About two in every three Americans are overweight or obese. This increases their chances of myriad chronic health conditions. These include diabetes, cardiovascular disease, stroke, and many others.
The good news is that today there are many tools available for weight loss. Especially for those for whom diet and exercise have been ineffective, there are proven medications that can help.
Two prominent ones are tesofensine and semaglutide. While they share some results, these drugs work in different ways and yield distinct benefits.
This article breaks down the differences between tesofensine vs semaglutide. It explains how each one works, as well as its advantages and drawbacks. Keep reading to find out which one may be right for your health goals.
Why Are Weight Loss Drugs Needed?
There are many theories about the causes of unwanted weight gain and the inability to lose weight. However, most dieticians, doctors, and researchers all agree on one thing: we are surrounded by calorie-dense foods that we are biologically driven to consume.
This has led experts to reassess culpability regarding weight gain and loss. In short, obesity is a symptom of evolution and our environment.
A Brief History of Weight Loss Drugs
The practice of using pharmacological interventions to achieve weight loss has been around for hundreds of years (or longer). However, the use of modern medications targeted at weight loss is relatively new (because the problem is new).
In the early 20th century, weight loss drugs were stimulants, like amphetamines. The main goal was to increase metabolism and the body’s fat-burning potential. Many of them also had appetite-suppressing qualities as well.
These drugs, however, only worked for short spans. They also had serious side effects and were very addictive.
Other appetite suppressants, such as the popular Fen-Phen of the 1990s, proved to be even more dangerous. After dozens of patients experienced cardiac arrest, the U.S. Food and Drug Administration (USDA) recalled it.
Breakthroughs with medications that block fat absorption in the body sparked another weight-loss-drug craze in the early 2000s. However, these also had negative side effects and were not proven to be effective for long-term weight loss.
It was not until the last 20 years that safe and effective weight loss medications like tesofensine and semaglutide were developed. They have limited and mild (when they do occur) side effects.
They also have proven to be useful for many related conditions. These include treating Type II diabetes, cardiovascular disease, and even anxiety and depression.
What Is Tesofensine?
Tesofensine is a medication that was developed to treat obesity by increasing the likelihood of weight loss. It is a small molecule compound that works as a “triple reuptake inhibitor.”
This means it works by blocking the body’s absorption of the three main neurotransmitters associated with “reward.” These are norepinephrine, dopamine, and serotonin. This in turn increases their presence in the spinal cord and brain.
Norepinephrine stimulates the contraction of skeletal muscle and the heart. This promotes optimal body function.
Dopamine is key for regulating motor function and cognitive function, as well as mood and motivation. Serotonin also helps regulate mood, as well as memory, sleep, and appetite.
Tesofensine stimulates neurotransmitter production synthetically. This means the patient does not turn to eating as a “reward” trigger for making them.
Tesofensine was developed by Danish scientists as a treatment for Alzheimer’s and Parkinson’s disease. Clinical trials ceased due to its limited effectiveness on the symptoms and progression of these conditions.
Significant weight loss was a side effect reported in these original studies. This was especially true in patients who were overweight or obese.
That led scientists to begin studying tesofensine as a potential weight-loss drug. Since it had already been confirmed as safe for humans, researchers were able to skip the animal testing phase. This expedited tesofensine’s approval.
What Are the Weight Loss Benefits of Tesofensine?
The main reason people take Tesofensine is weight loss. It does so by producing a feeling of satiety, which diminishes appetite. It tricks the brain into thinking that the gastrointestinal tract is full.
This is a result of tesofensine accomplishing two things. It binds to both the dopamine D1 receptor and alpha-1 adrenoceptors. The latter is normally activated by norepinephrine and epinephrine.
Compared to a placebo, tesofensine has been shown to reduce body weight by about 6 to 8 percent over a 12-week period. This was combined with diet, exercise, and lifestyle modifications for both groups.
It is worth noting that faster and greater weight loss can be achieved with larger doses of tesofensine. However, it is important to stay within the recommended dosage prescribed by your doctor based on your health status.
What Are the Other Health Benefits of Tesofensine?
There are other, related advantages of taking Tesofensine. These include improved insulin sensitivity, which can be a potential benefit for patients with Type II diabetes.
Tesofensine can also have antidepressant effects. That is because the presence of more dopamine in the brain helps increase energy and mood. This too can lead to weight loss, besides being a benefit in itself.
Tesofensine can have other neuroprotective effects as well. It can improve cognition, especially as it pertains to memory and learning.
Tesofensine also has proven to be effective in combatting alcohol addiction. Patients reported decreases in both cravings and incidence of relapse. This can make it an attractive option for individuals suffering from obesity as well as some form of alcohol abuse disorder.
Finally, Tesofensine is safe for long-term use. This can be particularly useful for patients who want to lose weight at a healthy rate. This in itself can contribute to patients keeping weight off.
What Is Semaglutide?
Semaglutids is a glucagon-like peptide-1 (GLP-1) agonist. GLP-1 is a hormone secreted by the intestines that helps regulate blood sugar levels. Semaglutide mimics the actions of this hormone.
Semaglutide was first developed in 2012. It was first approved by the U.S. Food and Drug Administration and became available for prescription at the end of 2017.
