TRULICITY® (DULAGLUTIDE) FOR WEIGHT LOSS

Trulicity® is the brand name for dulaglutide, a glucagon-like peptide-1 agonist (or GLP-1) medication. It is a once-weekly injectable medication and one of several GLP-1 medications prescribed by Calibrate doctors as a part of our Metabolic Reset program.

Other GLP-1s prescribed by Calibrate include semaglutide (brand names Ozempic®, Wegovy®, and Rybelsus®, all manufactured by Novo Nordisk), and liraglutide (brand names Saxenda® and Victoza®).

Trulicity® is manufactured by Eli-Lilly and Company, an American pharmaceutical company. Eli-Lilly also recently gained FDA approval for another, similar drug: The first dual GLP-1/GIP receptor agonist, Mounjaro™ (tirzepatide). 

Trulicity® was FDA-approved in 2014 as a treatment for adults with type 2 diabetes to be used in conjunction with lifestyle changes (i.e. food and exercise).

Across six unique clinical trials that included a total of 3,342 patients, treatment with dulaglutide “resulted in greater reductions from baseline in HbA1c levels compared with placebo.”  

Researchers declared Trulicity® an attractive option for patients thanks to its convenient, once-weekly dosing schedule and its efficacy in lowering blood sugar levels.

Trulicity®, like other GLP-1 drugs, works by mimicking the natural incretin hormones that your body produces. 

Incretin hormones signal to the brain, endocrine, and gastrointestinal systems that food has been consumed. This results in a complex cascade of hormones and neurotransmitters which effectively communicate feelings of satiety (feeling full) and slow down the rate at which food leaves your stomach (making you feel fuller for longer).

In addition, GLP-1 medications can improve blood sugar levels in people living with impaired glucose tolerance or diabetes. As explained by the manufacturer, Trulicity® “helps your pancreas release insulin in response to high levels of sugar in your blood after you eat” and “can limit how much sugar gets into your blood from your liver.”

If you’re worried about hypoglycemia (low blood sugar), rest assured that GLP-1 medications pose a relatively small risk. Hypoglycemia is typically only a concern when GLP-1s are used in conjunction with other diabetes medications such as insulin. 

As one 2015 study evaluating Trulicity® concluded, “The long-acting GLP-1 receptor agonists improve glycemic control and help to promote weight loss. Furthermore, based on their glucose-dependent mechanism of action, the GLP-1 receptor agonists have a low risk for hypoglycemia.”

Why Calibrate? Can’t I just take the medication?

As is the case with all GLP-1s, Trulicity® makes it easier to lose weight and stick to healthy habits—but it doesn’t produce weight loss on its own. It must be used in combination with habits to support metabolic health and avoid weight regain. These tactics may include modifications to what you eat, how and when you exercise, and other healthy lifestyle changes. 

Calibrate’s Metabolic Reset combines GLP-1 medication with evidence-based lifestyle recommendations to help participants maximize their success with Trulicity®. They’re called the Four Pillars of Metabolic Health, and they include: Food, Sleep, Exercise, Emotional Health.

Throughout your Calibrate program, you’ll work your way through a curriculum developed by a world-class medical advisory board that teaches you how to integrate healthy changes into your day-to-day routine, taking a science-based approach to weight loss. You’ll learn how to eat more whole foods and fewer fast-digesting carbohydrates, improve sleep quality, participate in at least 150 minutes of physical activity per week, and develop strategies for managing stressors. 

Through the Calibrate curriculum, both your mind and body will be set up for sustainable progress—allowing Trulicity® (or any other GLP-1 drug you might be prescribed) to work even more effectively.

While Trulicity® is not a weight loss drug in and of itself, those who take Trulicity® may lose weight, and it may be prescribed off-label for weight loss in patients with obesity or overweight.

Is there clinical evidence that Trulicity® produces weight loss? Yes. A 52-week clinical trial where Trulicity® was given to 1,842 patients with a mean BMI of 34.2 found that all three doses tested resulted in significant reductions in body weight from baseline at the 36‐week mark. The trial evaluated 1.5 mg, 3.0 mg, and 4.5 mg doses of Trulicity®. 

Patients with higher baseline BMI given higher doses of Trulicity experienced the most weight loss. The authors conclude, “Patients had a similar mean percentage weight loss across the BMI subgroups, with those escalated to the 4.5 mg dose having an average weight loss of around 5% in the overall study population and in each BMI subgroup.”

Like all other GLP-1 drugs, how well Trulicity works for weight loss will depend on how well you’re able to incorporate lifestyle changes such as dietary modifications and exercise. 

