Zepbound® vs. Wegovy®: The Pros and Cons of Each
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Zepbound® vs. Wegovy® for weight loss: Which is better?

PlushCare Content Team
Written by PlushCare Content Team
Mari Carlo Manzana
Medically reviewed by Mari Carlo Manzana, MD
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Have you tried dieting and exercise but are still struggling to lose weight? You are not alone, and for many, Zepbound® and Wegovy® are effective options to help reach your weight loss goals. Zepbound® and Wegovy® are two newer options that significantly help weight loss when combined with lifestyle changes. In clinical studies, people lost up to 15% of their body weight on Wegovy® and up to 21% on Zepbound®.1 

 

Both are FDA-approved prescription weight loss medications for adults. They are both injectable GLP-1 receptor agonist treatments for adults with a Body Mass Index (BMI) greater than 30 or a BMI greater than 27 with at least one weight-related health condition.  

 

Like Ozempic® and Mounjaro®, these medications help increase insulin production and decrease glucagon output.10 Insulin enables your body to convert the sugar in your food into energy, thus preventing excessively high blood sugar levels. The glucagon hormone tells the liver to release glucose into the blood when blood sugar levels are too low. Together, these hormones maintain balanced blood sugar levels. 

Get to know Zepbound® & Wegovy®

What is Zepbound®?

Zepbound® is an injectable medication for chronic weight management in adults. Developed by Eli Lilly, it is specifically FDA approved for use by those classified as obese (BMI ≥ 30) or overweight (BMI ≥ 27) and have additional weight-related health conditions.4  

 

Zepbound® is a GLP-1/GIP agonist medication. This means is works on both the GLP-1 and GIP receptors. This helps with increasing glucose-dependent insulin secretion, decreasing inappropriate glucagon secretion, slowing gastric emptying, and decreasing food cravings. Studies show that patients taking Zepbound® lose up to 21% of their weight after 36 weeks.1 

What is Wegovy®

Wegovy® is a weekly injectable medication developed by Novo Nordisk. It is specifically approved for chronic weight management in adults who are classified as obese with a BMI > 30 or overweight with a BMI > 27 with an additional weight-related health condition.3

 

Like Zepbound®, Wegovy® mimics the effects of GLP-1 (glucagon-like peptide-1) to make you feel full during and after eating.  Similar to Zepbound®, Wegovy® provides an additional tool to help you reach your goals. However, they both must be combined with lifestyle changes like diet and exercise for the best results.19 

Comparing Zepbound® and Wegovy®

Both Zepbound® and Wegovy® are FDA-approved weight loss medications, introduced in November 2023 and June 2021, respectively. 20 Both are intended for use alongside a balanced diet and exercise and are administered via weekly injections. 

 

The difference is that Wegovy® contains semaglutide, also found in Ozempic®, and Zepbound® contains tirzepatide, found in Mounjaro®. Zepbound® also works by working on the receptors of two hormones, GLP-1 and GIP, whereas Wegovy® only works on GLP-1 receptors. Wegovy® is also FDA-approved for treating obesity in pediatric patients of ages 12 and older.

Effectiveness: which one is better for weight loss?

In a recent head-to-head trial, Zepbound® (tirzepatide) demonstrated superior weight-loss outcomes compared to Wegovy® (semaglutide). Participants treated with Zepbound® lost an average of 20.2% of their body weight, surpassing the 13.7% reduction in those using Wegovy®2. This trial represents a 47% greater relative weight loss with Zepbound® compared to Wegovy.2 

Dosage of Zepbound® vs Wegovy®

The dosing of Wegovy® and Zepbound® are completely different. Wegovy® starts at a dose of 0.25 mg once a week and has other doses of 0.5 mg, 1.0 mg, 1.7 mg, and 2.4 mg. On the other hand, Zepbound® starts at a dose of 2.5 mg once a week and goes up in increments of 2.5 mg with the other doses being 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg. 4 

 

For both Wegovy® and Zepbound®, it is recommended to be on the same dose for 4 weeks prior to moving up to the next dose, if recommended by your physician. The weekly injections are self-administered, typically in your thigh, abdomen, or arm. They come in a pre-filled auto-injection device, so you will not have to worry about measuring. Each injection should happen on the same day each week and can be taken with or without food. 

