Peptides for Weight Loss: A Pharmacist Explains the Evidence
Medically reviewed by Mary Choy, PharmDMedically reviewed by Mary Choy, PharmDPeptides are parts of proteins that transmit signals throughout your body. Naturally occurring peptides your body produces include hormones, such as insulin, ghrelin, leptin, and glucagon-like peptide 1 (GLP-1). These peptides regulate your appetite, blood sugar, and energy usage.Synthetic peptides (i.e., made in a lab) for weight loss are injectables called glucagon-like peptide-1 receptor agonists (GLP-1 agonists). They were initially developed for type 2 diabetes. These medicines mimic the effects of GLP-1, which include breaking down glucose (sugar), reducing your appetite, and keeping you full.The use of GLP-1 agonists for weight loss has skyrocketed as they've gained traction on social media and among celebrities. However, the best peptides for weight loss depend on several factors.
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What's the Best Peptide for Weight Loss?The U.S. Food and Drug Administration (FDA) has approved several peptide medications for weight management. The following GLP-1 agonists may promote weight loss:Ozempic, Wegovy (semaglutide): The FDA approved Ozempic for type 2 diabetes, but it may be taken off-label (meaning it has not been FDA-approved) for weight management. Wegovy, on the other hand, is FDA-approved for long-term weight management. Ozempic and Wegovy are taken as once-weekly injections at any time of day, with or without food. Wegovy is approved for adults who are obese (having a body mass index or BMI greater than 30) or overweight (having a BMI greater than 27) plus have other conditions like diabetes or high blood pressure. It's also approved for children over age 12 with a BMI in the 95th percentile. Studies have shown that weight loss from Wegovy stops or slows after about 68 weeks.Victoza, Saxenda (liraglutide): Victoza is FDA-approved for controlling blood sugar in people with type 2 diabetes. Saxenda is FDA-approved for weight loss and weight management. Saxenda is given as a daily injection. It can be given at any time of the day, regardless of food. Saxenda is approved for adults with a BMI greater than 30 or those with a BMI greater than 27, plus other conditions like diabetes or high blood pressure. Children over 12 with a BMI greater than 30 and weighing over 60 kilograms can also take it. If you haven't lost weight after 16 weeks on Saxenda, you'll probably need to switch medications. Effects may slow down after this point.Mounjaro, Zepbound (tirzepatide): This medicine is considered dual-acting. It acts at the body's GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptors. Mounjaro is FDA-approved for type 2 diabetes. It's taken off-label for weight loss. Zepbound is FDA-approved for obesity. Zepbound is given as a weekly injection. It can be given at any time of the day, with or without food. If you take tirzepatide, weight loss will likely continue for 50 weeks or more.Other injectable peptides may help build muscle mass or reduce body fat but are not associated with weight loss per se. These peptides include:Egrifta (tesamorelin): This medicine helps the body release growth hormone. The FDA approved it to decrease abdominal fat in people living with human immunodeficiency virus (HIV).Geref (sermorelin): This medicine increases the amount of human growth hormone in the body. It's unlikely to cause weight loss but may increase lean muscle mass. It may be helpful for men with low testosterone.Do Peptides Really Work for Weight Loss?Peptides like GLP-1 agonists have proved effective for weight loss. How well they work depends on several factors, including the following:Whether you have type 2 diabetes. People with diabetes tend to lose less weight with GLP-1 agonists compared to people who don't have diabetes.Diet and exercise. Combining peptides with diet changes and increased physical activity is most effective for weight loss. Expect weight loss to be less dramatic if you use peptides without these lifestyle interventions.The specific medicine you use. Long-acting weekly injections seem to be more effective than daily ones.Do keep in mind that not everyone who uses peptides will lose weight. Studies show that only one in three people with type 2 diabetes who use peptides without also changing their diet or exercise will lose more than 5% of their body weight.Will You Need to Take Peptides for the Rest of Your Life?The short answer is, possibly, yes. Many people who achieve weight loss by taking peptides may need to stick with their therapy to maintain their weight.It may be common to regain weight after stopping medication. For instance, a clinical trial showed that people who stopped taking Wegovy regained about two-thirds of the weight they'd lost