Calibrate’s Metabolic Reset is uniquely designed to help members see the best possible results from their GLP-1 medication.

Calibrate uses proven methods for long-term results: The latest science, FDA-approved medication, doctor visits, and accountability coaching. The Calibrate program was designed by world-renowned obesity experts and is vetted and approved by a Clinical Advisory Board.

With Calibrate, members benefit from comprehensive, 1:1 support and coaching that spans four key areas: Food intake, exercise, sleep, and emotional health. These are what we call our Four Pillars of Metabolic Health.

Throughout your Calibrate program, you’ll apply these pillars by making small changes to your daily routine. Small, sustained lifestyle changes combined with GLP-1 medication, a support team, and a science-backed curriculum all come together to make metabolic health achievable. 

Everyone is different, so there’s no one answer when predicting how long it will take for Trulicity® to kickstart weight loss. However, most patients will need at least two weeks on medication before they start seeing results. Changes in appetite are generally noticeable within the first week.

When you join Calibrate, we’ll work to get your initial appointment scheduled as soon as possible so you can get started on your GLP-1 medication early on. Before that appointment, you’ll complete a comprehensive health intake—including blood work—that your Calibrate doctor will carefully review before customizing your treatment plan and prescribing your medication.

If we determine that Trulicity® is the right fit for you, we’ll walk you through all of the details on dosage, how to administer the medication, when to take it, and how it will work in conjunction with the rest of the program.

Calibrate doctors prescribe GLP-1s (glucagon-like peptide-1s) because research shows that, in combination with accountability coaching, they are the most effective and safe long-term medication for weight loss. Trulicity® is one of several GLP-1 medications available to Calibrate members.

All Calibrate members will be considered for Trulicity® as clinically appropriate and insurance eligible. We will work with your commercial/employer insurance to help get it covered for $25/month or less.

Contraindications & Limitations of Use

Trulicity® is FDA-approved and is safe when used as prescribed. As with all prescription medications, there are warnings and contraindications to keep in mind prior to starting treatment with Trulicity®. Your Calibrate doctor will discuss these with you and can answer any specific questions you might have about the risks of Trulicity® as it pertains to your own health and medical history.

The below limitations, contraindications, and warnings are sourced directly from the FDA.

- Trulicity® is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC), thyroid cancer, or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

- Trulicity® is also contraindicated in patients with a prior serious hypersensitivity or allergic reaction to dulaglutide.

- It is not known if Trulicity® can be used in people who have had pancreatitis.

- Trulicity® is not for use in people with type 1 diabetes.

- Trulicity® is not recommended for use in people with severe gastrointestinal disease.

Taking Trulicity® is easy. Even if you’re intimidated by an injectable medication, the pen is designed to be simple to use and relatively painless. Better yet, Trulicity® can be taken at any time of day, with or without food, and only needs to be injected once per week. Your doctor will provide thorough instructions to make self-injection easy and stress-free. 

Trulicity® is available in prefilled pens in the following doses:

- 0.75 milligrams (mg) pen

- 1.5 mg pen

- 3.0 mg pen

- 4.5 mg pen

Trulicity® may be prescribed alongside other diabetes medications like metformin and insulin. Talk to your doctor to learn more about possible drug interactions with Trulicity®.

The most common side effects of Trulicity® are:
- Nausea

- Constipation

- Diarrhea

- Stomach discomfort

- Vomiting

- Decreased appetite

- Indigestion

- Fatigue

The good news is that, in most cases, these side effects will go away between 3-4 weeks after starting the medication.

According to the manufacturer, “8% to 29% using Trulicity® experienced some nausea, which typically occurred during the first 2 to 3 days after they took their first dose.”

“Nausea generally subsided after the first 2 weeks, but some people experienced nausea with Trulicity® beyond their second week of treatment. Less than 2% needed to stop taking Trulicity® because of nausea.” 

If you’re experiencing side effects at the start of your Metabolic Reset, know that they are temporary, and don’t stop taking your medication. It’s important to stick to your dosing schedule to give your body a chance to acclimate.

Here are some tips for reducing nausea and stomach discomfort with Trulicity®:

- Eat blander foods

- Refrain from eating fatty, processed, or greasy foods

- Eat smaller meals or stick to smaller portion sizes

- Do your best to stay active

Learn more about foods to avoid with Trulicity®. 

Talk to your health care provider about any side effects of Trulicity® that become bothersome or that don’t go away. If you experience any allergic reaction such as anaphylaxis or shortness of breath, please seek immediate medical care.