How Does Trulicity Work for Weight Loss

Living with diabetes comes with unique health challenges. Maintaining a healthy weight is one of them. Nearly 90% of U.S. adults with diabetes are considered overweight or obese. So naturally, many people with diabetes have questions about which diabetes medications can help you lose weight.

Trulicity (dulaglutide) is one potential option. It's an FDA-approved medication for Type 2 diabetes when used along with a diabetes-friendly diet and exercise. And it's also approved to lower the risk of heart problems in people with Type 2 diabetes and heart disease (or risk factors for heart disease). Although it's not FDA approved specifically for weight loss, it can help in this arena as well. Here, we'll discuss Trulicity and when it can be a tool for healthy weight loss.

How does Trulicity work for weight loss?

Trulicity is a glucagon-like peptide-1 (GLP-1) agonist. It stimulates insulin release when you eat to help control your blood glucose (sugar) levels. Trulicity isn't FDA approved for weight loss specifically. But weight loss may be an added benefit of taking Trulicity.

GLP-1 is a type of incretin hormone. Incretins are released naturally in the body after you eat. They stimulate insulin release from your pancreas (an organ behind your stomach). This prevents blood glucose levels from rising too high.

Trulicity also slows down how quickly food travels from your stomach to your intestines. This helps you feel full sooner after eating, making you eat less. This effect helps regulate blood glucose and it can also lead to weight loss.

What does the research show about Trulicity and weight loss?

Trulicity is one of several diabetes medications that can cause weight loss. The amount of weight loss you'll lose depends on several factors, including your Trulicity dose, how long you take it, and your starting body mass index (BMI). Generally, people tend to lose more weight with higher doses, especially if they have a higher body weight initially.

In 2020, a large randomized controlled trial (the best type of study to look for cause and effect) was conducted to see how different Trulicity doses stacked up against each other. In the study, over 1,800 participants already taking metformin for Type 2 diabetes were started on Trulicity. Metformin is a common first-choice option for treating diabetes.

This study found that the amount of weight people lost, and how much their blood glucose decreased, was dose-related. People taking Trulicity 4.5 mg lost more weight (about 10 lbs) than people taking Trulicity 3 mg (about 9 pounds) or 1.5 mg (about 7 lbs) after about 9 months of treatment. Higher doses of Trulicity also decreased blood glucose more than lower doses.

How to use Trulicity

Trulicity comes as a single-dose injection pen that comes in four dosages:

• 0.75 mg

• 1.5 mg

• 3 mg

• 4.5 mg

The medication can be injected subcutaneously (underneath the skin) in the upper arm, thigh, or abdomen (belly). You'll only need to inject Trulicity once a week. Be sure to use a different injection site each week. This prevents lumps from forming underneath your skin.

What's a typical Trulicity dosage?

The starting dose of Trulicity is typically 0.75 mg once a week. You can inject Trulicity at any time of day, without regard to meals. So, pick a day and time that's convenient for you. Just make sure you inject your dose on the same day each week.

After 4 weeks, your dose may be increased to 1.5 mg if your blood glucose is still high. Then, if your blood glucose remains high after 4 weeks, your dose may be increased by 1.5 mg every 4 weeks until your blood glucose levels are controlled. The maximum dose is 4.5 mg once a week.

Keep in mind that blood glucose goals may vary from one person to the next. So talk to your diabetes care team about what your target blood glucose range is before starting Trulicity or other diabetes medications.

Trulicity side effects

The most common Trulicity side effects are gastrointestinal (GI) side effects. People most commonly experience GI side effects within the first few weeks of starting Trulicity, such as nausea, vomiting, and diarrhea. A decreased appetite, stomach pain, and indigestion can also occur.

Less common but more serious side effects include gallbladder disease and kidney damage. In rare cases, people taking Trulicity have reported pancreatitis. And thyroid tumors have been seen in animal studies, but haven't been confirmed in human studies.

Low blood glucose (hypoglycemia) can also occur. But it's less common with Trulicity than some other diabetes medications, such as insulin. Hypoglycemia is typically defined as blood glucose less than 70 mg/dL. Some common signs of hypoglycemia include:

• Shakiness

• Faster heart rate

• Sweating

• Hunger

• Anxiety

• Sleepiness

• Feeling weak

• Tingling

• Confusion

• Dizziness

Check your blood glucose right away if you experience any of these symptoms. Follow instructions from your diabetes care team for how to treat hypoglycemia (such as the "15-15 Rule"), and notify them as soon as possible.

Are GI side effects worse with higher doses of Trulicity?

Not usually. You may experience GI side effects with any dose of Trulicity. But most people don't experience worsening GI side effects as their doses are increased. In fact, side effects are most likely when you first start taking Trulicity. Severe side effects are uncommon at any dose.

Comparing GLP-1 agonists, such as Ozempic vs. Trulicity

Ozempic (semaglutide) and Trulicity are both GLP-1 agonists. They're both injectable medications, and they're both FDA approved to treat Type 2 diabetes and lower the risk of heart attack, stroke, and death in people with Type 2 diabetes and heart disease. What's more, neither medication is FDA approved for weight loss, though they can both cause weight loss when used. However, two other GLP-1 agonists are FDA approved for weight loss:

• Wegovy (semaglutide)

• Saxenda (liraglutide)

Additionally, Zepbound (tirzepatide) is another medication that's closely related to GLP-1 agonists and FDA approved for weight loss.

There are no studies directly comparing Trulicity to the GLP-1 inhibitors that are FDA approved for weight loss. But research has shown that Wegovy is more effective for weight loss than Saxenda. And Zepbound may cause even more weight loss than Wegovy. If you're interested in trying any of these medications for weight loss, talk to a healthcare professional about the risks and benefits of these medications.

Good to know: The active ingredient in Ozempic (semaglutide) is also available as Rybelsus, and the main ingredient in Saxenda (liraglutide) is also available as Victoza. Tirzepatide (the ingredient in Zepbound) is also available as Mounjaro. Rybelsus, Victoza, and Mounjaro are only FDA approved for Type 2 diabetes. They're not currently FDA approved for weight loss.

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