Switching From Semaglutide to Tirzepatide

Someone might switch from semaglutide to tirzepatide to achieve greater weight loss or improve blood sugar control. Tirzepatide has been shown to be more effective for some people because it works on two different hormones, GLP-1 and GIP. This combination can lead to better results in managing weight and overall health. 

Additionally, if a person stops losing weight on semaglutide or isn’t feeling as much appetite suppression, switching to tirzepatide could provide a new option, especially at higher doses.

In this podcast, we’ll discuss the feedback from doctors and patients about switching from semaglutide to tirzepatide for weight loss. The experiences shared are quite varied. Here are some common themes based on what healthcare providers and patients reported.

1. Appetite Suppression

• Patients’ Experiences:
  • Some patients report weaker appetite suppression with tirzepatide compared to semaglutide. They mention that they felt more consistently full or experienced less “food noise” (persistent thoughts about food) with semaglutide.
  • Others find tirzepatide equally or more effective at reducing hunger, especially at higher doses (10 mg to 15 mg). They note that their appetite was well-controlled after titrating to these higher doses.
• Clinicians’ Observations:
  • Many clinicians observe that tirzepatide’s appetite suppression is dose-dependent, with lower doses (5 mg) sometimes being less effective than semaglutide 2.4 mg, but higher doses (7.5 mg and up) providing stronger suppression.
  • Some clinics report that patients may need more time on tirzepatide for the full appetite-suppressing effects to become noticeable.

2. Weight Loss:

• Patients’ Experiences:
  • Many patients experience greater or more rapid weight loss with tirzepatide, especially when titrated to higher doses (10 mg or more). Some report that they plateaued with semaglutide but started losing more weight after switching to tirzepatide.
  • Others find that their weight loss slows down after switching to tirzepatide, particularly if their tirzepatide dose starts low (e.g., 2.5 or 5 mg), which may take time to match the effects of semaglutide 2.4 mg.
• Clinicians’ Observations:
  • Physicians often report that tirzepatide tends to lead to greater weight loss overall compared to semaglutide, especially when patients reach the higher doses (15 mg).
  • However, individual variability plays a significant role, with some patients responding better to one medication over the other, depending on their metabolic profile and personal response to the medications.

3. Side Effects:

• Patients’ Experiences:
  • Patients commonly note that tirzepatide’s side effects are similar to semaglutide, particularly stomach-related symptoms like nausea, vomiting, and diarrhea. However, these effects tend to lessen over time with both medications.
  • On the other hand, some patients may experience more intense side effects with tirzepatide, especially during the titration phase.
• Clinicians’ Observations:
  • Clinics generally find that tirzepatide’s tolerability improves when the dose is titrated slowly, starting at 2.5 mg. Jumping directly to higher doses (5 mg or more) can increase the likelihood of nausea and other stomach-related side effects.
  • Long-term side effect profiles are comparable between the two, but some clinics observe that tirzepatide’s dual mechanism (GIP + GLP-1) might cause more initial stomach discomfort in certain patients.

4. Patient Preferences:

• Some patients prefer staying on semaglutide because it effectively curbs their hunger and controls cravings better, even if tirzepatide provides more weight loss.
• Others favor tirzepatide due to its better results in weight loss and overall improvements in metabolic health, especially once they reach higher doses.

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