Tirzepatide vs Semaglutide
Reviewed by Dr Lucy NewtonBoth FDA-approved for weight loss, Zepbound (tirzepatide) typically shows higher weight loss results than Wegovy (semaglutide), but Wegovy has more long-term safety data.
See what users who've tried both medications report about effectiveness, side effects, and costs.
Side-by-side comparison based on 10,000+ Reddit discussions
| Feature | Zepbound | Wegovy | Source Notes |
|---|---|---|---|
| Active Ingredient | Tirzepatide | Semaglutide | Different molecules, different mechanisms |
| Mechanism | Dual GIP/GLP-1 | GLP-1 only | Tirzepatide targets two receptors |
| Typical Weight Loss | 20.2% | 13.7% | SURMOUNT-5 head-to-head trial (72 weeks) |
| Max Dose | 15mg weekly | 2.4mg weekly | Per prescribing information |
| Brand Cost (Self-Pay) | $399-549/mo (vials) | $349-499/mo (NovoCare) | 2026 self-pay pricing programs |
| Compounded Cost | $250-450/mo | $175-400/mo | Verified provider pricing Learn more → |
| FDA Approval | 2023 | 2021 | Weight loss indication dates |
| Cardiovascular Data | Ongoing | 20% MACE reduction | SELECT trial proven benefit for Wegovy |
Different molecules, different mechanisms
Tirzepatide targets two receptors
SURMOUNT-5 head-to-head trial (72 weeks)
Per prescribing information
2026 self-pay pricing programs
Weight loss indication dates
SELECT trial proven benefit for Wegovy
Data from the SURMOUNT-5 (The New England Journal of Medicine (2025))
The SURMOUNT-5 trial was the first large-scale, head-to-head Phase 3b clinical study directly comparing tirzepatide (Zepbound) and semaglutide (Wegovy) for weight loss in adults with obesity or overweight with at least one weight-related comorbidity (excluding diabetes).
| Comparison Metric | Zepbound | Wegovy |
|---|---|---|
| Average Weight Loss (%) | 20.2% | 13.7% |
| Total Body Weight Loss (lbs) | approx. 50 lbs | approx. 33 lbs |
| Lost >15% Body Weight | 71.3% | 45.1% |
| Lost >20% Body Weight | 52.5% | 28.1% |
| Lost >25% Body Weight | 33.1% | 13.6% |
"In this direct head-to-head comparison, tirzepatide (Zepbound) was found to be superior to semaglutide (Wegovy) for weight reduction at 72 weeks. While both medications are highly effective, Zepbound achieved nearly 50% more weight loss on average than Wegovy in this specific study population."
Results were statistically significant (p < 0.001) across all primary endpoints.
Latest verification performed January 2026.
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