Mounjaro, Wegovy result in lower weight loss in the real world than clinical trials, says study: What explains this gap?
At a time when makers of weight loss drug Mounjaro are claiming that you can lose up to 22.5 per cent of your starting body weight over 72 weeks on its highest dose of 15 mg, a new study says the reality is quite the opposite. Researchers found that people on weight loss injectables shed fewer pounds in the real world than in clinical trials.
In other words, this study indicates these drugs may not produce drastic weight loss in everyday settings. Researchers analysed data from 51,085 patients with a body mass index of 35 or greater and who were eligible for weight loss surgery and weight loss jabs. The team compared the three-year weight loss journey in 38,545 people prescribed semaglutide (sold under brand name Wegovy) and tirzepatide (Mounjaro) with 12,540 patients who underwent weight loss surgery. They found that those who underwent bariatric surgery had a significantly higher weight loss after two years, at 26.5%, compared with 5.7% for those prescribed semaglutide and tirzepatide. Semaglutide is a GLP1 receptor agonist (RA) which mimics the GLP 1 hormone and helps control blood sugar, reduce appetite and accelerate weight loss. Tirzepatide (Mounjaro) is a GLP1-RA cum GIP agonist. GIP has a role in food metabolism. The study will be presented at the American Society for Metabolic and Bariatric Surgery 2025 annual scientific meeting.
'The average patient on [GLP-1 RAs] in the real world is not getting the weight loss that we see in clinical trials,' says senior author Dr Karan Chhabra, Assistant Professor of Surgery & Population Health at Grossman School of Medicine, New York University. Does that mean that bariatric surgery will continue to be relevant? Listen in.
1) What could have been the reason for this discrepancy between weight loss in clinical trials and during real-time use of the drug? Though you have not done a data analysis on causes, what do you think went wrong?
I think many patients either discontinued treatment or were not titrated (a method of assessing the concentration of a substance) up to the high doses needed for maximal weight loss.
2) Does this mean that we still need widespread studies on GLP 1 RAs?
We need more real-world studies of GLP1 agonists – this study shows us that the clinical trial results do not always apply to real-world patients. Our team will be looking at this topic next – what can prescribers do to maximize the effectiveness of GLP1 RAs.
3) So far makers of weight loss drugs had claimed that their drugs were almost equivalent to bariatric surgery. How does this study challenge that perception?
This study shows that in real world conditions, these drugs lead to far lesser weight loss than bariatric surgery for the average patient.
4) Who needs bariatric surgery? Rather, which set of people are more likely to benefit from bariatric surgery?
Ultimately the treatment strategy should be tailored to individual patients' characteristics and preferences. Patients who do not want to be on lifelong medications, or who need 20 per cent weight loss to achieve their health goals, or who do not have insurance coverage for GLP1 RAs would be better served with surgery.
5) Do you see weight loss drugs having long-term efficacy?
Weight loss drugs are effective for maintaining weight loss only for as long as they are taken. Many studies show that patients regain as much as 70 per cent of the weight lost when they stop taking these drugs.
6) Are weight loss drugs more hype than effect?
No, this study underscores that these drugs are not a silver bullet but they can be highly effective when prescribed carefully by an expert physician. The goal is to get as many people to the right treatment (for obesity) as possible.
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Hindustan Times
2 hours ago
- Hindustan Times
This Indian dermatologist lost 14 kgs in 4 months with Mounjaro and lifestyle changes
Why are Mounjaro and Ozempic suddenly trending everywhere, especially for weight loss? Originally, these medications were designed to help people with type 2 diabetes manage their blood sugar levels. But lately, many people—including some celebrities—have been using them to lose weight fast. It sounds promising, but there is still a lot of confusion about how these drugs actually work and what to expect from them. Dr Nivedita Dadu, an Indian dermatologist, has shared her personal weight loss journey, revealing that she lost an impressive 14 kgs (about 31 pounds) in just 4 months using Mounjaro. She talked openly about her experience, the challenges, and the results. In a recently posted YouTube video, Dr Dadu explained that she had been overweight since childhood and tried several weight loss diets—intermittent fasting, walking, anti-inflammatory diets, and more—to lose weight. But nothing ever gave her lasting results. 'I'm a foodie and an emotional eater,' she admitted. Her demanding work schedule also made it hard to stick to rigid routines. After years of trying and failing and being a perennial dieter, she knew she had to break the cycle. That's when she came across Ozempic and Mounjaro. Before diving into Dr Dadu's experience, it is important to clarify what these medications are. As she explains, both Mounjaro (tirzepatide) and Ozempic (semaglutide) are injectable drugs originally designed to help manage blood sugar levels in people with type 2 diabetes. But they also influence appetite and metabolism in ways that promote weight loss. Dr Dadu says, 'These drugs mimic hormones in our body that regulate hunger and insulin. They help reduce appetite, improve blood sugar control, and slow down digestion, which together help people eat less and lose weight.' While both medications share similar mechanisms, Mounjaro is unique in that it targets two hormones—GLP-1 and GIP—making it a dual-action therapy. Ozempic primarily targets GLP-1. This dual action in Mounjaro is thought to contribute to more effective weight loss. When Dr Dadu first saw others, including celebrities, using Ozempic, she wanted to try it herself. However, Ozempic wasn't available in India. What was available was the oral version of semaglutide, sold as Rebelsis. 