[Health Column] Maunzaro vs. Wigobi Epee Comparison: Is It Okay to Choose Based Solely on Weight Loss Rate?

 

hello, Jeon Seung-yeop, Director of Jamsil FM Clinic and Specialist in Family Medicine no see.

 

"I heard that Maunzaro causes the most weight loss; should I choose it from the start?", "Does the domestic Epe have fewer side effects than Wigobi?" These are questions frequently asked in the clinic by people looking into obesity treatments.

 

With EFE receiving approval from the Ministry of Food and Drug Safety in October 2026, the options for once-weekly injectables have expanded. As such... Comparison of Maunzaro and Hugobi Epee In this regard, it is necessary to examine not only the weight loss effect but also which patients it is suitable for.

 

💡 The content covered in this article
· Differences in the components and mechanisms of action of Maunzaro, Wigovi, and Epe
· Points to note when reading weight loss effects and figures confirmed in clinical studies
· Whether gastrointestinal symptoms, cardiovascular protection, and muscle maintenance are selection criteria
Ultimately, what criteria should be used to select medication

 

 

🩺 What are the differences between Maunzaro, Hugobi, and Epee?

The active ingredient of Wigobi is semaglutide, and the active ingredient of Epe is efeglenatide. Both drugs are GLP-1 receptor It acts on. On the other hand, tirzepatide, a component of Maunzaro, It acts on both GLP-1 and GIP receptors. There is a difference in that. Although all three drugs are once-weekly injectables, their modes of action and dosage escalation processes differ.

 

The characteristics of the épée Phase 3 obesity clinical trial data involving 448 Korean adults The point is that we have secured [evidence]. This means there is direct evidence to refer to when explaining treatment results to domestic patients. However, the fact that it was developed in Korea does not mean it is judged to be more effective or safer for Koreans.

 

🩺 Does Maunjaro lose the most weight?

A direct comparison of Maunzaro and Wigobi SURMOUNT-5 study In this study, the maximum tolerated dose of each drug was administered to obese adults without diabetes. The 72-week average weight change rate was Tirzepatide −20.2%, Semaglutide −13.7% In this study, the weight loss effect of tirzepatide was greater.

 

EFE was evaluated in a separate domestic clinical trial. The initial reported 40-week average weight loss rate was 9.75%, and the analysis results currently listed in the approved labeling −9.02%, placebo group −0.89% Since the study subjects, duration, and analysis methods are different, this figure should not be placed side by side with the results of the previous two drugs to determine the ranking of effectiveness.

 

In clinical practice, the greater the weight loss goal and the more severe the obesity-related health problems, the more important the evaluation of sufficient weight loss effectiveness is. At the same time, actual treatment can only proceed after confirming how well the diet can be maintained and whether weight gains can be tolerated.

 

 

🩺 Is Epe less uncomfortable on the stomach and has consistent efficacy?

EFE is designed to maintain the drug in the body for a long period. In pharmacokinetic studies conducted on patients with type 2 diabetes, the difference between peak and trough concentrations was relatively small with repeated once-weekly administration. This provides grounds to expect gradual changes in drug concentration.

 

However, a flat blood concentration curve does not immediately mean that "appetite remains constant throughout the week" or that "nausea is less severe than with Wigobi or Maunjaro." To confirm this, comparative studies evaluating actual symptoms and changes in appetite are required.

 

Effe may also cause diarrhea, nausea, constipation, and vomiting. The incidence rate listed in the prescribing information is Diarrhea 17.6%, nausea 16.6%, vomiting 11.6% It is difficult to conclude which drug is more comfortable based solely on the side effect rates of different clinical trials.

 

🩺 Are cardiovascular protection or muscle maintenance also selection criteria?

Epeglenatide AMPLITUDE-O study Cardiovascular and renal effects were confirmed. When 4,076 high-risk patients with type 2 diabetes who had cardiovascular or renal disease were followed, the risk of major cardiovascular events was relatively 27% lower and the risk of renal composite events was 32% lower compared to placebo.

