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Comparison

Zepbound (Tirzepatide) vs Wegovy (Semaglutide)

Zepbound (tirzepatide) and Wegovy (semaglutide) are currently the two leading FDA-approved injectable medications for chronic weight management in adults. Zepbound is a dual GIP/GLP-1 receptor agonist that produces approximately 20–22.5% average body weight loss, while Wegovy is a GLP-1 receptor agonist that produces approximately 14.9% weight loss. Zepbound also holds the first-ever FDA approval for obstructive sleep apnea in adults with obesity (December 2024). Wegovy retains a unique advantage: the SELECT trial proved a 20% reduction in major cardiovascular events — a cardiovascular benefit not yet established for Zepbound.

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Quick Answer

Zepbound and Wegovy are both weekly injectable GLP-1-based medications for weight loss, but Zepbound (tirzepatide) adds GIP receptor activity, producing about 22.5% body weight loss vs Wegovy's 14.9% — roughly 7–8 percentage points more. Zepbound also causes less nausea at comparable doses. Wegovy has proven 20% cardiovascular event reduction (SELECT trial) and a longer safety track record. For maximum weight loss, evidence favors Zepbound; for patients with cardiovascular disease, Wegovy's CV benefit is a meaningful differentiator.

Head-to-Head Comparison

CriteriaZepbound (Tirzepatide)Wegovy (Semaglutide)
Active ingredientTirzepatide — dual GIP + GLP-1 receptor agonistSemaglutide 2.4 mg — GLP-1 receptor agonist only
FDA approval for obesityNovember 2023 (chronic weight management + OSA, Dec 2024)June 2021 (chronic weight management)
Average weight loss (pivotal trial)~20–22.5% body weight at 72–88 weeks (SURMOUNT-1, highest dose)~14.9% body weight at 68 weeks (STEP-1, 2.4 mg)
Starting dose → maintenance2.5 mg/week → titrate to 5, 10, or 15 mg over 20 weeks0.25 mg/week → titrate to 2.4 mg over 16–20 weeks
Dosing scheduleOnce weekly subcutaneous injectionOnce weekly subcutaneous injection
GI side effects (nausea)~31% nausea in SURMOUNT-1 at highest dose~44% nausea in STEP-1 at 2.4 mg
Cardiovascular outcomes evidenceSURMOUNT-CVOT ongoing; no dedicated CV outcomes data yet20% MACE reduction proven in SELECT trial (17,604 patients with CVD)
Obstructive sleep apnea indicationYes — FDA approved for moderate-to-severe OSA in adults with obesity (Dec 2024)No specific OSA indication
US list price (2026)~$1,060–$1,200/month (Zepbound)~$1,349–$1,430/month (Wegovy)
Manufacturer savings programLilly Savings Card: commercially insured may pay as low as $25/monthNovo Nordisk savings card: commercially insured may pay as low as $0/month
Compounded availability (2026)Available from 503B facilities; shortage status evolvingFDA removed from shortage list (early 2024); compounded versions in legal gray area
Years on market (obesity)~2 years (since Nov 2023)~5 years (since Jun 2021)

When to Choose Each

Choose Zepbound (Tirzepatide)

Adults seeking maximum weight loss, those who experienced insufficient results on Wegovy, patients with obstructive sleep apnea and obesity, or people who experienced more side effects at equivalent doses on semaglutide.

Choose Wegovy (Semaglutide)

Patients with established cardiovascular disease who benefit from the SELECT trial-proven 20% MACE reduction, those wanting the medication with the longer real-world safety track record, or patients covered by insurance specifically for Wegovy.

Verdict

In the direct comparison of weight loss outcomes, Zepbound consistently outperforms Wegovy by approximately 7–8 percentage points of body weight loss across clinical trials, with somewhat lower rates of nausea at doses producing equivalent efficacy. For patients whose primary goal is maximum weight reduction — particularly those without established cardiovascular disease — Zepbound is the leading evidence-based choice as of 2026. That said, Wegovy holds two meaningful advantages: five years on the market vs two for Zepbound, and the SELECT trial cardiovascular benefit (20% MACE reduction) that no other anti-obesity medication has yet matched. For patients with established cardiovascular disease, Wegovy's proven CV benefit may outweigh Zepbound's superior weight loss. Both medications require long-term use to maintain results. Consult your healthcare provider to weigh cardiovascular history, cost, and individual tolerability.

