A closer look at how Semaglutide and Tirzepatide work, what the clinical studies found, and what to consider before starting. Every treatment at PLUMP VIP begins with a provider review, and medication is provided only when a licensed provider determines it is appropriate for you.

PLUMP VIP provides compounded Semaglutide and Tirzepatide, prepared by a licensed 503A pharmacy for individual patients. Compounded medications are not FDA-approved, and they do not undergo FDA review for safety, effectiveness or quality. The studies summarized on this page were conducted with the FDA-approved versions of these medications (Wegovy®/Ozempic® and Zepbound®/Mounjaro®); individual results vary, and no result is guaranteed.

Semaglutide — Benefits in Depth

Semaglutide mimics GLP-1, a natural gut hormone. It acts on the areas of the brain that regulate appetite and food intake, slows stomach emptying, and helps the pancreas release insulin when blood sugar rises.

BENEFITS

  • Weight reduction. In the STEP 1 trial (adults with obesity or overweight, without diabetes), people on the FDA-approved weight dose lost an average of 14.9% of their body weight over 68 weeks, alongside a reduced-calorie diet and increased activity.
  • Appetite and craving control. Trial questionnaires showed improved control of eating and reduced cravings compared with placebo — patients typically feel fuller on less food.
  • Blood sugar management. Semaglutide improves blood sugar control in adults with type 2 diabetes.
  • Metabolic health. Alongside weight loss, studies documented improvements in blood pressure, cholesterol and triglycerides.
  • Cardiovascular outcomes. In the SELECT trial (17,604 adults with established cardiovascular disease and overweight or obesity, without diabetes), the FDA-approved version reduced major cardiovascular events (cardiovascular death, heart attack or stroke) by about 20% versus placebo. In March 2024 the FDA approved it to reduce the risk of cardiovascular death, heart attack and stroke in adults with cardiovascular disease and obesity or overweight.
  • Kidney outcomes. In the FLOW trial (adults with type 2 diabetes and chronic kidney disease), semaglutide reduced major kidney events and cardiovascular death by about 24%, and the FDA approved it to reduce the risk of worsening kidney disease and kidney failure in that population.

CONSIDERATIONS — THE NON-BENEFITS

Stomach side effects are common, especially while the dose is increasing. In weight-dose trials of the FDA-approved version:

EffectSemaglutidePlacebo
Nausea44%16%
Diarrhea30%16%
Vomiting24%6%
Constipation24%11%

Most effects were mild to moderate; about 7 in 100 people stopped treatment because of side effects. Serious but uncommon risks include pancreatitis, gallbladder disease, severe stomach or bowel problems, kidney injury from dehydration, and severe allergic reactions.

Important: Semaglutide carries a boxed warning for thyroid C-cell tumors (seen in animal studies; it is not known whether it causes them in humans). It must not be used by anyone with a personal or family history of medullary thyroid carcinoma, or with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). It is not for use during pregnancy, and the FDA-approved label advises stopping it at least 2 months before a planned pregnancy. Tell your provider about any history of pancreatitis, gallbladder or kidney problems, severe gastroparesis, diabetic eye disease, or if you use insulin or a sulfonylurea. Weight lost during treatment is commonly regained after stopping — in one study, about two-thirds of the lost weight returned within a year of stopping.

Tirzepatide — Benefits in Depth

Tirzepatide is a dual-action medication: it activates two gut-hormone pathways, GIP and GLP-1. Together they help regulate appetite and food intake, slow stomach emptying, and improve how the body handles blood sugar.

BENEFITS

  • Weight reduction — the largest averages in studies. In the SURMOUNT-1 trial (adults with obesity or overweight, without diabetes), average weight loss over 72 weeks was 15.0%, 19.5% and 20.9% at the three maintenance doses studied. In the head-to-head SURMOUNT-5 trial, Tirzepatide produced greater average weight loss than Semaglutide (−20.2% vs −13.7%).
  • Appetite control. By acting on GIP and GLP-1 receptors, it reduces appetite and food intake, helping patients feel satisfied with less food.
  • Blood sugar management. In the SURPASS-2 trial (adults with type 2 diabetes), Tirzepatide lowered HbA1c more than the Semaglutide dose studied (−2.0 to −2.3 points vs −1.9 points).
  • Metabolic health. Alongside weight loss, studies documented improvements in blood pressure and triglycerides and other cardiometabolic measures.
  • Sleep apnea. Tirzepatide (as Zepbound®) is the first medication the FDA has approved to treat moderate-to-severe obstructive sleep apnea in adults with obesity (December 2024).

CONSIDERATIONS — THE NON-BENEFITS

Stomach side effects are common, especially while the dose is increasing. In weight-dose trials of the FDA-approved version:

EffectTirzepatidePlacebo
Nausea25–28%8%
Diarrhea19–23%8%
Vomiting8–13%2%
Constipation11–17%5%

Most effects were mild to moderate; about 4–7 in 100 people stopped treatment because of side effects. Serious but uncommon risks include pancreatitis, gallbladder disease, severe stomach reactions, kidney injury from dehydration, and severe allergic reactions.

Important: Tirzepatide carries the same boxed warning for thyroid C-cell tumors (seen in animal studies; it is not known whether it causes them in humans). It must not be used by anyone with a personal or family history of medullary thyroid carcinoma, or with MEN 2. Birth control pills may work less well while on Tirzepatide — use a non-pill method or add a barrier method for 4 weeks after starting and after each dose increase, as your provider advises. It is not for use during pregnancy. Tell your provider about any history of pancreatitis, gallbladder or kidney problems, severe gastroparesis, diabetic eye disease, or if you use insulin or a sulfonylurea. Weight lost during treatment is commonly regained after stopping — in one study, people who switched to placebo regained a substantial amount of weight over the following year.

Before You Start

These medications are long-term treatments, not short courses, and they are not right for everyone. That is why PLUMP VIP begins with a provider review: your evaluation and health history guide every recommendation, and no medication is provided until a licensed provider determines it is appropriate for you. Individual results vary, and results are not guaranteed. A prescription is required.

Sources: FDA prescribing information for Wegovy®, Ozempic®, Zepbound® and Mounjaro® (DailyMed); FDA approval announcements (2024–2025); STEP 1, SELECT and FLOW trials (semaglutide); SURMOUNT-1, SURMOUNT-5, SURPASS-2 and SURMOUNT-OSA trials (tirzepatide). Brand names are trademarks of their respective owners; PLUMP VIP provides compounded medications and is not affiliated with those manufacturers.