Hungry if you don’t take it, forget to eat if you do? Who is this new drug, which can stabilize blood sugar and reduce waist size, suitable for?

In recent years, many public figures who have been “plump” in front of the camera for years and have publicly disclosed their metabolic disease history have become “as thin as two people” in just a few months, and even trended on social media and made headlines.

Many friends have come to me to “gossip”, and the questions have evolved from the initial
“What do you say, what kind of technology and fierce efforts did he use?” Gradually upgraded – first asked bluntly“Did he take semaglutide?”, Recently, it has been directly asked“Is there a more effective drug than semag than semag? That… tirzepatide?”

Today, let’s talk about this topic. If you are “confused” by these drug names, you can read on paragraph by paragraph; if you are only eager to know “is there a more effective drug than semag”, you can directly jump to the corresponding paragraph below.

How do these drugs cause weight loss?

The mechanism behind it is related to“insulin”.

Under normal circumstances, after we eat, the blood sugar in our body will increase,the body will secrete the hormone “insulin”,“directing” glucose to various parts of the body, such as muscles and liver.

However, sometimes insulin secretion can be problematic,such as not secreting, delayed secretion, or not being able to direct the body to process glucose(insulin resistance), then it will
trigger “diabetes”.. Many diabetic patients will exhibit frequent hunger, which is related toblood sugar levels.

As early as the 1960s and 1970s, scientists discovered an interesting phenomenon: oral glucose causes a stronger insulin secretion response than intravenous injection. In this phenomenon, two incretin hormones played a key role –Glucose-dependent insulinotropic polypeptide (GIP) and Glucagon-like peptide-1 (GLP-1).This provided a new idea for the treatment of diabetes.

GIP was the first discovered incretin, initially named “gastric inhibitory polypeptide” because it could inhibit gastric acid secretion, and later it was found that its main function was to promote insulin secretion.

GLP-1 was the second incretin discovered, in addition to stimulating insulin, it can also delay gastric emptying and suppress appetite.

The half-life of these two hormones in the body is only a few minutes(they are quickly broken down after being secreted), scientists have made efforts for many years and found more stable, usable for diabetes treatment analogs,also known as “receptor agonists”.

The first generation of GLP-1 analogs is called “exenatide”(Exenatide), which was introduced in 2005, and it was unexpectedly found at the time that this drug actually has a significant weight loss “side effect”.

Since then, “liraglutide”, “semaglutide” and other long-acting GLP-1 analogs have been introduced one after another, the weight loss “side effect” is stronger than the previous generation.

Since then, many “sugar friends” have controlled their blood sugar through medication and have also returned to a healthier weight level. So far, many “sugar friends” have controlled their blood sugar through medication and have also returned to a healthier weight level.Later, researchers noticed that although GIP alone is not effective for diabetic patients, but when GIP is used in combination with GLP-1, it can produce a synergistic effect, increasing the blood sugar-lowering effect of the latter, this discovery has promoted the development of “dual receptor agonists”. This discovery has promoted the development of “dual receptor agonists”.

Thus,” tirzepatide “was born. That is, everyone is curious – is there a drug stronger than semag.

Thanks to the “celebrity effect”, semag has become one of the most well-known drugs in recent years. From the perspective of “watermelon eaters”, tirzepatide and semag have many similarities –both are pre-filled injection pens, both need to be refrigerated, both are subcutaneous injections once a week, and both may cause gastrointestinal adverse reactions, etc.

Is tirzepatide really better in terms of efficacy?

Is the effect of tirzepatide better than semag?

At present, tirzepatide is approved for:

• Obese patients with BMI≥30;

• People with BMI≥27 but with at least one obesity-related disease(such as hypertension, type 2 diabetes, etc.).

Side effects:Common side effects include gastrointestinal symptoms such as nausea, diarrhea, and constipation, but most will subside over time.

Risks:Due to its potential to cause thyroid C-cell tumors(medullary carcinoma)risk(in animal experiments), patients with a personal or family history of thyroid medullary carcinoma should avoid using it.

Advantages:Tirzepatide can improve a variety of metabolic indicators.Studies have shown that it can reduce blood sugar, blood pressure, blood lipids, and even improve fatty liver. For patients with both type 2 diabetes and obesity, it is a two-for-one treatment option.

According to clinical trial data(SURMOUNT-1 series of studies), obese patients using the highest dose(15mg/week), after 72 weeks of treatment, the average weight loss reached 15-20%, equivalent to a person weighing 100kg losing 15-20kg. Among them, about two-thirds of users lost more than 10% of their weight, nearly half lost more than 15%, and even 30% lost more than 20%.(Such effects could only be achieved by weight loss surgery before)

1. Pharmacological mechanism

Semag is a single GLP-1 receptor agonist, while tirzepatide is a dual agonist of GIP and GLP-1.

First, it acts on the appetite control center of the brain through the GLP-1 pathway, especially the hypothalamus, enhancing satiety and reducing hunger. Many users describe that after taking the medicine, their desire for food has significantly decreased, making it easier to control their food intake. At the same time, it will also delay gastric emptying, allowing food to stay in the stomach for a longer time, further extending the feeling of fullness.This is also the reason why some users may experience gastrointestinal reactions such as nausea in the early stage.

Secondly, GIP and GLP can work synergistically to help adipocytes more effectively absorb and store fat,preventing fat accumulation in the blood;at the same time, reducing ectopic fat deposition,reducing the risk of fat accumulation in organs such as the liver and pancreas.

In addition, studies have found that pharmacological doses of GIP can enhance the appetite-suppressing effect of GLP-1, and the weight loss effect produced by the combination of the two is stronger than that of GLP-1 drugs alone.

2. Treatment effect

In the SURPASS-2 clinical trial that directly compared the efficacy of the two in diabetic patients,tirzepatide was superior in both blood sugar reduction and weight loss.Patients using the highest dose of tirzepatide(15mg/week)reduced HbA1c(blood sugar indicator)by 0.5% more than semaglutide(1mg/week), and lost about 2.5kg more weight.

The latest SURMOUNT-5 clinical trial conducted in simple obesity patients showed that tirzepatide lost about 7% more weight than semaglutide(20.2% vs 13.7%), and reduced waist circumference by 5cm(18.4cm vs 13cm).

3. Price

In terms of price, both are high-priced drugs, and the specific cost varies by region and insurance coverage.

4. Side effects

The side effect spectrum is also similar, mainly gastrointestinal reactions(but tirzepatide may cause less nausea due to its stronger GIP effect).

2.Jastreboff AM et al. (2022) Tirzepatide once weekly for the treatment of obesity. N Engl J Med.

3.Frías JP et al. (2021) Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes. N Engl J Med.

4. Louis JA et al. (2025) Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. N Engl J Med.