Semaglutide gets all the press because it's a lot cheaper and actually available (barely available, but available). Tirzepatide is much more difficult to get access to, though IMO it should be the one that people default to if they're going to take this class of drug.
Semaglutide will probably have the most side effects because it only has one action (GLP-1 agonist). Tirzepatide has slightly lower side effects because it adds a dual action (GLP-1 agonist + GIP analogue) so it can act at a lower magnitude on the GLP-1 receptors to avoid strong side effects, while still having higher efficacy due to its additional, separate, GIP action.
LY3437943 looks even more promising, with fewer side effects. LY3437943 retains both the actions of Tirzepatide but adds a third action, glucagon receptor agonist. So it should be able to have higher efficacy at a lower equivalent dose than the other two (less action on GLP-1 and GIP mechanisms, fewer side effects).
Ozempic has been around longer and there were a bunch of celebrities taking it and talking about it on twitter so I think it has more cultural cachet. Most people probably don't know about mounjaro, I don't even think it's approved for weight loss yet.
Mounjaro is not yet approved for weight loss in the US even though there is strong evidence that it will be, and there's little question that there has generally been weight loss in those taking it for diabetes.
Recent studies have very clearly shown it's effective for weight loss even in those without diabetes, but there's a lag as the FDA reviews those studies. Until then, Lilly simply can't advertise it as a treatment for obesity.
It’s not weird at all if you’re aware of the regulations.
Drug companies can’t promote a drug for something it’s not FDA approved for (off-label promotion). Companies face multi-billion dollar penalties for doing so.
Mounjaro is approved for type 2 diabetes. And weight loss is a great way to help get your type 2 diabetes under control.
So highlighting that it helps type 2 patients lose weight, while having an FDA mandated disclosure that it’s not approved for weight loss alone, makes perfect sense.
The wonderful Paul Ford has the best writeup I've seen that discusses these more meta levels, the post-human implications of a drug we can genuinely widescalely reprogram ourselves with. Paul's so great. https://www.wired.com/story/new-drug-switched-off-appetite-m... https://news.ycombinator.com/item?id=34660232