using these medications is essential. A nutrient-rich, protein-rich diet supports lean muscle mass and aids in weight maintenance.

Incorporating strength/resistance training into your routine can also be highly beneficial. This type of exercise helps counteract the reduction in muscle mass associated with significant weight loss and prevents a drastic decrease in basal metabolic rate. Remember, the more muscle you have, the more calories you burn at rest.

This is why we strongly advise working with our registered dietitian, especially at the beginning, to establish a solid foundation for nutrition and weight training. Together, we can ensure the best possible results.

SLOWED GUT MOTILITY

The speed at which food travels through our digestive system is crucial for various bodily functions, including digestion, absorption of nutrients, blood sugar regulation, and waste elimination. Tirzepatide/semaglutide works by slowing down gut motility, providing a beneficial effect during mealtime by allowing ample time for the breakdown and absorption of nutrients in the small intestine.

However, this slowed gut motility can sometimes lead to issues like constipation, akin to a trash buildup in our system. Regular elimination is vital for removing toxins from both internal biochemical waste and external exposures, reducing the risk of disease. Therefore, it’s essential to support your body’s elimination processes while on tirzepaitde/semaglutide.

Emphasizing a nutrient-rich diet, particularly rich in vegetables and plant fiber, is crucial. In some cases, supplementation may be necessary to maintain normal elimination. Although the impact of these medications on gut microbiota is not fully understood, GLP-1 may potentially reduce gastrointestinal inflammation and improve gut lining barrier function. However, slowed gut motility poses a risk for small intestinal bacterial overgrowth, which can cause symptoms like bloating and changes in stool quality.

While data on the exact effects of these medications on gut microbiota remains limited, adopting mindful eating habits such as chewing food slowly and supporting the production of digestive enzymes can aid in smooth digestion and help maintain microbial balance. So, chew your food well, ditch the multitasking, and savor each bite mindfully while using tirzepatide/semaglutide for optimal digestive health.

BOOMERANG HUNGER

The most critical challenge lies in averting the rebound hunger that often occurs when abruptly discontinuing these medications, especially after reaching higher doses.

For those utilizing these medications for short-term weight loss objectives, I recommend a gradual tapering-off approach. This allows your body’s natural balance mechanism, known as homeostasis, to adjust smoothly. Even when these medications are prescribed within appropriate clinical contexts, it’s essential to implement a comprehensive lifestyle plan when tapering off. It’s crucial to understand that they are intended for long-term treatment from the outset.

Never discontinue tirzepatide/semaglutide abruptly without the guidance and support of your clinician, alongside a structured lifestyle management plan in place. Smooth transitions ensure the best outcomes for your health journey.

Here at Advanced Vitality HRT, we encourage the use of medically supervised weight loss to assist our patient’s in reaching their goals, as well as improve inflammatory markers and internal health. We understand there is a lot of chatter in the news and social media regarding tizepatide/semaglutide, often times portraying these incredible medications in a negative way. We firmly believe the positive effects of these medications in not only enhancing a patient’s self confidence and body image but also their effects on lowering inflammation, maintaining a healthy body weight and improved internal health markers.