 

While this is a meaningful result, the same reduction rate cannot be applied to obese patients without diabetes. Since the current domestic indication for weight management of EFE is also limited to adults without diabetes, the significance of the study must be distinguished from the actual target population for prescription.

 

Even when viewing body composition data Distinguishing between lean body mass and skeletal muscle mass You must do so. Lean body mass includes water and organs in addition to muscle. Rather than describing "increasing lean body mass" as "medication that increases muscle," it is more accurate to monitor muscle mass, dietary intake, and exercise performance together during treatment.

 

 

🩺 Ultimately, what criteria should I use to choose medication?

First, each medicine Whether it falls under the scope of permission We assess the required weight loss, comorbidities, and previous drug responses. Even at the same body weight, treatment plans vary depending on the presence of diabetes, gastrointestinal symptoms, and dietary patterns. Regarding cost, you must compare not only the cost of the starting dose but also the long-term expenses associated with the maintenance dose.

 

At Jamsil FM Clinic, we monitor changes following the prescription by linking attending physician consultations with nutritional counseling management. If weight is lost but protein intake is insufficient or meals are skipped due to vomiting, the dosage and meal plan must be adjusted. Satiety for a few days after the injection, appetite before the next administration, and changes in bowel movements are helpful information for making such assessments.

 

💡 Things to check together before choosing medicine
· Whether it falls under the approval criteria (body mass index, comorbidities)
· Required weight reduction and previous drug response
· Whether you can maintain your diet while tolerating gastrointestinal symptoms
· Long-term costs including maintenance capacity

 

 

🩺 Frequently Asked Questions

Q1. If the Wigovina or Maunzaro was uncomfortable, should I switch to the épée?
Other medications may be considered. However, you must first determine whether the symptoms are due to the type of medication, rapid dosage increases, or changes in dietary intake. The switching dose and starting time are determined based on the existing administration history.

 

Q2. Is the Epee suitable if the goal is to lose 5–6 kg?
Whether to prescribe is not determined solely by weight loss goals. Approval criteria, such as BMI and comorbidities, are checked first. It is important to distinguish between cases where a patient seeks to lose a few kilograms for cosmetic purposes from a normal weight and obesity treatment.

 

Q3. If I switch to the épée, do I need to do less strength training?
Diet and exercise are continuously necessary to maintain muscle mass. Regardless of the choice of medication, protein intake, strength training, and recovery status must be managed together.

 

🩺 Comparing Maunzaro, Wigovi, and Epee is the process of finding the 'treatment that suits me'.

Comparing Maunzaro, Wigovi, and EFE is not about determining which drug is the best, but rather a process of selecting the treatment that is right for you. You must consider weight loss effects confirmed in direct comparison studies, clinical evidence regarding Koreans, individual tolerability, and treatment costs together.

 

Even after a prescription, treatment must be adjusted by monitoring weight, metabolic indicators, and nutritional status. Medical professionals play a crucial role in achieving sustainable weight loss. If you are considering which obesity medication to choose, we recommend reviewing your current condition with a medical team rather than making a decision alone.

 

 

Director Jeon Seung-yeop of Jamsil FM Clinic

Family Medicine Specialist at Asan Medical Center
Obesity specialist certified by the Korean Society of Obesity
Secretary General of the Korean Society for the Study of Obesity
Current Chief Director of Jamsil FM Clinic

 

The medical content of this column was written based on the following materials.
· Ministry of Food and Drug Safety Drug Safety Korea. Epe Auto Injector Injection Approval Details.
· Aronne LJ, et al. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. New England Journal of Medicine. 2025.
· Yoon KH, et al. Pharmacokinetic and dose-finding studies on efpeglenatide in patients with type 2 diabetes. Diabetes, Obesity and Metabolism. 2020.
· Gerstein H.C., et al. Cardiovascular and Renal Outcomes with Efpeglenatide in Type 2 Diabetes. New England Journal of Medicine. 2021.
※ This column provides general health information, and treatment methods and dosages may vary depending on individual health conditions.