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Wegovy vs Trulicity: two GLP-1 medications, but which is best for weight loss?

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You’ve most likely heard of Wegovy® because of its success in helping patients lose weight. It may also be top of mind because of the newsmaking shortages its manufacturer, Novo Nordisk, has faced since the U.S. Food and Drug Administration (FDA) approved it in June 2021 for weight loss in those with obesity or with a Body Mass Index (BMI) 27 or greater with weight-related medical problems. 

Trulicity® is also a household name for many patients with type 2 diabetes or know of someone who does. Trulicity, which Eli Lilly manufactures, is FDA approved to treat those who have type 2 diabetes. But it’s also shown promising results for patients who use it off-label to treat overweight and obesity.

And, if Trulicity sounds familiar, you might also recognize other type 2 diabetes GLP-1 meds like Byetta® and Bydureon BCise® (exenatide), Victoza® (liraglutide), and Rybelsus® (semaglutide).  

When on a weight loss journey, it can be challenging to decipher the differences between medications and which one may be best for you for weight management. Let’s break things down between Wegovy vs Trulicity. Here’s what we know. 

What is Wegovy?

Wegovy is the brand name for the drug semaglutide. It’s FDA-approved for weight loss in adults with a BMI  of 30 or greater or a BMI of 27 or greater and a weight-related condition like high blood pressure, high cholesterol, or type 2 diabetes. 

Semaglutide is part of the glucagon-like peptide 1 (GLP-1) receptor agonist medication class. Wegovy mimics the GLP-1 hormone your body naturally makes, which helps regulate appetite and food intake. By controlling your appetite, Wegovy can help you manage how much food you eat and support weight loss.

What is Trulicity?

Dulaglutide is the active ingredient and generic name for Trulicity. It was FDA-approved in September 2014 for the treatment of type 2 diabetes. It’s also used off-label to treat overweight and obesity successfully. 

Like Wegovy, it’s part of the GLP-1 receptor agonist drug class. Trulicity works for weight loss by helping with satiety and stimulating the pancreas’s insulin secretion after eating to keep blood sugar levels stable. Along with appetite control, dulaglutide works by slowing digestion (stomach emptying), helping to make you feel fuller longer. 

Not only that, Trulicity is FDA approved to reduce the risk of adverse cardiovascular events, including death, heart attack, or stroke in people with type 2 diabetes and cardiovascular disease or multiple cardiovascular risk factors. 

Wegovy vs Trulicity: which is more effective for weight loss?

Truthfully, both medications have shown significant weight loss results when combined with lifestyle changes like a reduced-calorie diet and physical activity

But, when comparing the results of clinical trials of semaglutide and dulaglutide, those taking semaglutide lost more weight. For example, the results of a double-blind 68-week study of semaglutide published in 2021 in The New England Journal of Medicine found that of 1,961 patients, those given a weekly 2.4-mg dose of semaglutide lost an average of about 34 pounds or almost 15 percent of their body weight compared to about 6 pounds or nearly 2.5 percent in the placebo group.

In a randomized controlled Eli Lilly-funded dulaglutide study published in Diabetes Care in 2021, patients given 4.5 mg of dulaglutide (Trulicity), the highest dose in the trial, lost an average of about 10 pounds after 36 weeks of use. 

So, when measuring the two meds against each other, semaglutide (Wegovy) patients lose significant weight. Remember that Trulicity is currently only FDA-approved for type 2 diabetes, while Wegovy is FDA-approved for weight loss. This may be why we see substantial weight loss in Wegovy patients.

Wegovy vs Trulicity: side effects

Like many drugs in the GLP-1 receptor agonist family, the most common side effects for Wegovy and Trulicity are nausea, diarrhea, and vomiting. But, there are more serious side effects you should be aware of before taking them. Here’s what to look out for:

Wegovy side effects

Serious side effects:

  • Risk of Thyroid C-cell Tumors

  • Pancreatitis

  • Hypoglycemia

  • Hypersensitivity Reactions

  • Acute Kidney Injury

  • Severe Gastrointestinal Disease

  • Diabetic Retinopathy Complications

  • Acute Gallbladder Disease

  • Heart rate increase

  • Suicidal behavioral and ideation

Novo Nordisk also warns in its safety prescribing info that those who are pregnant or thinking about becoming pregnant in the next two months shouldn’t take Wegovy or those patients who are breastfeeding or planning to breastfeed.

Trulicity side effects

Mild side effects include nausea, diarrhea, vomiting, abdominal pain,  decreased appetite, indigestion, and fatigue.

