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doi: 10.1073/pnas.1306241110 28 HellmichMRColettaCChaoCSzaboC
Support programs are important for spanning the divide as insurance coverage still develops
My general framework: Start with semaglutide if cost is a significant concern, or if there is no strong reason to expect poor tolerance Start with tirzepatide if the patient has tried semaglutide before and struggled with side effects, if faster initial response matters clinically, or if the patients goals require larger total weight loss Switch to tirzepatide if a patient on semaglutide is experiencing persistent nausea or has plateaued and escalation options are limited One pattern worth noting: men I see a consistent pattern with male patients who struggle to tolerate semaglutide nausea and GI disruption can be particularly disruptive for them, and theyre often less willing to push through it
He and a team of researchers followed about 600,000 patients over three years to see if GLP-1 drugs had an effect on addiction
Too little and the therapeutic window narrows