in one year.Reaching a weight-loss plateau typically means your body's metabolism has adapted, not that your medicine has stopped working.Maintaining a healthy weight is a great accomplishment. Research shows that losing even 5% of one's body weight can lower blood pressure and cholesterol levels and improve overall heart health.Do You Need a Prescription for Peptides for Weight Loss?Yes. You'll need a prescription from a healthcare provider for any FDA-approved injectable peptides.How Much Weight Do You Lose on Peptides?The amount of weight you can expect to lose on peptides varies based on personal factors like diet, amount of exercise, and other health conditions you have.As with many weight loss methods and medications, there's no easy way to predict how well you will respond to peptides for weight loss or exactly how much weight you'll lose. However, data from clinical trials suggests the following:People with diabetes who take a GLP-1 peptide in addition to diet and exercise changes can expect to lose 4% to 6% of their body weight. To put this in context, someone who weighs 250 pounds is likely to lose 10 or 15 pounds.People with diabetes who take a GLP-1 peptide without diet and exercise modifications will lose less weight, usually around 3% or 4% of their body weight.People without diabetes who take one of these peptides in addition to diet and exercise changes will typically lose more weight. Typical weight loss in this group can be between 6% and 17% of body weight. So, someone without diabetes who weighs 250 pounds is likely to lose 15 to 42 pounds.Studies show that Zepbound is the most effective specific weight-loss medication, followed by Wegovy and Saxenda.What Are Potential Side Effects and Risks of Peptides?There are some significant side effects to remember if you use a GLP-1 agonist for weight loss, including the following:NauseaVomitingDiarrheaConstipationStomach fullnessHypoglycemia (low blood sugar)PancreatitisGallbladder disordersCancer riskGastroparesis (delayed stomach emptying)Intestinal blockageAspiration (food or liquids entering the lungs), especially if you have to be sedated for surgeryPsychiatric effects, including anxiety, eating disorders, and trouble sleepingHypersensitivity reactions, including life-threatening anaphylaxisIf you develop these side effects, contact your healthcare provider or seek emergency medical care.Who Should Consider Peptides for Weight Loss?Optimal candidates for GLP-1 agonists include the following:People with a BMI above 30.People with a BMI above 27, plus other health conditions like diabetes, high blood pressure, or high cholesterol.People who can implement exercise and healthy diet choices. Though these lifestyle changes are not required, adding them to your medication regimen will help you lose more weight. Specific goals include cutting out 500 calories daily and walking for at least 150 minutes a week.Remember that BMI is just one data point and doesn't give a complete picture of your overall health. For this reason, it's not always accurate. For instance, BMI doesn't distinguish between body fat and lean muscle. It also doesn't specify the location of the body fat. Fat that accumulates around the abdomen is more concerning in terms of diabetes and heart disease risk, but BMI alone doesn't guide us in this direction.Not everyone is a good candidate for peptide treatment. People who shouldn't take GLP-1 agonists include:Pregnant peoplePeople with a history or family history of thyroid cancerPeople who have multiple endocrine neoplasia syndromeIf you're considering peptides for weight loss, discuss your wellness goals with your healthcare provider, who can help you weigh your options.SummaryA class of prescription peptides called GLP-1 agonists can help some people lose weight, particularly when combined with a healthy diet and exercise. These medicines help curb appetite, keep you full, and reduce food intake. The amount of weight you can expect to lose on peptides varies. People without diabetes typically lose more weight than those who have diabetes.Many people will need lifelong peptide treatment to maintain weight loss.Peptides have been approved for people with specific BMIs, but there may be other reasons they're a good choice for you. Be sure to discuss your health goals and concerns with your healthcare provider, who can help you with a weight management plan.If you decide to use a GLP-1 agonist like Ozempic, Zepbound, or Saxenda, watch out for side effects. Gastrointestinal side effects include nausea, vomiting, and diarrhea. More severe side effects include pancreatitis, gastroparesis (paralysis of the stomach leading to food sitting too long in the stomach), and psychiatric events. Read the original article on Verywell Health.
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