Zepbound a game changer? A look at weight management’s new weapon

Imagine a future where managing weight becomes less of a struggle and more of a sustainable lifestyle change. This future has now become a reality, with the FDA’s approval of Eli Lilly and Company’s Zepbound, promising a revolutionary approach to chronic weight management. This new treatment represents the company’s commitment to addressing complex health challenges with advanced therapeutic solutions — Zepbound is set to offer hope to millions of Americans battling obesity and related conditions.

Zepbound was approved in November 2023 for overweight and obese adults. For those with an initial body mass index (BMI) of 30 kg/m² or greater, Zepbound offers a promising new option for weight management. Additionally, individuals with a BMI of 27 kg/m² or greater, or those who have weight-related comorbidities such as hypertension, dyslipidemia, type 2 diabetes mellitus, obstructive sleep apnea, or cardiovascular disease, can benefit from Zepbound. Used alongside a reduced-calorie diet and increased physical activity, Zepbound aims to help patients achieve and maintain a healthier weight, improving overall wellbeing and quality of life.

Zepbound works by activating receptors for two hormones, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), which are secreted from the intestine. Zepbound then boosts insulin production and decelerates the digestive process. The rise in insulin reduces blood sugar levels, while the slower digestion enhances feelings of fullness and decreases food consumption, making weight loss more achievable for individuals who have struggled with traditional diet and exercise alone. This drug is injectable and taken once a week.

In two large scale placebo-controlled trials, Zepbound has demonstrated robust effectiveness. These studies involved over 3,400 participants who showed significant weight reductions after 72 weeks. Patients taking 5 mg, 10 mg, and 15 mg doses of Zepbound experienced substantial weight loss compared to a placebo, with many achieving at least a 5% reduction in body weight. 

In a larger Zepbound trial of adults without diabetes, participants on the highest dose lost an average of 18% of their body weight, starting from average body weight of 231 pounds and BMI of 38 kg/m². In adults with type 2 diabetes, those on the highest dose lost 12% of their body weight, starting from average body weight of 222 pounds and BMI of 36 kg/m². These results highlight Zepbound’s significant potential for weight management in both diabetic and non-diabetic populations.

Before the introduction of Zepbound, drugs like Ozempic and Wegovy were the go-to options for weight loss and diabetes management. However, Zepbound brings a new dimension to the table. While Ozempic and Wegovy are single-agonist drugs that primarily activate the GLP-1 pathway to reduce appetite and control blood sugar levels, Zepbound is a dual-agonist drug.

The “combination peptide approach” of Zepbound refers to its ability to target and activate both GIP and GLP-1 receptors and appears to yield even greater weight loss results compared to single-agonist medication. By engaging both types of receptors, Zepbound may offer enhanced therapeutic benefits for weight management compared to treatments that target only one receptor type.

“This particular medication opens up a new era for obesity medications. It is the first combination peptide to get FDA approval for obesity.”

Dr. Cecilia Low Wang, an expert on endocrinology, diabetes, and metabolism, told UCHealth, “This particular medication opens up a new era for obesity medications. It is the first combination peptide to get FDA approval for obesity.”

While Zepbound shows promise as a weight management solution with its ease, there are important considerations to keep in mind. Firstly, like similar medications such as Ozempic and Wegovy, long-term use may be necessary to maintain weight loss, which can result in ongoing costs and accessibility challenges due to its expense and availability. Additionally, gastrointestinal side effects such as nausea, vomiting, diarrhea, constipation are a common issue with these types of drugs. Despite its benefits, it’s crucial for individuals considering Zepbound to weigh these potential risks and consult with their healthcare provider before starting treatment.