'I started with a low dose, 7 mg, then increased to 14 mg. But I had so much nausea that I couldn't focus on work,' she said. While it helped her lose weight, the side effects made it unsustainable and she had to give up on Rebelsis. Next, she tried an anti-inflammatory diet. While it supported a healthy lifestyle, the results were slow. 'You cannot expect to lose 25–30 kgs with an anti-inflammatory diet. I was finding it boring and not that practical,' she said. Then came Liraglutide (Victoza), a daily injectable. 'It was better than Rebelsis—no side effects, and I started losing weight. But I hit a plateau after losing 6–8 kgs because the dose couldn't be increased much.' When she found that Ozempic is not available in India through legal channels, she turned to Mounjaro and started her research on it before trying it on herself and her patients. She found that Mounjaro could help people lose up to 20% of their body weight, compared to 6–7% with Ozempic. Also, while Ozempic wasn't FDA-approved specifically for weight loss, tirzepatide in Mounjaro was. So, she began using it personally and with her patients. Dr Dadu revealed that while she tried several ways to lose weight, Mounjaro helped a lot. 'Since I don't have a significant medical history, I was a good candidate. And after that, the protocol is to get tests every 1.5–2 months if you are on the medication. I have been on Mounjaro for 4 months. So, I have lost 14 kgs in the last 4 months. I've not seen a plateau or ceiling effect like with Liraglutide. No nausea like I had with Rebelsis. People meeting me daily can't tell I'm on an injection. I take it once a week." "I feel more confident now. I don't feel lethargic or tired in the evening. And the food cravings I had for 10 years—especially after coming home tired—are gone. Tirzepatide works by giving a feeling of fullness. So, you don't feel like eating too much. I still have cheat days and eat food of my choice like pizza,' reveals Dr Dadu. Along with the weekly injections, Dr Dadu followed a clean and nutritious diet and practiced yoga every morning. She starts her day with lemon water and hydrates post-yoga with coconut water. 'Some days I take a protein shake or cold coffee. During busy days, I sip on green tea or lemon water. Lunch might be just one cucumber, mango, or fruit yogurt—or sometimes nothing.' Despite how light her meals sound, she emphasized that her diet is not lacking. 'I'm not compromising on anything. My diet is healthy. I take all nutrients, vitamins, and especially care of my protein and healthy fats. I'm not depriving myself. I'm staying fit and healthy. I calculate protein—one protein shake gives 24–30g. Since you started this, I wanted to share.' Since Dr Dadu was already familiar with Rebelsis and Mitosa, she decided that the lowest quantity, which is 2.5 mg, was not for her. So, she started with 5 mg of Mounjaro once a week. She continued the doses for 3–4 weeks, about 1 to 1.5 months. She escalated to 7.5 mg, which she followed for nearly three months, achieving most of her weight loss without any side effects. However, she revealed that 'I was also taking IV drips—every 2 or 3 weeks in our clinic. These drips had collagen, glutathione, vitamins, minerals—so there should not be any deficiency.' Dr Dadu highlighted that Mounjaro, or any GLP-1 analogue, helps in multiple ways. It is not just weight loss, but it makes you a healthier version of yourself. The Mounjaro's active ingredient, Tirzepatide, works by: This combination helped Dr Dadu feel less hungry, especially during vulnerable moments like after work when she used to binge. She addressed common concerns like sagging skin and hair thinning that some people face after weight loss. Due to her past PCOS and dry skin conditions, she proactively underwent IV drips with nutrients like collagen and vitamins, did hydration and facial treatments, and used body contouring devices at her clinic to maintain skin elasticity. She also clarified that 'Ozempic face,' or facial sagging, is avoidable when weight loss is not extreme. In fact, Mounjaro can help correct hormonal imbalances and insulin resistance. Dr Dadu does not recommend staying on high doses long-term. 'When you reach your goal weight, you don't need to go up to 15 mg. You can start reducing the dose or increasing the gap between doses,' she explained. Eventually, it is about maintaining a healthy lifestyle with foods like jowar, bajra, ragi, oats, fruits, vegetables, and regular exercise. 'Doctor supervision is necessary before taking Mounjaro,' warned Dr Dadu. Mounjaro isn't suitable for everyone. It is especially not recommended for people with: Apart from this, there are some other medicines that you have to inform your doctor about. Because in that case, your Mounjaro injection dose will be titrated. Apart from this, if you are taking insulin injections for diabetes, then you can opt for Mounjaro injections for weight loss. But your insulin requirement will be reduced. Because if Mounjaro increases your insulin sensitivity, then you will not have that much insulin requirement, as per Dr Ddau. She added that some medications may interact with Mounjaro, so consultation with your doctor is important. If you are on insulin, Mounjaro might reduce your insulin needs. 'Yes, you can opt for these injections even if you don't have diabetes. Because Mounjaro or any other GLP-1 agonist does not reduce your sugar levels, in the sense that it will not cause hypoglycemia. If the sugar is high, then it will reduce it. But it will not let hypoglycemia happen. That is why it is absolutely safe for people who do not have diabetes,' explains Dr Dadu. For best results, check with your endocrinologist. To get the best results, Dr Dadu recommends: 'The goal is to achieve maximum results with minimum dose and time,' she said. 'And that's only possible under proper medical supervision.'
