How they work
Semaglutide mimics one gut hormone, GLP-1, which slows stomach emptying and reduces appetite. Tirzepatide mimics two hormones, GIP and GLP-1, which appears to add extra effect.
Results
| Semaglutide (Wegovy) | Tirzepatide (Zepbound) | |
|---|---|---|
| Average weight loss in main trials | ~15% (STEP-1, 68 weeks) | ~21% at top dose (SURMOUNT-1, 72 weeks) |
| Head-to-head (SURMOUNT-5) | ~14% | ~20% |
| Dosing | Weekly injection or daily pill | Weekly injection |
| Brand cash price (direct) | ~$349/mo injection; pill from ~$149 | ~$299–$449/mo vials |
Side effects
Both commonly cause nausea, diarrhea, constipation and vomiting, mostly while the dose is increasing. Both carry a warning about thyroid C-cell tumors seen in animal studies and are not for people with a personal or family history of medullary thyroid cancer or MEN2. Your prescriber will go through the full list.
Which should you choose?
- Tirzepatide if you want the most weight loss and are fine with injections.
- Semaglutide if you prefer a pill, your insurance covers Wegovy, or you've done well on it before.
The right choice depends on your health history and coverage, so make it with a clinician.
Find a provider that offers both →
GLP1Rated is for general information only and is not medical advice. GLP-1 medications are prescription drugs with real risks and side effects. Talk to a licensed clinician before starting, stopping or changing any medication or supplement.