Though Mounjaro and other GLP-1 agonists show great promise for weight loss, there are some populations who may not be eligible for or should avoid these medications entirely.
Trizepatide, also known as Mounjaro, is a medication that is being used in treating type 2 diabetes. It is a combination of three different hormones - glucagon-like peptide-1 (GLP-1), gastric inhibitory polypeptide (GIP), and glucagon receptor agonist (GRA) - that work together to help regulate blood sugar levels and promote weight loss.
GLP-1 and GIP are both hormones that are naturally produced in the body and help to regulate insulin secretion and blood sugar levels. GRA, on the other hand, is a medication that works by stimulating the glucagon receptor, which can help to reduce liver fat and promote weight loss.
It has gained attention for its benefits with weight loss and is now undergoing approval for managing obesity. You may have had a discussion with your provider about taking Mounjaro for weight loss or have read about the benefits online. Either way, there are a few things you should know before moving forward with starting Mounjaro for weight loss. There are some people who may not be eligible for or even should avoid GLP-1 medications like Mounjaro altogether.
Here are some groups of people who should NOT take Trizepatide for weight loss:
Mounjaro is not the only GLP-1 agonist available for weight loss. The price range for a supply of Mounjaro can range from $25- $1000 per month, depending on insurance coverage. That can be really expensive for most people!
There are other cheaper and still effective options on the market, such as Wegovy or Ozempic. Also, some practitioners may be in partnership with pharmacies that can produce a compounded option at a lower price. Compounding means that they take the medication and combine it with another substrate, usually a vitamin so that it can be marketed at a lower price than the brand name. Be on the lookout for these options and ask your provider for more information.
Mounjaro can increase the risk of pancreatitis, a condition where the pancreas becomes inflamed and swollen. If you have a history of pancreatitis, you should not take Trizepatide for weight loss.
Mounjaro can cause gastrointestinal distress as a common side effect, so if this is a consistent and severe problem for you, then this may not be a good option for you.
Mounjaro has been shown to put patients with active gallstones at risk of developing acute cholecystitis, which is the inflammation of the gallbladder and bile tract due to usually a gallstone blocking the ducts and preventing the release of bile. This can present with sudden upper right abdominal pain after eating, along with nausea and vomiting.
If you have a history of gallstones or active gallbladder disease, then discuss this with your provider before starting Mounjaro. If you have had your gallbladder removed, then you do not need to worry.
In rat models, Mounjaro caused a dose-dependent and treatment-duration-dependent increase in the incidence of thyroid tumors in a 2-year study. Due to this finding, Mounjaro may not be prescribed if you have a history of Medullary (not follicular or other types) Thyroid Cancer or have a family history of Multiple Endocrine Neoplasia Syndrome Type 2 (MEN-2). This is also true for other GLP-1 agonists.
If you have previously had an allergic reaction or a serious adverse effect to Trizepatide, you should not take the medication for weight loss. Signs of an allergic reaction may include hives, itching, swelling, difficulty breathing, or chest tightness.
As you may have heard, insulin lowers blood sugar levels in diabetic patients. In combination with Mounjaro or any other GLP-1 agonist, this could lead to severe and potentially life-threatening hypoglycemia.
Also, if you had a prior history of hypoglycemia with your current treatment, then taking Mounjaro may put you at further risk for another episode. Therefore, if you are currently taking insulin or have a history of hypoglycemia, then you should avoid using Mounjaro.
It has been shown that there seems to be an increased risk in the development of diabetic retinopathy when people are taking GLP-1 agonists like Mounjaro, which can lead to vision loss. For this reason, your provider may not recommend Mounjaro or other GLP-1 medications if you have a family history of diabetic retinopathy or have an active diagnosis of diabetic retinopathy.
In conclusion, though many people want to get started on GLP-1 agonists such as Mounjaro to lose weight, there are some things you should discuss with your provider before starting. It is important to have this discussion so you can formulate a treatment plan that can effectively help you lose weight while not causing you harm in the long run. 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