Indian Express
6 hours ago
- Indian Express
Mounjaro, Wegovy result in lower weight loss in the real world than clinical trials, says study: What explains this gap?
At a time when makers of weight loss drug Mounjaro are claiming that you can lose up to 22.5 per cent of your starting body weight over 72 weeks on its highest dose of 15 mg, a new study says the reality is quite the opposite. Researchers found that people on weight loss injectables shed fewer pounds in the real world than in clinical trials. In other words, this study indicates these drugs may not produce drastic weight loss in everyday settings. Researchers analysed data from 51,085 patients with a body mass index of 35 or greater and who were eligible for weight loss surgery and weight loss jabs. The team compared the three-year weight loss journey in 38,545 people prescribed semaglutide (sold under brand name Wegovy) and tirzepatide (Mounjaro) with 12,540 patients who underwent weight loss surgery. They found that those who underwent bariatric surgery had a significantly higher weight loss after two years, at 26.5%, compared with 5.7% for those prescribed semaglutide and tirzepatide. Semaglutide is a GLP1 receptor agonist (RA) which mimics the GLP 1 hormone and helps control blood sugar, reduce appetite and accelerate weight loss. Tirzepatide (Mounjaro) is a GLP1-RA cum GIP agonist. GIP has a role in food metabolism. The study will be presented at the American Society for Metabolic and Bariatric Surgery 2025 annual scientific meeting. 'The average patient on [GLP-1 RAs] in the real world is not getting the weight loss that we see in clinical trials,' says senior author Dr Karan Chhabra, Assistant Professor of Surgery & Population Health at Grossman School of Medicine, New York University. Does that mean that bariatric surgery will continue to be relevant? Listen in. 1) What could have been the reason for this discrepancy between weight loss in clinical trials and during real-time use of the drug? Though you have not done a data analysis on causes, what do you think went wrong? I think many patients either discontinued treatment or were not titrated (a method of assessing the concentration of a substance) up to the high doses needed for maximal weight loss. 2) Does this mean that we still need widespread studies on GLP 1 RAs? We need more real-world studies of GLP1 agonists – this study shows us that the clinical trial results do not always apply to real-world patients. Our team will be looking at this topic next – what can prescribers do to maximize the effectiveness of GLP1 RAs. 3) So far makers of weight loss drugs had claimed that their drugs were almost equivalent to bariatric surgery. How does this study challenge that perception? This study shows that in real world conditions, these drugs lead to far lesser weight loss than bariatric surgery for the average patient. 4) Who needs bariatric surgery? Rather, which set of people are more likely to benefit from bariatric surgery? Ultimately the treatment strategy should be tailored to individual patients' characteristics and preferences. Patients who do not want to be on lifelong medications, or who need 20 per cent weight loss to achieve their health goals, or who do not have insurance coverage for GLP1 RAs would be better served with surgery. 5) Do you see weight loss drugs having long-term efficacy? Weight loss drugs are effective for maintaining weight loss only for as long as they are taken. Many studies show that patients regain as much as 70 per cent of the weight lost when they stop taking these drugs. 6) Are weight loss drugs more hype than effect? No, this study underscores that these drugs are not a silver bullet but they can be highly effective when prescribed carefully by an expert physician. The goal is to get as many people to the right treatment (for obesity) as possible.
Time of India
2 days ago
- Time of India
Indore-based surgeon Mohit Bhandari to receive prestigious International Surgeon Award in US; all you need to know about him
Mohit Bhandari BHOPAL: Dr Mohit Bhandari, a surgeon based in Indore, Madhya Pradesh, is set to receive the prestigious International Surgeon Award at the upcoming American Society for Metabolic and Bariatric Surgery (ASMBS) Global Congress in Washington D.C. , scheduled from 15 to 19 June 2025. The award is regarded as one of the highest global honours in the field of metabolic and bariatric surgery. Dr Bhandari has been chosen for this international recognition due to his development of the Self-Forming Magnetic Anastomosis Technique, an innovative surgical method that enhances safety, simplifies the procedure, and improves the effectiveness of bariatric surgeries. This technique is especially helpful for patients with extreme obesity (weighing 200 kg or more), who are often not considered suitable for traditional surgical methods. Having performed a record number of bariatric surgeries — claimed to be the highest in Asia — Dr Bhandari has significantly contributed to advancements in this medical field. He has also introduced modern, non-surgical weight loss techniques in India, including Endoscopic Sleeve Gastroplasty (ESG) and the Allurion Balloon. His achievements have earned him a place in the World Book of Records. 'This award is not just a personal milestone but a recognition of India's growing expertise and research in advanced medical science,' claims Dr Bhandari.
