Who is the Prince of Tides? The first GLP-1 receptor agonist to be FDA-approved was introduced in 2005. A diabetes management drug, Exenatide was sold under the brand name Byetta and required two injections per day. Liraglutide was the first once-daily GLP-1, approved in 2010 under the brand name Victoza. Liraglutide was also used for chronic weight management under the brand name Saxenda. Dulaglutide, aka Trulicity, was approved in 2014 and injected only once per week.
Semaglutide was approved in 2017 under the brand names Ozempic and Wegovy for diabetes treatment but was later approved for obesity in 202. Tirzepatide, a novel dual GLP-1/GIP agonist, came out in 2023. Tirzepatide is also known by the brand names Mounjaro and Zepbound.
Confused yet? Wait, it gets even more convoluted. Due to the overwhelming commercial success of GLPs like Ozempic, there are now several more in the process of testing by pharmaceutical companies including Mazdutide, Survodutide, Cagrilintide and Retatrutide. Retatrutide is the closest to finishing phase 3 trials, the patent held by Eli Lilly. It is already available through research peptide companies online if you want to roll the dice on the gray market…. Something I don’t recommend you do unless you are willing to cough up the $300 required to test the product and make sure it is in fact Retatrutide and that it does not contain LPS, (lipopolysaccharides), which are highly inflammatory in your body.
Clear as mud, right? Let’s focus on the ones available here in Cabo through a reputable doctor, Semaglutide and Tirzepatide and the one that will likely be available soon, Retatrutide. What's the difference? Which one should you take? How much does it cost? All valid questions and the answer is: It depends. It depends on how much weight you need to lose, whether or not you are willing to strength train and make some changes to your diet and how much cash you have on hand.
The following statistical comparison is of Semaglutide, (Ozempic), Tirzepatide, (Zepbound) and Retatrutide, (nickname is “Triple G” because it acts on 3 receptors). It should be noted that the muscle loss figures are based on studies in which no other interventions besides the GLP drug were introduced, such as a high-protein diet or strength training for example. Had these interventions been part of the studies, I personally feel that the muscle loss figures could have been substantially reduced in all cases.
Comparative Summary of Semaglutide vs Tirzepatide vs Retatrutide
Semaglutide (Wegovy, Ozempic)
Study participants lost an average of 15% of their body weight after 68 weeks. That would be the equivalent of a 250-pound person losing 37.5 pounds. Not too shabby by any means. However, 25-30% of the total weight loss after 68 weeks was lean muscle mass which is not a good trade-off and has led to a lot of criticism and phrases like “Ozempic Face”. As I mentioned previously, these studies did NOT intervene with a high protein diet and strength training which would have mitigated the muscle loss. Semaglutide is still a healthy option to help you lose weight but I strongly recommend not using it as a crutch for your unhealthy lifestyle. That will not work long term. On the upside, semaglutide is the least expensive of the peptides we are comparing here. At the minimum dose of .25mgs/week, it's available here in Cabo in compounded form for $100 per month.
Tirzpetatide: (Zepbound, Mounjaro)
Study participants lost an average of 22.5 % of their body weight after 72 weeks but only 15-20% of that loss was lean mass. So, more fat was lost and less muscle which is better for maintaining the loss long term. Taking the 250-pound person as an example again that would be a 56.25 pound loss and only 15-20% of that loss would be muscle. Tirzepatide offers significant fat loss with better muscle preservation compared to semaglutide. Its dual agonist effect, (acting on GLP 1 and GIP receptors), not only helps with fat loss but also minimizes muscle loss. The upside is we have it here in Cabo in compounded form but it's more expensive than semaglutide. A 5mg dose would be around $250 per month.
Retatrutide: (No Brand Name, Patent Eli Lilly)
Study participants lost an average of 24.2% over 48 weeks at the highest dose of 12 mg per week. 21% of the loss was muscle mass which was the least of the 3 peptide drugs for the volume of weight lost in the shortest time: 48 weeks vs 68 and 72 weeks. Retatrutide is a triple agonist acting on GLP 1, GIP and Glucagon receptors. It is believed in the bodybuilding community to be the holy grail because when combined with the right amount of protein and correctly executed weightlifting it promises to be able to do the impossible: Build muscle and burn fat at the same time.
Keep in mind that very few people you see in the gym are weightlifting correctly or eating diets with the right amount of protein. Retatrutide is definitely the priciest option of the 3 weight loss peptides. Even at the smallest dose of 4mgs it costs $240 per month from research peptide companies and many bodybuilders are taking up to 12 mgs/week which is $480 per month at retail pricing and you should sacrifice a vial and pay to have it tested which is $300.
In short, if you are just the average person who wants to lose 20 or 30 pounds and you aren’t a bodybuilder, then either Semaglutide or Tirzepatide would probably be the best place to start with some simple exercises like pushups or hill walks and try to prioritize protein and fiber over margaritas and nachos. If you are into bodybuilding, get your hands on some Retatrutide but again, I suggest you have it tested the first time to make sure it’s pure and free of lipopolysaccharides.
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