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Comparing the Newest Weight Loss Drugs: Tesofensine vs Semaglutide

Rediscover Your Best Self Through Safe and Effective Medical Weight Loss

Obesity is a complex disease that impacts an estimated 93 million Americans. Carrying excess weight can negatively affect nearly every aspect of health, from increasing your risk for diabetes and heart disease to causing joint pain, sleep apnea, and more. 

While diet and exercise are critical for weight management, there are times when medical interventions can help people struggling with obesity reclaim their health. 

Two of the newest prescription medications for treating obesity are tesofensine and semaglutide

Keep reading as we explore how these innovative drugs work, their effectiveness for weight loss, potential side effects to consider, and overall costs.

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What is Tesofensine?

Tesofensine is the first-in-class medication for treating obesity that works as a triple monoamine reuptake inhibitor. This means it inhibits the reabsorption of three key neurotransmitters in the brain: serotonin, norepinephrine, and dopamine. 

By keeping higher levels of these chemical messengers active in the nervous system, tesofensine curbs appetite and enhances feelings of fullness and satisfaction after eating smaller portions.

The effects of tesofensine on promoting weight loss appear to come from both suppressed appetite and increased metabolic rate. This dual mechanism helps spur considerable fat burning while reducing daily calorie intake through lessened hunger cues.

What is Semaglutide?

tesofensine vs semaglutide

Semaglutide is an injectable anti-diabetic medication in the glucagon-like peptide-1 (GLP-1) agonist class of drugs. It mimics the effects of GLP-1, a hormone produced in the gut that boosts insulin secretion while lowering glucagon release. 

This improves blood sugar control. Semaglutide was initially approved for treating type 2 diabetes, but has since also been approved for chronic weight management at a higher dose than what is used for diabetes.

As a GLP-1 receptor agonist, semaglutide impacts appetite regulation pathways in the brain to promote feelings of fullness, reduce hunger, and decrease overall calorie intake. It also slows stomach emptying to curb food cravings. In large placebo-controlled studies, semaglutide led to considerable weight loss over 68 weeks when combined with diet and exercise modifications.

Mechanism of Action: How These Drugs Work

Tesofensine and semaglutide promote weight loss through different mechanisms of action.

Tesofensine works as a triple monoamine reuptake inhibitor. It blocks the reabsorption of the neurotransmitters serotonin, norepinephrine, and dopamine in the nervous system. 

This leads to increased concentrations of these chemical messengers in the brain which curb appetite. Tesofensine also appears to increase resting metabolic rate. The combined effects of eating less and burning more calories results in significant weight loss.

In contrast, semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. It mimics the effects of the natural hormone GLP-1 which stimulates the release of insulin from pancreatic beta cells while suppressing glucagon secretion. 

This results in better blood sugar control. GLP-1 also delays gastric emptying and promotes satiety through effects on appetite regulation pathways in the brain. By acting like GLP-1, semaglutide improves glycemic control and decreases calorie consumption which drives weight loss.

Route of Administration: Pills vs Injections

tesofensine vs semaglutide

Tesofensine is taken as a once daily oral tablet. This offers convenience and avoids the need for injections. However, some patients may have trouble remembering to take a daily pill or don't absorb the medication optimally.

Semaglutide is administered as a subcutaneous injection given once weekly. Patients must get comfortable self-injecting the drug. However, the weekly dosing regimen can improve compliance compared to a daily pill. Some patients also prefer infrequent injections over daily pills.

Ultimately, the decision between an oral tablet like tesofensine and an injectable like semaglutide depends on your preferences for taking medication and how well each fits into your lifestyle.

Pills or injections? Discuss your preferences and find the perfect fit for your lifestyle with a consultation at Dr. V Medical Aesthetics

Onset of Action: How Quickly These Medications Work

When evaluating obesity drugs, it is useful to consider how quickly weight loss effects are seen once starting treatment. This gives an idea of the onset of action.

Tesofensine appears to produce noticeable results within the first 1-2 weeks of therapy based on clinical evidence. The effects on appetite and metabolism stimulate fat burning right away.

In comparison, semaglutide's weight loss benefits tend to emerge more gradually. It often takes 4 weeks or longer to begin seeing the scale drop. Maximum benefits may take 3-6 months.

So tesofensine generally has a faster onset, leading to weight loss within 14-30 days. Semaglutide works more slowly, taking 1-2 months to ramp up. This is useful to set expectations when starting either medication.

Side Effect Profile Comparison

All prescription medications come with potential adverse effects, so it’s important to weigh the risks versus benefits.

The most problematic side effects of tesofensine include:

  • Anxiety or mood changes: tesofensine affects neurotransmitters involved in mood regulation. Pre-existing anxiety disorder may be worsened.
  • Sleep disturbances: trouble falling asleep or frequent waking can occur due to the stimulant-like effects.
  • Dry mouth: decreased saliva production is common.
  • Headaches: tension headaches are frequently reported.
  • Increased blood pressure and heart rate: patients should have cardiovascular health monitored.

For semaglutide, the most common side effects are:

  • Nausea: feelings of queasiness, especially when first starting.
  • Diarrhea: loose bowel movements may persist for several weeks.
  • Vomiting: throwing up may occur as the body adjusts.
  • Constipation: difficulty moving bowels regularly.
  • Abdominal pain: cramping or discomfort in the stomach area.

Semaglutide's gastrointestinal effects like nausea and diarrhea appear more frequent than tesofensine's side effects but are still usually mild. Tesofensine may pose higher risks related to mental health and cardiovascular issues in some patients. Working closely with your obesity medicine doctor can help minimize risks when using either medication.

Understand the side effects and make an informed decision about your weight loss treatment with expert advice from Dr. V Medical Aesthetics

Cost Comparison

An important factor when considering weight loss drugs is cost and insurance coverage. Tesofensine is currently only approved in Europe, Mexico, Argentina, and a few other countries. It has not yet been approved for use in the United States. No definitive price estimates are available.

Semaglutide is approved for chronic weight management in the US under the brand names Ozempic and Wegovy. Per the manufacturers, these drugs cost approximately $1,000-$1,500 per month without insurance. 

Some insurances may cover semaglutide, often with prior authorization requirements and limitations on length of approval. Out-of-pocket costs can be significant for patients paying fully cash-based.

Semaglutide appears to be the more affordable option for most patients at this time since tesofensine costs are uncertain. However, many people struggle to pay for semaglutide long-term. 

This is where options like working with specialty pharmacies on manufacturer copay programs or exploring off-label GLP-1 drugs can help reduce the financial burden.

The Takeaway

Dr. V and her staff at Dr. V Medical Aesthetics

Tesofensine and semaglutide take different approaches to weight loss, but both can be game-changers for people battling obesity. With double-digit average weight loss achieved in clinical testing, they are two of the most effective medications available.

Tesofensine may produce faster progress, but its approval is limited globally. Semaglutide is widely available yet can be costlier and takes longer to reach maximum results. 

Having an open and honest conversation about your weight loss goals, health history, and treatment preferences with an expert can help determine if one of these modern medications is right for you.

At Dr. V Medical Aesthetics, we specialize in personalized medical weight loss plans tailored to your unique needs. Whether you want to learn more about prescription medications or take a more holistic approach, we're here to help you rediscover your healthiest and happiest self. 

Get in touch with us by booking an appointment online or calling us at (850) 407-2803 today.


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