If you’re considering medication-assisted weight loss, you’ve undoubtedly heard of GLP-1 receptor agonists—specifically, Wegovy® and Ozempic®. These brand-name medications for semaglutide have set off a media storm in the last year, fueling a wave of supply shortages and questionable prescribing practices.
If you’re skeptical about the hype, you’re not wrong. Not because these medications aren’t effective in promoting weight loss in some people but because the medication is just one part of a bigger puzzle that a health care professional must tailor to you and your unique biology. Otherwise, as the old adage goes, you’re throwing spaghetti at the wall with each medication to see if something sticks.
Don’t get us wrong—there are many reasons to be excited about drug innovations in the obesity and diabetes space. For instance, in 2014, the U.S. Food and Drug Administration (FDA) approved Trulicity®, the brand name for dulaglutide, to treat type 2 diabetes. Six years later, the FDA approved Trulicity to reduce the risk of adverse cardiovascular events like heart attack, heart failure, and stroke in adults with type 2 diabetes. Even though Trulicity has not been FDA-approved for weight loss, research by its manufacturer Eli Lilly found Trulicity patients with a body mass index (BMI) of 33 or higher taking the 4.5 mg dose lost an average of about 11 pounds in 52 weeks.
Health care professionals prescribe Trulicity off-label for weight loss for people with excess weight or obesity when they believe there’s good reason to consider this drug for weight loss.
But what does it mean to take Trulicity for weight loss? Found is an evidence-based weight loss clinic, and we’ve gathered all relevant information to help you make an informed decision with your medical provider.
Dulaglutide is part of the glucagon-like peptide-1 (GLP-1) receptor agonist drug class. These medications are unique because they mimic the GLP-1 incretin hormone in your body, which helps appetite regulation and blood sugar control. More than mimicking GLP-1, however, dulaglutide also works to slow digestion (stomach emptying), helping to make you feel fuller longer.
U.S. drug manufacturer Eli Lilly developed and brought Trulicity to market. In September 2020, the FDA approved higher doses of dulaglutide (3.0 mg and 4.5 mg), and the higher doses showed further body weight loss in patients and reductions in blood glucose levels.
Trulicity alternatives exist if you find this medication isn’t the right match for you. Other GLP-1 medications have shown promising results when taken for weight loss, too. But, non-GLP-1 medications are also available and are often the first medications health care professionals prescribe for weight management because they are widely available and cost-effective. Non-GLP-1 medicines can deliver weight loss results when prescribed as part of a personalized approach.
Clinicians prescribe Trulicity for weight loss in non-diabetics only off-label at the moment (it’s only FDA-approved to treat type 2 diabetes). However, research has shown it can be an effective tool for weight loss when combined with healthy lifestyle changes.
In 2014, the journal Diabetes Care published the results of a clinical trial of 1,098 patients with type 2 diabetes who took either a 1.5 mg or 0.75 mg dose of dulaglutide, 100 mg of sitagliptin (a drug used to treat type 2 diabetes by increasing the amount of insulin the body releases), or a placebo. The study found those who took even the lowest dose of dulaglutide lost weight. After 52 weeks, participants lost an average of about nine pounds on the 1.5 mg dose of dulaglutide.
Likewise, in a study published in 2021 in Diabetes Care, patients with type 2 diabetes with an average BMI of 34 who had failed the first-line diabetes drug metformin were given once-weekly dulaglutide (Trulicity) doses of 1.5 mg, 3.0 mg, or 4.5 mg for 52 weeks. The randomized controlled trial of 1,842 patients found that the 4.5 mg dose of dulaglutide was the most effective, and those who received the 4.5 mg dose had an average weight loss of about 10 pounds after 36 weeks.
This depends entirely on your unique biology. However, there is some promising research.
In a review of dulaglutide published in 2016 in the peer-reviewed journal Pharmacy & Therapeutics, researchers noted patients on dulaglutide lost about six pounds, which was “sustained over at least 26 weeks,” so it may take longer to achieve weight loss with dulaglutide.
A word of caution before you move on: Sustainable weight loss takes time and patience. Medications can be incredibly effective at helping with weight loss when they are part of a targeted treatment plan that also includes lifestyle changes. Your Found provider and health coach can tailor a program specifically for your needs.
Depending on your lifestyle, medical history, and weight history, many factors can influence whether Trulicity for weight loss is right for you.
How much does Trulicity cost?
The list price for a month’s supply of Trulicity is $930.88 when prescribed for those with type 2 diabetes. However, that is without any insurance coverage. Because Trulicity is a type 2 diabetes drug, many insurance companies cover it for that use.
Eli Lilly explains that, with insurance, 92% of Trulicity prescriptions cost between $0 and $30 monthly. Of course, how much Trucity costs you will depend on your insurance, area, local pharmacy prices, and availability.
Is Trulicity safe to take with other diabetes drugs?