References

  1. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1) (2022) — PubMed
  2. Once-weekly semaglutide in adults with overweight or obesity (STEP 1) (2021) — PubMed
  3. Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes (SURPASS-2) (2021) — PubMed
  4. Semaglutide and cardiovascular outcomes in patients with overweight or obesity (SELECT) (2023) — PubMed
  5. Tirzepatide for moderate-to-severe obstructive sleep apnea (SURMOUNT-OSA) (2024) — PubMed
  6. Weight regain and cardiometabolic effects after withdrawal of semaglutide (STEP 1 extension) (2022) — PubMed
  7. Tirzepatide once weekly for the treatment of obesity in adults with type 2 diabetes (SURMOUNT-2) (2023) — PubMed
  8. Two-year effects of semaglutide in adults with overweight or obesity (STEP 5) (2022) — PubMed

Compare Telehealth Providers

Find the right provider for your peptide therapy needs

Hims & Hers

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4.3

Starting at $199/mo

Hims & Hers is a leading telehealth platform offering physician-supervised GLP-1 weight loss programs including compounded semaglutide and tirzepatide. Board-certified providers, async or video consults, and medication shipped to your door.

✓Large, established platform with strong physician network
✓Compounded semaglutide available where branded shortages exist
✓Easy async consult — no video call required
✗Does not offer a wide range of peptides beyond GLP-1s
✗Pricing is on the higher end for GLP-1 programs

Henry Meds

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Starting at $249/mo

Henry Meds is a telehealth provider specializing in hormone optimization and peptide therapy. Beyond GLP-1 weight loss, Henry Meds offers testosterone replacement therapy, growth hormone peptides, and other advanced hormonal protocols managed by licensed physicians.

✓Broadest peptide therapy menu of any major telehealth provider
✓Growth hormone peptides (sermorelin, ipamorelin, CJC-1295) available
✓Repair peptides including BPC-157 and TB-500
✗Higher starting price due to comprehensive programs
✗More complex onboarding including lab work requirements

Ro Body

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4.1

Starting at $149/mo

Ro Body is a telehealth weight management program powered by GLP-1 medications. Ro connects patients with licensed providers who prescribe compounded semaglutide or branded GLP-1 therapies depending on eligibility, paired with behavioral coaching.

✓Competitive pricing starting at $149/mo
✓Dedicated health coach included in program
✓Strong clinical protocols with lab-work integration
✗Narrower peptide offering — GLP-1s only
✗Video consult required for initial visit

Calibrate

4.0

Starting at $199/mo

Calibrate is a metabolic health company offering a one-year GLP-1 program built around four pillars: food, sleep, exercise, and emotional health. Calibrate works with insurance to cover medication costs and provides extensive behavioral coaching alongside prescriptions.

✓Insurance navigation support for medication coverage
✓Evidence-based one-year program with structured milestones
✓Four-pillar lifestyle coaching (food, sleep, exercise, emotional health)
✗Annual program commitment required
✗Primarily focused on GLP-1s — no broader peptide therapy

Found

3.9

Starting at $129/mo

Found is a weight management telehealth platform that combines GLP-1 medications with behavioral coaching and a supportive community. Found emphasizes a whole-person approach, pairing pharmacological treatment with lifestyle intervention for sustainable results.

✓One of the more affordable monthly program fees
✓Strong community and peer support features
✓Certified health coaches with regular check-ins
✗Medication billed separately from program fee — total cost can be higher
✗Limited peptide variety beyond standard GLP-1s

Sponsored · We may earn a commission. Learn more · Updated February 2026

Hims & HersMost Popular

Hims & Hers is a leading telehealth platform offering physician-supervised GLP-1 weight loss programs including compounded semaglutide and tirzepatide. Board-certified providers, async or video consults, and medication shipped to your door.

From $199/moLearn More →
Henry MedsMost Peptides

Henry Meds is a telehealth provider specializing in hormone optimization and peptide therapy. Beyond GLP-1 weight loss, Henry Meds offers testosterone replacement therapy, growth hormone peptides, and other advanced hormonal protocols managed by licensed physicians.

From $249/moLearn More →
Ro BodyBest Value

Ro Body is a telehealth weight management program powered by GLP-1 medications. Ro connects patients with licensed providers who prescribe compounded semaglutide or branded GLP-1 therapies depending on eligibility, paired with behavioral coaching.

