Function
While Semaglutide is approved for type 2 diabetes and chronic weight management, significantly lowering HbA1c and body weight by modulating incretin pathways232480, Tesamorelin is FDA-approved to reduce excess visceral adipose tissue in HIV-associated lipodystrophy and is studied for broader body-composition, NAFLD, and cognitive effects via GH/IGF-1 axis modulation1893.
Mechanism
While Semaglutide works as a modified GLP-1(7–37) analog with three key changes—Ala8→Aib, Lys26 acylated with a C18 fatty diacid, and Lys34→Arg—resulting in a long-acting GLP-1 receptor agonist that enhances glucose-dependent insulin secretion, suppresses glucagon, slows gastric emptying, and reduces appetite23647480, Tesamorelin is a full-length 44-amino-acid GHRH analog with an N-terminal trans-3-hexenoic acid modification that binds GHRHR, activating cAMP/PKA signaling to increase endogenous GH and IGF-1, with improved stability versus native GHRH182893102.