Safety depends on the specific drug that may be used with Trulicity, whether studies have determined its safety when used with Trulicity, and what your doctor recommends. For example, metformin, the first-line type 2 diabetes drug, has been studied for use with Trulicity. Research has shown the combo increases the efficacy in lowering blood glucose levels.
But other GLP-1 drugs aren’t recommended for use with Trulicity because they can increase the risk of side effects or cause dangerously low blood sugar (hypoglycemia). Talk to your health care professional about other meds you’re currently on and any you’ve tried before considering weight loss with Trulicity.
Who shouldn’t take Trulicity for weight loss?
There’s not enough information or data on taking dulaglutide while pregnant or breastfeeding; talk to your doctor or obstetrician before taking Trulicity to see if its benefits outweigh the possible risks to the fetus or infant through breast milk.
People with a personal or family history of a specific type of thyroid cancer called medullary thyroid carcinoma (MTC) or with the condition multiple endocrine neoplasia syndrome type 2 (MEN 2) shouldn’t take Trulicity. Lilly also warns Trulicity “is not for use in people with type 1 diabetes and is not recommended for use in people with severe stomach or intestinal problems.”
What are the side effects of taking Trulicity for weight loss?
Your Found provider will supply you with all pertinent information on Trulicity before writing a prescription.
The most common side effects of Trulicity are:
Because Trulicity slows the digestion of food in your stomach, it can also cause some medications to be digested slower. This slowing may affect the absorption rate of some drugs, so you may not get enough of the medication into your system. The manufacturer says to keep your doctor up-to-date about your oral medications and be sure to monitor them to ensure they’re still effective.
Additionally, some serious side effects can occur when taking dulaglutide. Remember that while we mention these side effects, the chance of them ever happening is rare. These include:
Risk of thyroid C-cell tumors
Acute kidney injury
Severe gastrointestinal disease
Diabetic retinopathy complications
Acute gallbladder disease
Do other medications for weight loss have side effects?
Just as GLP-1s have side effects and risks, so, too, do non-GLP-1 drugs. Sitagliptin, which is sold as Januvia®, is not a GLP-1. The most common side effects of sitagliptin are upper respiratory tract infection, stuffy or runny nose and sore throat, and headache. It can cause serious side effects, including pancreatitis, which may be severe and lead to death. Before you start sitagliptin, tell your doctor if you’ve ever had pancreatitis. Kidney problems, sometimes requiring dialysis, have also been reported. Read more about this drug here.
Metformin is another non-GLP-1 medication used off-label for weight loss. The FDA has a “black box warning” on metformin as it carries a serious safety risk of lactic acidosis. This rare but potentially fatal condition causes a buildup of lactic acid in the blood. It can lead to low blood pressure, breathing issues, heart failure, and even death. Additionally, metformin can stimulate ovulation in those with PCOS or who are premenopausal and may increase the risk of unintended pregnancy. If you’re in a sexual relationship that can result in pregnancy, use at least one form of birth control unless you’re planning on getting pregnant. Read more about metformin here.
How to use Trulicity
Trulicity comes in a once-weekly prefilled injectable pen. Store the pens in the fridge between 36°F and 46°F. You’ll take your pen from the fridge, verify it’s not expired, inspect that it's damage-free, and wash your hands well. You’ll then uncap your pen, place and unlock your pen, then press and hold the button. To use the Trulicity pen, you and your health care provider will determine the best injection site. You’ll inject the weekly dose subcutaneously into your upper thigh, upper arm, or abdomen (stomach). The Trulicity pen then inserts the medication under your skin. Watch the full video on using your Trulicity pen here.
What is the dosing schedule for weight loss with Trulicity?
The recommended starting Trulicity dosage for weight loss is 0.75 mg once weekly. After four weeks, your provider may increase your dose to 1.5 mg. If you tolerate it, your physician may increase doses by 1.5 mg every four weeks until you reach a maximum dose of 4.5 mg weekly.
The data is promising: Trulicity is worth considering for medication-assisted weight loss. While the list price might deter some, if your insurance policy covers Trulicity, you might be able to pay very little for this potentially life-saving medication.
Research shows it’s important to incorporate lifestyle changes into your routine while taking any medication. Found leverages a powerful combination: physicians trained and certified in obesity medicine, health coaching, and a proprietary health assessment engine, MetabolicPrint. Our doctor-designed program will support you every step of the way to ensure your treatment is working with your body and not against it. Start your journey with us today.
GLP-1 prescriptions, filled through your local pharmacy, are now available as part of Found's weight-loss toolkit. While GLP-1s are effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a thorough evaluation of your medical history, eating behavior, lab work, and insurance coverage. If a GLP-1 is not appropriate for you, our providers will work with you to determine an effective medication for your health profile.
Found is among the largest medically-supported weight care clinics in the country, serving more than 200,000 members to date. To start your journey with Found, take our quiz.