From $149/moLearn More →

Sponsored · Affiliate Disclosure

Frequently Asked Questions

Which causes more weight loss — Zepbound or Wegovy?
Clinical trials consistently show Zepbound (tirzepatide) produces greater average weight loss than Wegovy (semaglutide). SURMOUNT-1 found tirzepatide at its highest dose produced ~20–22.5% body weight loss, while STEP-1 found semaglutide produced ~14.9% at 2.4 mg. The SURPASS-2 trial directly compared tirzepatide vs semaglutide in people with type 2 diabetes and found tirzepatide superior on weight loss at all doses tested. However, individual results vary significantly — some patients respond better to one agent than the other. Consult your provider.
Which has fewer side effects — Zepbound or Wegovy?
Head-to-head data from SURPASS-2 (comparing the active ingredients tirzepatide vs semaglutide) shows tirzepatide produced lower rates of nausea (31% vs 44%) and vomiting (12% vs 24%) compared to semaglutide at doses delivering equivalent glycemic control. Both drugs cause similar GI side effects — nausea, diarrhea, constipation — that typically peak during dose escalation and improve after 4–8 weeks. Slower titration reduces side effects for both. Individual responses vary substantially.
Does Zepbound or Wegovy have better cardiovascular protection?
Wegovy currently has stronger cardiovascular evidence. The SELECT trial (2023) enrolled 17,604 patients with overweight/obesity and established cardiovascular disease and demonstrated semaglutide 2.4 mg reduced major adverse cardiovascular events (MACE) by 20% vs placebo — the first anti-obesity drug ever to prove this. Zepbound's cardiovascular outcomes trial (SURMOUNT-CVOT) is still ongoing. For patients with established cardiovascular disease, Wegovy's proven MACE reduction is a clinically important advantage.
Can I switch from Wegovy to Zepbound?
Yes, switching is common and generally safe under physician supervision. Many patients who plateau on Wegovy switch to Zepbound and report additional weight loss, likely due to Zepbound's added GIP receptor activity. A typical transition involves stopping Wegovy and starting Zepbound at 2.5 mg/week, then titrating upward as tolerated. Always coordinate any medication switch with your prescribing provider — do not switch independently.
Which is cheaper — Zepbound or Wegovy?
At 2026 US list prices, Zepbound runs approximately $1,060–$1,200/month and Wegovy approximately $1,349–$1,430/month. With manufacturer savings programs, commercially insured patients may pay as little as $25/month for Zepbound (Lilly's card) or $0/month for Wegovy (Novo's card). Compounded tirzepatide and semaglutide are available from 503B facilities at $200–$500/month where legally permitted. Insurance coverage varies widely — check your plan's formulary.
Is Zepbound approved for anything Wegovy is not?
Yes — Zepbound received FDA approval in December 2024 for moderate-to-severe obstructive sleep apnea (OSA) in adults with obesity, making it the first pharmacological treatment ever specifically approved for OSA. This approval was based on the SURMOUNT-OSA trial, which found tirzepatide reduced the apnea-hypopnea index (AHI) by 55–63% vs placebo. Wegovy does not have an OSA indication. Both drugs are approved for chronic weight management.
Do you regain weight after stopping Zepbound or Wegovy?
Studies show significant weight regain occurs when either medication is stopped. The STEP 1 extension trial found two-thirds of weight lost with Wegovy (semaglutide) was regained within one year of stopping. Similar patterns are expected with Zepbound based on mechanism — both drugs address appetite hormonally, and the underlying drivers of weight regain return after discontinuation. Both medications are generally considered long-term, potentially lifelong treatments. Discuss the long-term plan with your provider before starting.
What is the difference between Zepbound and Mounjaro?
Zepbound and Mounjaro contain the same active ingredient — tirzepatide — at the same doses (2.5–15 mg). The only difference is the FDA indication: Mounjaro is approved for type 2 diabetes; Zepbound is approved for chronic weight management and obstructive sleep apnea. Because the drug itself is identical, the clinical effects on weight loss and GI side effects are the same. Insurance coverage differs — many weight-loss plans cover Zepbound but not Mounjaro for obesity.
How long does it take to see results on Zepbound vs Wegovy?
Both medications show early weight loss that accelerates as the dose titrates up. In clinical trials, statistically significant weight loss typically emerges by weeks 4–8, with more substantial results at 20+ weeks. Zepbound at maximum dose (15 mg) produced its 22.5% average weight loss over 88 weeks (SURMOUNT-1). Wegovy at 2.4 mg produced its 14.9% weight loss over 68 weeks (STEP-1). Individual response timelines vary — 3 to 6 months of consistent use is typically needed to assess meaningful response.
Is Zepbound or Wegovy better for patients with type 2 diabetes?
For patients with both obesity and type 2 diabetes, tirzepatide (Mounjaro/Zepbound) and semaglutide (Ozempic/Wegovy) are both effective. Head-to-head data from SURPASS-2 found tirzepatide produced greater A1C reductions (~2.0–2.3% vs ~1.5–1.8%) and more weight loss at all doses compared to semaglutide. For patients with T2D and established cardiovascular disease, semaglutide's LEADER and SELECT trial cardiovascular benefit is an important clinical consideration. Consult your endocrinologist for individualized guidance.

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