Side effects: how do Zepbound® and Wegovy® compare?

The side effects reported by users of Wegovy® and Zepbound® are similar. These vary depending on person and dosage, but the most common are:
Nausea
Diarrhea
Constipation
Vomiting
Low blood sugar
Be on the lookout for rare but severe side effects, including: 
Pancreatitis
Gallbladder problems
Kidney problems
Hypoglycemia
Always be sure to give your doctor your complete medical history before starting these injections and report any severe side effects immediately. Your doctor will closely monitor how your body responds to the medications, especially when starting treatment or increasing the dosage.14 

Alternative medications

Similar injectable weight loss medications include Saxenda®. Contrave® (naltrexone HCl/bupropion HCl) is a prescription-only, FDA-approved weight loss pill that may help certain types of overweight and obese adults.8 Contrave® titrates up slowly, starting from one tablet by mouth once a day for a week and gradually increasing the dose week to week for a max dose of two tablets by mouth twice a day, provided that the patient does not experience any side effects.  

 

Lifestyle changes are also an important part of your weight loss journey. A balanced diet, regular exercise, counseling or support groups, and long-term lifestyle changes are tried-and-true ways to develop healthier habits. Most of the initial weight loss studies for Zepbound® and Wegovy® had their participants enrolled in programs to implement healthy diet and exercise modifications. If you want to give yourself the best shot at losing weight and maintaining the weight loss long term, incorporating a healthy diet with consistent exercise of greater than 150 minutes per week is very important.

Cost of Zepbound® vs. Wegovy®

Wegovy® and Zepbound® are both prescription medications that can be filled at many pharmacies. However, overall demand has continued to exceed supply, and some patients may have difficulty filling Wegovy® and Zepbound® prescriptions, leading to intermittent shortages of these medications. 

 

If not covered by insurance, Wegovy® is generally the more expensive option, with costs ranging from $1,300 to $1,500 for a month's supply without insurance. Zepbound®, on the other hand, typically ranges from $1000 to $1,200 per month.20 There are also coupons available online from the manufacturers of these medications but there are exclusion criteria for those coupon cards that limit who may be able to use them.

Zepbound® vs. Wegovy® FAQs

How much weight do you lose?

The amount of weight lost varies by person. With Wegovy®, clinical trials found people lost an average of 14.9% of their body weight over 68 weeks. The weight loss is gradual and steady over time with the injections. 

 

On average, patients lose roughly 15-20% of their body weight with tirzepatide. The highest dose of Zepbound®, 15 mg, offered the most amount of weight loss. However, for safety reasons, patients must start at the lowest dose of Zepbound® at 2.5 mg once a week and have the option gradually titrate up, if appropriate, every 4 weeks.

Who should not take these medications?

Wegovy® or Zepbound® may not suit you if you have certain medical conditions including: 

  • Pregnancy or breastfeeding 
  • Personal or family history of Medullary Thyroid Carcinoma or Multiple Endocrine Neoplasia Syndrome (type 2) 
  • Gastroparesis or severe gastrointestinal disease 
  • A history of pancreatitis 

 

Ensure your doctor knows your complete medical history, including any prescription and over-the-counter medications or supplements you are taking before starting treatment. 

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Related resources

Sources:

