Obesity has become one of the most challenging health problems of the 21st century, affecting millions of people worldwide. In the United States, where approximately 70% of adults are overweight or obese, the search for effective treatments has driven a revolution in drug development. In recent years, new therapeutic options have emerged, bringing hope to Brazilians living in the United States who face this condition.
Zepbound: The Latest FDA-Approved Drug
In November 2023, the FDA (Food and Drug Administration), the United States drug regulatory agency, approved Zepbound, manufactured by Eli Lilly, for the treatment of obesity. This drug represents a significant advance in the fight against excess weight and sets a new standard of effectiveness for available treatments.
What is Zepbound?
Zepbound's active ingredient is tirzepatide, the same substance present in Mounjaro, a medication already used to treat type 2 diabetes. The difference between them lies in the official indication: while Mounjaro is intended to control diabetes, Zepbound was specifically approved for the treatment of obesity.
Tirzepatide, a component of Zepbound, stands out for its dual mechanism of action, acting simultaneously on two hormone receptors:
- GLP-1 (glucagon-like peptide 1): This gut hormone lowers blood sugar levels, slows gastric emptying, and decreases appetite in the brain.
- GIP (glucose-dependent insulinotropic polypeptide): Intensifies the effects of GLP-1, enhancing the feeling of satiety and improving blood glucose control.
This dual action differentiates Zepbound from other weight loss medications, such as Ozempic and Wegovy (semaglutide), which only act on the GLP-1 receptor.
Proven Effectiveness
The results of clinical trials with Zepbound were impressive. In studies lasting 72 weeks (approximately a year and a half), participants who received the highest dose of the drug (15 mg) experienced an average weight loss of 20,9% – approximately one-fifth of their initial body weight.
For comparison, in similar studies, Wegovy (semaglutide) showed an average weight loss of 14,9% at its maximum dose. This significant difference demonstrates the revolutionary potential of Zepbound in the treatment of obesity.
One in three patients treated with the highest dose of Zepbound lost more than 26 kg during the study, a result that approaches those achieved with bariatric surgery, but without the need for surgical intervention.
Form of Administration
Zepbound is administered via a weekly subcutaneous injection. It is available in six different dosages: 2,5 mg, 5 mg, 7,5 mg, 10 mg, 12,5 mg and 15 mg, which allows for personalized treatment according to each patient's needs.
The recommended initial dose is 2,5 mg, which should be administered subcutaneously once a week. After four weeks, the dose can be increased to 5 mg, with subsequent increments until the ideal maintenance dosage is reached, which may be 5 mg, 10 mg or 15 mg, depending on the patient's response to treatment.
In August 2024, Eli Lilly announced that Zepbound would also be available in single-dose vials in the United States, where patients can use a syringe to withdraw the medication instead of traditional pre-filled injection pens. This new form aims to expand access to the treatment while offering a more cost-effective option.
Side effects
Like any medication, Zepbound can cause side effects. The most common are gastrointestinal in nature, including:
- Nausea
- Diarrhoea
- Vomiting
- Cold
- Abdominal pain
- Fatigue
- Allergic reactions
- Burping and gastroesophageal reflux
Most of these effects tend to be mild to moderate in intensity and usually decrease over time. In rare cases, more serious effects may occur, such as inflammation of the pancreas, gallbladder problems, low blood sugar levels, acute kidney injury, and suicidal behavior or thoughts.
Contraindications
Zepbound is not recommended for:
- Patients with a personal or family history of medullary thyroid cancer
- People with multiple endocrine neoplasia syndrome type 2
- Individuals with a history of severe allergic reaction to tirzepatide
- Combined use with Mounjaro or other GLP-1 receptor agonists (such as Ozempic, Wegovy, Saxenda)
Access and Cost in the US
In the United States, Zepbound is available by prescription. The list price for a 28-day course of the full dose (15 mg) is approximately $1.059,87, which is equivalent to about R$5.000 at the current exchange rate.
To expand access to the drug, Eli Lilly recently introduced more affordable single-dose vials. A four-week supply of 2,5 mg vials costs $399, while a four-week supply of 2.195 mg vials costs $5.
These new vials are available through the LillyDirect platform, which coordinates telemedicine services and prescriptions for out-of-pocket patients, including those with Medicare, which typically does not cover weight-loss medications.
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Comparison with Other Medicines
Zepbound vs. Ozempic/Wegovy
Ozempic and Wegovy, both manufactured by Novo Nordisk, contain the same active ingredient, semaglutide, but in different concentrations and for different indications. Ozempic is approved for type 2 diabetes, while Wegovy is indicated for the treatment of obesity.
