Over the past few years, medications like Ozempic® (semaglutide) and Mounjaro® (tirzepatide) have gained enormous attention for their effectiveness in weight management and blood sugar regulation. These drugs belong to a class of medications that work on the body’s natural hormone systems, supporting appetite regulation, insulin sensitivity, and metabolic health.
As naturopathic physicians, we approach these medications with both curiosity and caution. In this post, we’ll explore the differences between GLP and GIP medications, compare Ozempic vs Tirzepatide, review insurance and compounding issues, and outline the lifestyle foundations that must accompany these medications for sustainable health.
GLP vs GIP: What’s the Difference?
- GLP-1 (Glucagon-like Peptide-1) medications: such as Ozempic®, Wegovy®, and Rybelsus® mimic a naturally occurring hormone that slows stomach emptying, increases insulin release, and signals satiety to the brain.
- GIP (Glucose-dependent Insulinotropic Polypeptide) medications: often combined with GLP action, as in Tirzepatide (Mounjaro®) stimulate insulin secretion and may enhance fat metabolism.
- Dual GIP/GLP agonists (like Tirzepatide): appear to provide greater weight loss and metabolic improvements than GLP-only medications, though long-term data is still emerging.
Tirzepatide vs Ozempic
- Tirzepatide (Mounjaro®): Works on both GLP and GIP receptors. Early studies show greater average weight loss (up to 20% of body weight) compared to semaglutide.
- Ozempic® (semaglutide): A GLP-1 only agonist, effective for both type 2 diabetes and weight management (under the name Wegovy®). Average weight loss is closer to 10–15%.
- Key difference: Tirzepatide may offer superior results but is newer, meaning less is known about its long-term safety compared to semaglutide.
Compounding vs Prescription
- FDA-approved prescriptions (Ozempic, Mounjaro, Wegovy, etc.) are manufactured under strict safety standards and are the preferred option when available.
- Compounded versions of semaglutide or tirzepatide is available in combination with other ingredients, like B12, to reduce side effects like nausea and fatigue.
- Patients should be cautious: not all “semaglutide” from compounding pharmacies is true semaglutide; some versions contain semaglutide salts, which are not FDA-approved.
Insurance Coverage and Prior Authorization
These medications are expensive, $350-$650/mo if purchased directly from the manufacturer.
Insurance coverage typically requires:
- Diagnosis criteria (type 2 diabetes, or BMI ≥30, or BMI ≥27 with weight-related conditions like hypertension, sleep apnea, or insulin resistance).
- Documentation of failed lifestyle interventions (nutrition, exercise, behavioral therapy).
- Prior authorization paperwork, where your physician must show medical necessity and compliance with insurance criteria.
Many insurers will not cover weight-loss use unless strict criteria are met. Some may approve only diabetic patients or patients with sleep apnea and obesity.
Lifestyle Foundations: Nutrition & Exercise
Even with GLP or GIP medications, success depends on lifestyle:
- Dietary focus:
- High protein (to preserve lean muscle mass and reduce cravings, we recommend 1 gram of protein per pound of optimal body weight).
- High fiber (to support digestion, gut microbiome, and satiety).
- Whole, minimally processed foods, balancing macronutrients, and mindful eating practices.
- Exercise recommendations:
- Strength/resistance training 2–3 times per week minimum (critical to protect against muscle loss, which is a real risk during rapid weight loss).
- Daily movement: walking, stretching, light cardio, to improve insulin sensitivity
Side Effects to Watch For
- Common: Nausea, constipation, diarrhea, bloating, reflux.
- Less common but serious: Gallstones, pancreatitis, severe GI upset.
- Nutrient concerns: Some patients may develop protein or micronutrient deficiencies if appetite suppression is extreme.
Naturopathic medicine supports minimizing these risks with individualized diet plans, digestive and GI motility support, and monitoring labs as needed.
Treatment Duration and Weaning
- These medications are designed for long-term or even indefinite use. Studies show that stopping treatment often leads to weight regain within months.
- Some patients may wish to wean off medications once they’ve reached health goals, but this requires careful planning:
- Gradual tapering under medical supervision.
- Continued emphasis on high-protein, high-fiber nutrition.
- Ongoing strength training and lifestyle coaching.
Naturopathic medicine can play a key role in supporting sustainable health habits, reducing reliance on medications over time when appropriate.
Bottom Line
GLP and GIP medications like Ozempic® and Mounjaro® are powerful tools in metabolic medicine. But they are not magic bullets, they work best when paired with a whole-person approach that emphasizes nutrition, exercise, and long-term health strategies.
As naturopathic physicians, our role is to help patients use these tools safely and effectively while addressing the root causes of metabolic imbalance at the same time, using dietary and lifestyle counseling, accountability and herbal or supplemental support to reduce risk of side effects.
