Phase 3: Making Your Shift
Medication Options: Charting Your Potential Tailwinds
This chart provides a comparative overview. Your doctor will help determine if medication is appropriate for you and which option best suits your individual vessel and voyage.
Medications Approved in Canada for Weight Management
| Medication (Sail/Tool) | How it Works (Vessel Effect) | Key Populations Benefitting* & "Wind Power" (Avg. Wt. Loss @1yr) | Positive 'Current' Shifts (Health Benefits) | Resource Investment (Cost Est.) | Provincial Coverage (Obesity) |
|---|---|---|---|---|---|
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Liraglutide 3.0mg (Saxenda®) Daily SC Injection |
GLP-1 Agonist: Helps 'Appetite Radar' signal fullness; slows 'Fuel Processing'. |
Ovw/Ob, PreDM, T2DM, NASH, OSA. ~8% (vs ~2.6% placebo) |
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Naltrexone-Bupropion 16/180mg (Contrave®) Oral Tablet BID |
Works on brain's 'Appetite Control Center' & 'Reward System'. |
Ovw/Ob, T2DM. ~5-6% (vs ~1.3% placebo) |
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Orlistat 120mg (Xenical®) Oral Tablet TID w/ Meals |
Reduces 'Cargo' (fat) absorbed from food in intestines. |
Ovw/Ob, PreDM, T2DM. ~3-4% (placebo subtracted) |
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Semaglutide 2.4mg (Wegovy®) Weekly SC Injection |
GLP-1 Agonist: Powerful effect on 'Appetite Radar' (fullness) & 'Compass' (cravings). |
Ovw/Ob (incl. adol.), PreDM, T2DM, NASH, Est. CVD. ~15% (vs ~2.4% placebo) |
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*Ovw/Ob = Overweight/Obesity. Clinical trials often conducted in populations with overweight/obesity, sometimes with specific comorbidities (PreDM, T2DM, NASH, OSA, CVD).
Abbreviations: SC = Subcutaneous; PO = Oral; BID = Twice Daily; TID = Three Times Daily; PreDM = prediabetes; T2DM = type 2 diabetes mellitus; NASH = nonalcoholic steatohepatitis; OSA = obstructive sleep apnea; CVD = Cardiovascular Disease; A1C = hemoglobin A1c; BP = blood pressure; QoL = quality of life; MACE = Major Adverse Cardiovascular Event. Cost Estimate: $ (Lowest) to $$$$$ (Highest). Coverage 🚫 = No general provincial formulary coverage for obesity indication at time of writing.
Other Key Medications Discussed in The Shift
(May be Used Off-Label for Weight Management in Canada)
| Medication (Sail/Tool) | How it Works (Vessel Effect) | Key Populations & "Wind Power" (Avg. Wt. Loss for weight focus) | Positive 'Current' Shifts (Health Benefits) | Resource Investment (Cost Est.) | Primary Approved Use (Canada) |
|---|---|---|---|---|---|
|
Tirzepatide (Mounjaro® / Zepbound®**) Weekly SC Injection |
Dual GIP/GLP-1 Agonist: Very powerful effect on 'Appetite Radar' & 'Metabolic Engine'. | Ovw/Ob, T2DM. ~15-22% |
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Type 2 Diabetes (Mounjaro®) | |
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Semaglutide 0.5mg/1.0mg (Ozempic®) Weekly SC Injection |
GLP-1 Agonist: Similar to Wegovy® but at diabetes treatment doses. |
T2DM, Ovw/Ob (off-label). ~4-7% (at 1mg) (Wt. loss secondary) |
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Type 2 Diabetes | |
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Semaglutide Oral (Rybelsus®) Daily Oral Tablet |
Oral GLP-1 Agonist: Affects 'Appetite Radar'. Less potent than injections. |
T2DM, Ovw/Ob (off-label). ~3-4% (Wt. loss secondary) |
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Type 2 Diabetes | |
| Metformin Daily Oral Tablet(s) | Improves 'Insulin Receptor Sensitivity'; can act as "GLP-1 Sparing" agent. |
T2DM, PCOS/Insulin Resistance (off-label). Modest/Variable (often adjunct) |
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Type 2 Diabetes |
**Zepbound® is the weight-loss indicated brand name in some countries for tirzepatide; Mounjaro® is the diabetes-indicated brand name in Canada.
Off-label use means a medication is prescribed for a condition or in a way not officially approved by Health Canada, but may be supported by clinical evidence and expert judgment. Discuss with your doctor.
Engage with these resources to become an informed Captain, able to discuss these options knowledgeably with your healthcare team.