The main difference between Zepbound and these medications is in the mechanism of action. While semaglutide acts only on the GLP-1 receptor, tirzepatide present in Zepbound acts on both GLP-1 and GIP, which explains its greater effectiveness in weight loss.
In practice, this translates into significantly greater average weight loss with Zepbound (20,9%) compared to Wegovy (14,9%) when used at the maximum dose for a similar period.
New Drug: VK2735 from Viking Therapeutics
On the horizon for obesity treatment, a new promising drug is emerging: VK2735, developed by the American pharmaceutical company Viking Therapeutics. Still in the clinical testing phase, this drug has attracted attention due to its impressive preliminary results.
VK2735 uses the same principle as current drugs, acting as a dual GLP-1 and GIP agonist, similar to Zepbound. However, initial studies suggest even greater efficacy in weight loss and, most importantly, a much faster speed of action.
In a phase 2 study, participants who received VK2735 lost an average of 14,7% of their body weight in just 13 weeks of treatment — a result that would typically take 40 to 56 weeks to achieve with drugs like Ozempic and Wegovy.
In addition to the injectable version, Viking Therapeutics is also developing an oral version of VK2735, which has shown promising results in early trials. Participants who received the highest dose of the tablet lost an average of 3,3% of their body weight in just 28 days, a significant result for an oral drug in such a short period of time.
If proven effective and safe in larger studies, VK2735 could represent the next revolution in obesity treatment, offering faster results and potentially in tablet form, which would eliminate the need for injections for many patients.
Obesity and Health: Why These Medications Are Important
Obesity is not just an aesthetic issue, but a medical condition associated with several health complications, including:
- Diabetes type 2
- Arterial hypertension
- High cholesterol
- Cardiovascular diseases
- Sleep apnea
- joint problems
- Certain types of cancer
Studies show that a weight loss of 5% to 10% is enough to significantly reduce the risk of many of these complications. With new medications capable of promoting weight loss of 15% to 20%, the impact on overall health can be transformative.
Considerations for Brazilians in the USA
For Brazilians living in the United States who suffer from obesity or overweight, these new medications represent an important treatment opportunity. However, some factors must be considered:
Health Insurance Coverage
Many health insurance plans in the U.S. still do not cover weight loss medications, classifying them as “cosmetic” or “lifestyle” treatments. It’s important to check your plan’s coverage before starting treatment.
For patients who pay out of pocket, manufacturer assistance programs can significantly reduce the cost. Eli Lilly, for example, offers Zepbound at reduced prices through its LillyDirect platform.
Eligibility Criteria
These medications are usually prescribed for people with:
- BMI ≥ 30 (obesity), or
- BMI ≥ 27 (overweight) with at least one weight-related condition, such as high blood pressure, type 2 diabetes, or high cholesterol
Integrated Approach
It is essential to understand that these medications work best when combined with lifestyle changes, including:
- Balanced diet with reduced calories
- Regular physical activity
- Continuous medical monitoring
Without these changes, results may be limited or temporary.
The Future of Obesity Treatment
The field of obesity drugs is rapidly evolving. Competition between big pharma companies like Eli Lilly (Zepbound), Novo Nordisk (Wegovy) and new entrants like Viking Therapeutics (VK2735) is sure to bring more innovation and potentially more affordable prices in the long run.
Future trends include:
- oral medications: The search for tablet versions of current injectables is one of the main research fronts.
- Longer duration of action: Studies with VK2735 suggest the possibility of monthly injections, rather than weekly.
- Combination of molecules: New drugs that act on three or more receptors simultaneously are already in development, promising even greater efficacy.
- Personalized medicines: In the future, we may see treatments adapted to each patient's genetic and metabolic profile.
Conclusion
New obesity medications available in the United States represent a revolutionary advance in the treatment of this chronic condition that affects millions of people. For Brazilians living in the United States, these options may offer an effective alternative when traditional approaches have not been sufficient.
Zepbound, with its ability to promote weight loss of up to 20%, comparable to the results of bariatric surgery, stands out as one of the most promising options currently available. And with new drugs like VK2735 on the horizon, promising even faster results, the future of obesity treatment looks increasingly promising.
However, it is important to remember that no medication is a “magic pill.” Success in treating obesity continues to depend on an integrated approach that includes a healthy diet, regular physical activity, and appropriate medical monitoring.
If you are a resident of the U.S. and are considering these treatment options, consult a physician to discuss the risks, benefits, and appropriateness of these medications for your specific condition. Only a qualified healthcare professional can determine which treatment is best for your individual condition.
meta description Revolution in weight loss: Discover the new drug approved in the USA that promises weight loss 5x faster than Ozempic. Brazilians in the United States can now access Zepbound with impressive results of up to 20% weight loss. Transform your health with these revolutionary options!
