Obesity + diabetes - Tesiparatide may be your best choice

June 24, 2025

When the numbers on the scale remain high and the blood glucose meter's readings keep sounding the alarm, are you looking for a weapon that can "snipe" these two major health killers at the same time? In the dilemma of diabetes and obesity, traditional treatment often falls into the embarrassing situation of "pressing one problem but causing another": hypoglycemic drugs may cause weight gain, while weight loss alone is unlikely to change stubborn high blood sugar. However, a drug called Tirzepatide The new drug is igniting hope for people who suffer from both obesity and type 2 diabetes with unprecedented efficacy. It is not only a powerful tool for controlling sugar, but also a powerful ally for getting rid of excess weight, and it may become your "best choice".

🔍 Double Dilemma: Why is obesity + diabetes so difficult?

Obesity (especially abdominal obesity) and type 2 diabetes mellitus (T2DM) are closely related and are often collectively referred to as " diabesity ":

● Fat cells “run amok” : Excessive visceral fat releases a large amount of inflammatory factors and free fatty acids, which directly damage insulin sensitivity (insulin resistance).

● Pancreas “overwork” : Long-term insulin resistance forces pancreatic beta cells to work overtime and secrete more insulin, eventually leading to functional failure and uncontrolled blood sugar.

● Vicious cycle : High blood sugar itself promotes fat accumulation and abnormal energy metabolism, further aggravating obesity and insulin resistance.

Limitations of traditional treatment options:

1. Most hypoglycemic drugs do not cause weight loss and may even cause weight gain : For example, insulin, sulfonylureas, glinides, and thiazolidinediones (TZDs) often cause weight gain.

2. Diet pills are not good at lowering blood sugar : Traditional diet pills have limited or unstable effects on improving blood sugar.

3. Lifestyle intervention is “easier to know than to do” : Although diet control and exercise are the cornerstones, long-term adherence to them and achieving significant weight loss and blood sugar control are huge challenges for most patients.

4. Metabolic surgery has high risks : Weight loss surgery is effective, but it is an invasive procedure with surgical risks and complications, and is not suitable for everyone.

Dilemma faced by patients : The patient needs to take medication frequently, worries about hypoglycemia, weight gain instead of loss, large fluctuations in blood sugar, and reduced confidence in treatment.

💊 Tesiparatide: A "smart missile" that kills two birds with one stone

Tesiparatide (trade name: Mounjaro ) is an innovative dual agonist of the glucose-dependent insulinotropic polypeptide (GIP) receptor and the glucagon-like peptide-1 (GLP-1) receptor . It mimics two "smart messengers" naturally produced by the human intestine - GIP and GLP-1, but its effects are stronger and more lasting.

🌟 How does it achieve a win-win situation of "lowering blood sugar + reducing weight"

1. Intelligent blood sugar reduction, safe and efficient:

a. Glucose-dependent stimulation of insulin secretion : It promotes the release of insulin from pancreatic β cells only when blood sugar is elevated, and its effect is weakened when blood sugar is normal or low, significantly reducing the risk of hypoglycemia .

b. Inhibit glucagon secretion : reduce excessive glucose output from the liver.

c. Delay gastric emptying : Allow food to stay longer in the stomach, slow down the absorption of glucose into the blood, and make blood sugar levels more stable after meals.

2. Powerful weight loss and metabolism remodeling:

a. Acts on the hypothalamus of the brain : enhances satiety signals, reduces hunger, and makes you eat less naturally.

b. Increase energy expenditure : Studies have suggested that it may slightly increase the metabolic rate.

c. Directly act on adipose tissue : may promote the conversion of white fat (bad fat) into brown fat (good fat that can consume energy).

d. Improve fatty liver : Significantly reduce liver fat content.

The agonist effect of GIP receptors is considered to be the key reason why tesiparatide performs better in weight loss than simple GLP-1 receptor agonists (such as semaglutide). GIP plays a complex role in energy metabolism and fat storage, and tesiparatide's specific activation mode of GIP receptors brings stronger metabolic benefits.

📊 Shocking data: How strong is the clinical effect of tesiparatide

The results of several large, rigorous Phase III clinical trials (such as the SURPASS series for diabetes and the SURMOUNT series for obesity/overweight) are impressive:

1. The blood sugar lowering effect "reaches the top":

a. In monotherapy or combination therapy, the effect of tesiparatide (5mg, 10mg, 15mg) in reducing glycated hemoglobin (HbA1c) is significantly better than the current mainstream injectable drugs ( such as semaglutide 1mg) and oral drugs (such as sitagliptin).

b. A very high proportion of subjects achieved blood sugar control (HbA1c <7.0%), and a considerable proportion even reached normal levels (HbA1c <5.7%).