Patients can take semaglutide orally or inject it subcutaneously. It is typically taken once a week for the sole purpose of weight loss. Patients can take it up to two times a week for the management of Type II diabetes.
Semaglutide is sold under the brand names Ozempic and Rybelsus. These are both versions designed to treat Type II diabetes. The drug is also sold under the brand Wegovy, which is formulated for weight loss alone.
What Are the Weight Loss Benefits of Semaglutide?
Like tesofensine, the main benefit of semaglutide is weight loss. This happens because the production of GLP-1 helps control hunger and suppresses appetite.
As mentioned, it is also key to controlling blood sugar levels by stimulating insulin release. Improved glycemic control can be a central component of weight loss for many patients.
Semaglutide is particularly effective at treating binge eating disorders by dulling impulsive eating. It also has proven to help combat recurring and/or obsessive thoughts about food.
What Are the Other Health Benefits of Semaglutide?
Like tesofensine, semaglutide also has some other health benefits that are worth considering. One is that it is effective in treating non-alcoholic fatty liver disease.
It can be used to lower the risk of heart attack and stroke in individuals with heart or blood vessel disease. This can make it an attractive option for anyone who wants to lower these risks while treating obesity.
GLP-1 receptor agonists like semaglutide often can impact energy levels. While it is not the medication’s main method for combatting obesity, it can result in accelerated fat-burning and faster weight loss.
As mentioned, tesofensine was originally developed as a prospective treatment for neurodegenerative diseases like Alzheimer’s and Parkinson’s. Ironically, semaglutide has proven to be a more effective treatment in reversing the effects of these conditions. The hypothesis is that this is due to elevated glucose levels in the brain.
Tesofensine vs Semaglutide: Similarities
It can be difficult to objectively compare the effectiveness of each drug. That is because they work in very different ways, even though some of their outcomes overlap.
In general, both tesofensine and semaglutide can be effective weight-loss tools. They both can generate feelings of satiety and appetite suppression. And they each can impact the basal metabolic rate (although they do so through distinct mechanisms).
Tesofensine vs Semaglutide: Differences
There are many different factors to weigh when choosing between tesofensine vs semaglutide. Here are the main ones to consider.
How They Work in the Body
As mentioned, tesofensine and semaglutide use very different mechanisms to achieve the desired effects. For this reason, which one is more effective depends on the individual patient and their unique health goals.
For instance, one person may respond well to increased neurotransmitters stimulated by tesofensine. Another may see better results from semaglutide’s ability to balance blood glucose levels.
Also, coexisting health goals can impact which medication is right for you. For instance, if you have some level of alcohol abuse disorder, tesofensine may be able to help you control your urges to drink. If you have Type II diabetes or prediabetes, semaglutide can be integral to controlling blood glucose levels.
Side Effects
Before making a final decision between tesofensine vs semaglutide, it is important to weigh the potential side effects with their health benefits. The most common ones associated with semaglutide are headache, nausea, vomiting, abdominal pain, diarrhea, and constipation.
Other mild symptoms include bloating and heartburn. In rare cases, patients reported blurred vision and confusion.
Tesofensine has very similar side effects. These include nausea, diarrhea, and constipation. In some cases, patients also experience mild dizziness, dry mouth, headaches, and insomnia.
Some people taking tesofensine saw elevated heart rate and blood pressure. In rare instances, there were reports that it triggered anxiety, agitation, and depression. More serious side effects include hallucinations, psychosis, and seizures.
As with any medication, you should report any side effects to your doctor. An adjustment to dosage or a change in medication may be warranted.
Also, both tesofensine and semaglutide can interact with other medications. Be sure to discuss these with your medical provider as well before taking them.
Frequency and Method of Dosage
Semaglutide can be taken as an injection or tablet. Injections are taken once to twice a week (depending on the health goals), while the tablet must be taken once a day.
Tesofensine can only be taken in capsule form. Patients must take the medication daily for it to be effective.
Can You Combine Tesofensine and Semaglutide?
Since these medications work in two distinct ways, it may be safe to take both. However, there are several reasons to consider avoiding this.
In most cases, taking either tesofensine or semaglutide alone will help an individual achieve a healthy weight and reach their other health goals. Taking both medications may be unnecessary. You could be enduring needless side effects of one medication or the other.
Next, potential interactions between the drugs have not been extensively researched. Also, it may be possible for one medication to diminish the effectiveness of the other. This too can depend on the individual and the way the drugs work in their body.
The short answer is that you should consult your doctor before combining any medications. If you are currently taking either tesofensine or semaglutide and wish to switch to the other, make sure your physician is aware
These medications have different half-lives, which also can vary among individuals. It is safest to ensure that the biological effects of one have diminished before starting the other.
Learn More About Healthy Ways to Lose Weight
Now that you understand the differences between tesofensine vs semaglutide, you can determine which one is right for your weight loss goals. Medical professionals can further advise you on the best weight loss plan based on your unique circumstances.
At Evolve, our team is dedicated to providing safe, quality care and treatment options to our patients. Our healthcare professionals can help you determine the best course of action for your weight loss journey. Contact us to schedule a telehealth appointment with one of our highly trained doctors today.
