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Ozempic directly, available data for both drugs suggests that Zepbound may cause greater weight loss than Ozempic
Cowie CC, Casagrande SS, Menke A (2018) Diabetes in America

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It increases the risk of: Type 2 diabetes MASLD (metabolic dysfunction-associated steatotic liver disease, formerly called NAFLD) Cardiovascular disease The loss of estrogen also accelerates sarcopenia, the loss of lean muscle mass, which further slows metabolism and reduces energy expenditure