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GLP-1s, GIPs, and Orals

A. Semaglutide

Semaglutide (Ozempic) belongs to the GLP-1 (glucagon-like peptide-1) receptor agonist drug class, that are injectable medications used to treat type 2 diabetes and obesity. It mimics the GLP-1 hormone to regulate appetite, increase insulin secretion (slows digestion) when blood sugar is high, and slows gastric emptying (promoting a feeling of satiety (fullness) and reducing hunger sounds.


Common side effects nausea, vomiting, bloating, gas, constipation, and diarrhea.


More serious side effects but less common: pancreatitis, gallstones, dehydration, allergic reactions, and thyroid tumors


Contraindicated: personal history or family history of Medullary Thyroid carcinoma (MCT), OR Multiple Endocrine Neoplasia Syndrome type 2 (MEN 2).

B. Tirzepatide

Tirzepatide (Mounjaro-for type 2 diabetes and Zepbound- for weight management) acts as a dual GIP and GLP-1 receptor agonist that increases insulin release, lower blood sugars, and slows gastric emptying, helping with glycemic control and satiety (fullness). This drug can induce significant weight loss (up to 15-20% of body weight).


You should not take Tirzepatide if you have a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), a history of pancreatitis, severe gastrointestinal issues like gastroparesis, or a history of severe allergic reactions (anaphylaxis/angioedema) to tirzepatide or similar drugs; 


Contraindicated: pregnancy, breastfeeding, and caution is advised for those with diabetic eye disease or kidney/gallbladder issues.


How it works:

  • Tirzepatide stimulates insulin release from the pancreas and decreases the amount of sugar released by the liver. It also slows the emptying of the stomach and increases feelings of fullness by reducing appetite.


Side effects:

  • Common: Nausea, vomiting, diarrhea, constipation, decreased appetite, and stomach pains are common side effects.
  • Serious: Serious side effects can include symptoms of an allergic reaction (swelling, trouble breathing) or severe stomach pain.

C. Phentermine

Phentermine is an appetite suppressant used for short-term weight loss (3 months). This drug is a sympathomimetic amine which mimic the effects of endogenous agonists of the sympathetic nervous system effects such as heart rate, force of contraction, and blood pressure.


Side effects: dry mouth, trouble sleeping (insomnia), headaches, constipation, tachycardia (fast heart beat), hypertension, palpitations, arrhythmia, anxiety, and tremors. 


Avoid use: heart disease, uncontrolled high blood pressure, hyperthyroidism, or glaucoma.


Contraindicated: patients using MAO inhibitors

 A consultation is required to assess the best products for your needs. 


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