Eli Lilly recommends following a few tips to help manage these side effects: 

  • Eat smaller meals.

  • Stop eating when full.

  • Avoid fat or fatty foods.

  • Try eating bland foods like toast, crackers, or rice.

Serious side effects: 

  • Risk of thyroid tumors 

  • Pancreatitis

  • Hypoglycemia

  • Severe allergic reactions

  • Acute kidney injury

  • Severe gastrointestinal problems

  • Changes in vision (diabetic retinopathy complications)

  • Acute gallbladder problems

Wegovy and Trulicity carry warnings that if you or any in your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or an endocrine system condition called multiple endocrine neoplasia syndrome type 2 (MEN 2), you should not take these drugs.

How are Wegovy and Trulicity taken?

Wegovy and Trulicity are subcutaneous injections—meaning under the skin. You’ll inject yourself in your upper arm, upper thigh, or abdomen once a week. Your doctor, pharmacist, or health care provider will walk you through exactly how and when to use med when you begin to take it.

The thought of a needle going into your skin is less than appealing, so rest assured, there were only a few reports of pain at the injection site when administering it, and most told their doctors that it was virtually painless.

Wegovy vs Trulicity: dosing schedules 

Wegovy and Trulicty have step-up dosing schedules that start you off at a lower dose and increase as your body shows it can tolerate it. 

Trulicity dosing schedule

The recommended starting dose for Trulicity is 0.75 mg once weekly. After four weeks, the dose can increase to 1.5 mg. Then, depending on tolerability and weight loss, the doses can  increase 1.5 mg every four weeks until you reach a maximum dose of 4.5 mg weekly.

Wegovy dosing schedule

The recommended starting dose for Wegovy is 0.25 mg once weekly. After four weeks, depending on tolerability and weight loss, the dose can increase to 0.5 mg, 1 mg for month three, 1.7 mg in month four, and 2.4 mg weekly in month five.

Do Wegovy and Trulicity cost the same?

Weight loss results aside, cost is one of the big differences between these drugs. Indeed, Trulicity has been around for almost a decade, allowing it the opportunity to funnel through trials and health insurance approvals. Because of this, many insurance companies cover a majority of the cost of Trulicity when prescribed as indicated. Expect your monthly co-pay to be between $0 and $30 if your insurance covers the drug. If you don’t have insurance, or it’s not covered, you’ll pay around $930.88 per month. 

On the other hand, Wegovy has a couple of hurdles when it comes to cost. First, it’s new, so there’s no generic option, so many insurance companies don’t cover any of the cost. Second, health insurance companies rarely cover obesity drugs. This lack of coverage is highly disappointing since obesity is a recognized disease. As such, we should have access to the meds we need to help treat this chronic condition—just as we would for depression or cancer. 

While the list price for Wegovy is $1,349.02 per package, which is a 28-day supply, Novo Nordisk asserts that most people don’t pay the list price because of Wegovy coupons it offers, and for some, there is some insurance coverage. 

Check your insurance coverage for Trulicity and Wegovy coverage before taking them to get an estimate on how much you may pay out-of-pocket.

Are there other medications you can take for weight loss besides Wegovy or Trulicity?

Yep. There’s the FDA-approved weight loss drug Saxenda® (liraglutide)—a GLP-1 that’s been around since 2014. Along the same lines, the GLP-1 diabetes drug Ozempic (semaglutide) is used off-label for weight management. But wait a minute, doesn’t Wegovy have semaglutide as its active ingredient? It sure does, just at a higher dose than Ozempic, so it works similarly.

But, if you’d like to try something new and don’t want to dip your toes into the world of GLP-1s just yet, you can try the first-line drug metformin. It also helps to control high blood Contentsugar and is the first most prescribed diabetes type 2 med. 

It comes from the biguanide drug class and helps reduce glucose production in the liver and improves insulin sensitivity. On top of that, metformin is an oral tablet, so it may be the right option if a pill is easier for you to take.

Trulicity vs Wegovy: which is better?

That depends. A few factors will determine your decision when choosing the best med for you. It first comes down to you and what works best. You may have side effects with one that you don’t have with the other and decide you prefer it, and it’s working for your goals.

Cost may also be a factor. If you don’t have insurance coverage, or the manufacturer coupons have certain restrictions, Wegovy may not be an option right now. That’s totally fine. You can also try different meds—you’re not married to one if it isn’t working.

Just let your health care provider know about your experience with new medications. Also, give them a full list of current meds or supplements and your complete medical history. That way, they're fully educated on any medical conditions when finding what’s right for you.

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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.

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