2. Record-breaking weight loss effect:

a. For patients with type 2 diabetes (SURPASS study) :

i. Using a 15 mg dose for approximately 40-52 weeks, patients can achieve an average weight loss of 10-13 kg (approximately 22-29 lbs) .

ii. More than half (50%+) of the patients lost ≥10% of their weight, and more than one-third (30%+) of the patients lost ≥15% of their weight!

b. For obese/overweight people without diabetes (SURMOUNT study) :

i. With a 15 mg dose for 72 weeks, patients experienced an average weight loss of 20.9% (approximately 22.5 kg or 49.5 lbs) .

ii. More than 57% of patients lost ≥20% of their weight, and more than 36% of patients lost ≥25% of their weight!

iii. The effect is significantly better than placebo and active control drugs (such as semaglutide 2.4 mg).

3. Comprehensive metabolic benefits are significant:

a. Blood pressure drops : Both systolic and diastolic blood pressure improve significantly.

b. Improve blood lipids : reduce triglycerides and increase "good cholesterol" HDL-C.

c. Decrease in inflammatory indicators : such as a decrease in C-reactive protein (CRP).

d. Cardiovascular benefits are beginning to emerge : preliminary analysis shows that it may reduce the risk of major adverse cardiovascular events, and a large outcome study is underway (SURPASS-CVOT).

📋 Who is most likely to benefit from tesiparatide

Tesiparatide offers a powerful new option for people who:

1. Patients with type 2 diabetes and overweight or obesity (BMI ≥27 kg/m²) , especially for:

a. Those whose blood sugar level still does not meet the target after using one or more oral hypoglycemic drugs (such as metformin).

b. Those who need more effective blood sugar lowering and hope to lose weight at the same time.

c. Pay attention to those at risk of hypoglycemia.

d. Those with risk factors for cardiovascular disease (more long-term evidence is needed, but improvement in metabolic indicators is a positive sign).

2. Patients with simple obesity or overweight (BMI ≥30 kg/m² or ≥27 kg/m² with at least one weight-related comorbidity) are eligible for:

a. Those who have not achieved good results in losing weight through diet and exercise.

b. Those with weight-related health problems (such as hypertension, dyslipidemia, sleep apnea, fatty liver, increased risk of cardiovascular disease, osteoarthritis, etc.).

Important Tips: Tesiparatide is a prescription drug and must be prescribed after evaluation by a doctor . The doctor will consider your disease, physical condition, medication history, etc. to determine whether it is suitable.

⚠️ Usage, side effects and precautions

1. How to use:

a. Dosage form : Injection pen, pre-filled with liquid medicine.

b. Injection site : subcutaneous injection in the abdomen, thigh or upper arm.

c. Frequency : Once a week, injection can be given at any time of the day, regardless of meals.

d. Dosage : The dose needs to be gradually increased (dose escalation) to reduce gastrointestinal side effects. The starting dose is usually 2.5 mg/week, increased by 2.5 mg every 4 weeks, and the target maintenance dose is 5 mg, 10 mg or 15 mg/week (determined by the doctor based on efficacy and tolerability). Do not adjust the dose on your own!

2. Common side effects and management:

a. Gastrointestinal reactions are the most common : nausea, vomiting, diarrhea, constipation, abdominal pain, indigestion, etc. They usually occur during the dose escalation period, are mostly mild to moderate, and last for a short time.

i. Coping strategies : strictly follow the dose escalation plan; avoid high-fat, greasy or large amounts of food after injection; eat small meals frequently; ensure drinking water; doctors can prescribe symptomatic drugs if necessary. Most patients can gradually tolerate it over time.

b. Other potential side effects : decreased appetite (one of the treatment goals), injection site reactions (redness, swelling, itching, usually mild), slightly increased heart rate (needs to be monitored), possible increased risk of gallbladder-related events (such as gallstones) (especially when losing weight rapidly), risk of acute pancreatitis (rare but symptoms need to be alerted), risk of complications of diabetic retinopathy (especially in patients with rapid improvement in blood sugar, regular eye examinations are required).

