You may have come across Wegovy or Trulicity while searching for the best prescription weight-loss medication. Wegovy (semaglutide) and Trulicity (dulaglutide) are both medications that belong to the class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. They are both approved by the FDA for the treatment of type 2 diabetes and for weight loss in adults with obesity or who are overweight and have at least one weight-related condition. However, there are some key differences between these two medications that should be considered when deciding which one is right for you.
Both Wegovy and Trulicity work by mimicking the action of the hormone GLP-1, which is naturally produced in the body and helps to regulate glucose metabolism and appetite. When administered, these medications bind to and activate GLP-1 receptors in various organs, including the pancreas, stomach, and brain.
This leads to several physiological effects that can help with weight loss and the management of type 2 diabetes. Specifically, these medications stimulate the release of insulin from the pancreas, which helps to lower blood glucose levels. They also slow down the rate at which food is digested and absorbed in the stomach, which can help to reduce feelings of hunger and increase feelings of fullness.
Wegovy is administered once a week as a subcutaneous injection (under the skin). The recommended starting dose is 0.25 mg once a week for four weeks, followed by an increase to 0.5 mg once a week. After 16 weeks, the dose may be increased to 1 mg once a week, if necessary, to a maximum of 2.4 mg per week.
Trulicity is also administered once a week as a subcutaneous injection. However, the starting dose is lower than that of Wegovy, at 0.75 mg once a week. After four weeks, the dose may be increased to 1.5 mg once a week if necessary.
Both Wegovy and Trulicity have been shown to be effective in managing weight loss.
The STEP 1 Trial was a large randomized control trial with around 1900 participants that examined how effective Wegovy (semaglutide) was at treating obesity in non-diabetic patients. Wegovy was given as a once-weekly pen injection starting at a low dose that was gradually increased to a maximum of 2.4mg over a period of 68 weeks. After 68 weeks, they found that participants taking Wegovy along with diet and exercise experienced a significant reduction in body weight (around 15%) compared to the placebo group.
As for Trulicity (dulaglutide), the AWARD-11 trial showed that higher doses of dulaglutide lead to a significant reduction in body weight. The study originally investigated the efficacy and safety of dulaglutide for glycemic control in patients with uncontrolled diabetes. Along with measuring HbA1c levels, they also looked at the effects of a higher dose of dulaglutide on weight loss. They found that there was significantly more weight loss achieved in participants taking higher doses of dulaglutide (3.0mg or 4.5 mg) when compared to the lower dose of 1.5 mg.
The SUSTAIN-7 Trial, was another randomized control trial that directly compared semaglutide and dulaglutide for patients with uncontrolled diabetes. They saw that semaglutide, overall, better improved glycemic control and weight loss when compared to dulaglutide.
Both Wegovy and Trulicity can cause similar side effects, including nausea, diarrhea, and constipation. However, there are some differences in the frequency and severity of these side effects. Based on the SUSTAIN-7 trial, higher doses Dulaglutide were seen to have more reported gastrointestinal side effects when compared to semaglutide.
Wegovy may also cause more serious side effects, such as pancreatitis and thyroid cancer. However, the risk of these side effects is low and should be weighed against the potential benefits of the medication.
You should avoid both of these medications if you have a medical history of medullary thyroid cancer or a family history of multiple endocrine neoplasia cancer syndrome type 2 (MEN-2).
The cost of both Wegovy and Trulicity can vary depending on your insurance coverage and other factors. However, in general, Wegovy tends to be more expensive than Trulicity. While Wegovy has been approved by the FDA for weight loss, Trulicity is still considered an off-label weight loss medication. This might make it more difficult to find coverage through your insurance plan for Trulicity.
According to GoodRx, the average retail price for a 4-week supply of Wegovy is around $1,400, while the average retail price for a 4-week supply of Trulicity is around $800-900. However, it's worth noting that these prices can vary widely depending on where you purchase the medication and what kind of insurance coverage you have.
Both Wegovy and Trulicity are effective prescription weight-loss medications; however, Wegovy may be more effective. Both medications have similar side effects and contraindications. They are both once-weekly injections, however, the dosage may vary. Since Wegovy is FDA approved for weight loss, insurance plans may cover some of the costs of the medications. Regardless, you should always reach out to your insurance providers to see which medication is covered under your plan and if you are eligible for coverage in the first place.
It is also always important to note that either of these medications should be taken in conjunction with diet and exercise in order to achieve maximum benefits.
If you would like to learn more about GLP-1 medications or want to see if you might be eligible for medication-assisted weight loss, check out Mochi Health, where board-certified obesity medicine physicians can offer expertise in this realm!
Dr. Constantine Joseph Pella, MD
Boston University Medical Center