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  1. Zepbound outperforms Ozempic and Wegovy in head-to-head weight loss study https://www.nbcnews.com/health/health-news/zepbound-outperforms-ozempic-wegovy-head-head-weight-loss-study-rcna160630 
  2. National Library of Medicine "Semaglutide Treatment of Excessive Body Weight in Obese PCOS Patients Unresponsive to Lifestyle Programs" Accessed on April 16, 2024, at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531549/ 
  3. US Food and Drug Administration “FDA Approves New Medication for Chronic Weight Management” Accessed on April 16, 2024, at https://www.fda.gov/news-events/press-announcements/fda-approves-new-medication-chronic-weight-management 
  4. Zepbound (tirzepatide) Injection “What is Zepbound? Accessed on April 16, 2024, at https://zepbound.lilly.com/ 
  5. National Library of Medicine “GIP and GLP‐1, the two incretin hormones: Similarities and differences” Accessed on April 16, 2024, at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4020673/ 
  6. National Library of Medicine “Maintenance of lost weight and long-term management of obesity” Accessed on April 16, 2024, at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/ 
  7. OAC “Wegovy® – A New Treatment for Obesity” Accessed on April 16, 2024, at https://www.obesityaction.org/resources/wegovy-a-new-treatment-for-obesity/ 
  8. US Food and Drug Administration “FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014” Accessed on April 16, 2024, at https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014 
  9. Drugs.com “How do Ozempic, Mounjaro, Wegovy, Zepbound compare for weight loss?” Access on April 16, 2024, at https://www.drugs.com/medical-answers/mounjaro-wegovy-ozempic-compare-weight-loss-3570898/#:~:text=Both%20products%20are%20manufactured%20by,can%20help%20you%20feel%20fuller 
  10. National Library of Medicine “Glucagon-Like Peptide-1 Receptor Agonists” Accessed on April 16, 2024, at https://www.ncbi.nlm.nih.gov/books/NBK551568/ 
  11. Science Direct “Glucagon-like peptide 1 (GLP-1)” Accessed on April 16, 2024, at https://www.sciencedirect.com/science/article/pii/S2212877819309135 
  12. Drugs.com “Weight Loss Drugs: What Are Your Options?” Accessed on April 16, 2024, at https://www.drugs.com/article/prescription-weight-loss-drugs.html 
  13. NovoMedLink “Wegovy” Accessed on April 16, 2024, at https://www.novomedlink.com/obesity/products/treatments/wegovy/about-wegovy/adolescent-indication.html#:~:text=Indications%20and%20Usage&text=to%20reduce%20excess%20body%20weight,least%20one%20weight%2Drelated%20comorbidity 
  14. National Library of Medicine “What Is Best for Weight Loss? A Comparative Review of the Safety and Efficacy of Bariatric Surgery Versus Glucagon-Like Peptide-1 Analogue” Accessed on April 16, 2024, at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10613430/ 
  15. National Library of Medicine “Estimating and reporting treatment effects in clinical trials for weight management: using estimands to interpret effects of intercurrent events and missing data” Accessed on April 16, 2024, at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8081661/ 
  16. National Library of Medicine “Weight Loss Outcomes Associated with Semaglutide Treatment for Patients with Overweight or Obesity” Accessed on April 16, 2024, at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/ 
  17. Drugs.com “Comparing Wegovy vs Zepbound” Accessed on April 16, 2024, at https://www.drugs.com/compare/wegovy-vs-zepbound 
  18. Drugs.com “How long until I lose weight on Wegovy?” Accessed on April 16, 2024, at https://www.drugs.com/medical-answers/long-lose-weight-wegovy-3570091/ 
  19. New England Journal of Medicine “Once-Weekly Semaglutide in Adults with Overweight or Obesity” Accessed on April 16, 2024, at https://www.nejm.org/doi/full/10.1056/NEJMoa2032183 
  20. Lilly Investors “FDA Approves Lilly's Zepbound® (tirzepatide) for Chronic Weight Management, a Powerful New Option for the Treatment of Obesity or Overweight with Weight-Related Medical Problems” Accessed on April 16, 2024, at https://investor.lilly.com/news-releases/news-release-details/fda-approves-lillys-zepboundtm-tirzepatide-chronic-weight 
  21. Continued Treatment with Tirzepatide for Maintenance of Weight Reduction in Adults with Obesity https://jamanetwork.com/journals/jama/fullarticle/2812936 
  22. Semaglutide vs Tirzepatide for Weight Loss in Adults with Overweight or Obesity | Obesity | JAMA Internal Medicine | JAMA Network at https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2821080 
  23. Lilly's Zepbound® (tirzepatide) superior to Wegovy® (semaglutide) in head-to-head trial showing an average weight loss of 20.2% vs. 13.7% https://investor.lilly.com/news-releases/news-release-details/lillys-zepboundr-tirzepatide-superior-wegovyr-semaglutide-head 





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