3. Important precautions and taboos:

a. Contraindications :

i. Those with a history of severe allergy to tesiparatide or its components.

ii. Those with a personal or family history of medullary thyroid carcinoma (MTC).

iii. People with multiple endocrine neoplasia type 2 (MEN 2). ( Black Box Warning : Animal studies have shown that tesiparatide may cause thyroid C-cell tumors. The risk to humans is unknown, but it is contraindicated in this risk group).

b. Pancreatitis : People with a history of pancreatitis should be cautious. If persistent, severe abdominal pain (which may radiate to the back) occurs during use, with or without vomiting, seek medical attention immediately.

c. Hypoglycemia : When used in combination with insulin or sulfonylureas, the risk of hypoglycemia increases and the dose of these drugs may need to be adjusted.

d. Renal impairment : Patients with moderate to severe renal impairment should be cautious when starting and increasing the dose. It is not recommended for patients with end-stage renal disease. Monitor renal function during medication.

e. Pregnancy and breastfeeding : Adequate research has not been conducted in pregnant women and its use is not recommended. Breastfeeding women should weigh the pros and cons or stop breastfeeding.

f. Gastroparesis : GLP-1 drugs may delay gastric emptying and should be used with caution in patients with a history of severe gastroparesis.

g. Suicidal thoughts/behaviors : No clear association has been reported, but attention should be paid to mood changes during use of any weight loss drug.

💡 Why tesiparatide may be the “best choice”

1. Dual efficacy, breaking through bottlenecks : While effectively controlling blood sugar (even better than existing mainstream drugs), it also brings about significant weight loss effects far exceeding traditional hypoglycemic drugs, directly attacking the core of "diabetes and obesity".

2. One injection per week, convenient management : Compared with drugs that need to be taken multiple times a day, it has higher compliance and less burden on life.

3. Low risk of hypoglycemia : The glucose-dependent mechanism of action is its safety advantage.

4. Comprehensive metabolic improvement : It not only reduces blood sugar and weight, but also brings beneficial effects on blood pressure, blood lipids, inflammation and other aspects, comprehensively reducing cardiovascular metabolic risks.

5. Bring hope and confidence to patients : Significant weight loss and improvement in blood sugar can greatly improve patients' quality of life, body image and confidence in treatment, breaking the vicious cycle.

📍 Look at it rationally and use it scientifically

● Not a panacea : Tesiparatide is a powerful tool, but it cannot replace a healthy lifestyle ! A balanced diet, regular exercise, adequate sleep and stress management are still the cornerstones. Only when the drug is combined with lifestyle can the greatest and longest-lasting benefits be achieved.

● Individualized treatment : The effect and tolerance vary from person to person, and the most suitable dosage and treatment plan should be found under the guidance of a doctor.

● Long-term management : Obesity and diabetes are chronic diseases. Weight and blood sugar may rebound after stopping medication. Long-term adherence to treatment (including medication and lifestyle) is the key to maintaining efficacy. Doctors will assess the necessity and benefit-risk of long-term medication.

● Ongoing research : Its long-term safety (such as cardiovascular outcomes, pancreatic safety, etc.) is still under continuous monitoring and research.

✅ What should I do?

1. Assess your own situation : Understand your BMI, blood sugar control level (HbA1c), comorbidities and current treatment plan.

2. Consult a professional doctor : If you are a patient with type 2 diabetes and obesity/overweight, or a patient with simple obesity (and meet the indications), be sure to discuss in depth with your endocrinologist or obesity specialist :

a. Is tesiparatide suitable for my specific situation?

b. What is the expected efficacy (blood sugar, body weight)?

c. What side effects may occur and how to manage them

d. How to coordinate or adjust with existing drugs

e. What is the long-term treatment plan?

3. Set reasonable expectations : Understand that it takes time for the drug to take effect (weeks to months), and that weight loss and blood sugar improvement are gradual processes. Focus on long-term benefits.

4. Commit to lifestyle changes : Work with your doctor or nutritionist or sports rehabilitator to develop a practical diet and exercise plan and actively cooperate.

5. Regular follow-up monitoring : Follow the doctor's orders for regular follow-up visits, monitor blood sugar, weight, blood pressure, blood lipids, liver and kidney function and other indicators, evaluate the efficacy and safety, and adjust the plan in a timely manner.

🌈 Embrace new possibilities of dual health

The dilemma of obesity and diabetes has made countless people feel powerless. The emergence of tesiparatide, with its revolutionary dual mechanism of action and excellent clinical data, provides a powerful weapon to break this dilemma. It is not just a hypoglycemic or weight-loss drug, but also represents a new treatment strategy that simultaneously solves two core metabolic problems and achieves comprehensive health improvement .

If you are stuck in the quagmire of "diabetes and obesity", you don't have to accept the results of a treatment that compromises your health. Take the initiative to communicate with your doctor to evaluate whether tesiparatide may be the best choice for you. Combined with firm healthy lifestyle changes, you are fully capable of regaining control of your blood sugar, reshaping your body, and embracing a healthier, lighter, and more energetic future. This metabolic health revolution is worth it!