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Note: This can be tricky to time around pre- and post-workout nutrition

Best For Patients who have plateaued on semaglutide or tirzepatide Patients with significant weight to lose (50+ pounds) Patients with fatty liver disease (MASLD/NAFLD) or metabolic syndrome Patients who want access to the most advanced mechanism currently available Patients with established GLP-1 experience and good tolerance Side Effect Comparison All three medications share a similar side effect profile driven primarily by gastrointestinal effects: Common Side Effects (All Three) Nausea most common during dose escalation, usually resolves within 2 to 4 weeks at each dose level Diarrhea reported by 15 to 25 percent of patients Vomiting reported by 8 to 15 percent Constipation reported by 6 to 12 percent Decreased appetite nearly universal and considered therapeutic Tirzepatide and retatrutide may have slightly higher rates of GI side effects than semaglutide due to the additional pathway activation

According to federal data, Ozempic and Wegovy together made up nearly 10% of all Medi-Cal drug reimbursements in 2024

Neural Plast 2013:429815 Wendt S, Wogram E, Korvers L, Kettenmann H (2016) Experimental Cortical Spreading Depression Induces NMDA Receptor Dependent Potassium Currents in Microglia

I had to stop Mounjaro eventually because the cost was way too high, Hamilton said

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