Compare active ingredients, clinical weight loss data, FDA approvals, dosing schedules, side effects, and 2026 cost ranges — side by side.
Medical Disclaimer
This comparison is for educational purposes only. Weight loss results are averages from clinical trials and individual outcomes vary. Consult a licensed healthcare provider before starting any GLP-1 medication.
Choose 2–3 medications to display side by side. All four are selected by default.
| Category | Wegovy | Ozempic | Mounjaro | Zepbound |
|---|---|---|---|---|
| Active Ingredient | Semaglutide | Semaglutide | Tirzepatide | Tirzepatide |
| Manufacturer | Novo Nordisk | Novo Nordisk | Eli Lilly | Eli Lilly |
| Mechanism | GLP-1 receptor agonist | GLP-1 receptor agonist | Dual GLP-1 + GIP receptor agonist | Dual GLP-1 + GIP receptor agonist |
| FDA Approval | Weight Management | Type 2 Diabetes Off-label for weight loss | Type 2 Diabetes Off-label for weight loss | Weight Management |
| Max Dose | 2.4 mg/week | 2 mg/week | 15 mg/week | 15 mg/week |
| Dosage Schedule | Titrate over 16 weeks: 0.25→0.5→1→1.7→2.4 mg | Titrate: 0.25→0.5→1→2 mg over 8+ weeks | Titrate over 20 weeks: 2.5→5→7.5→10→12.5→15 mg | Titrate over 20 weeks: 2.5→5→7.5→10→12.5→15 mg |
| Administration | Weekly subcutaneous injection (pen) | Weekly subcutaneous injection (pen) | Weekly subcutaneous injection (pen) | Weekly subcutaneous injection (pen) |
| Avg. Weight Loss (clinical trial) |
~15% STEP 1 trial (68 wk) |
~9–14% STEP 1–8 & SUSTAIN |
~20–22% SURMOUNT-1 (72 wk) |
~20–21% SURMOUNT-1 (72 wk) |
| Common Side Effects | Nausea, diarrhea, vomiting, constipation, headache | Nausea, diarrhea, vomiting, constipation, abdominal pain | Nausea, diarrhea, vomiting, decreased appetite, constipation | Nausea, diarrhea, vomiting, decreased appetite, constipation |
| Key Warnings | Thyroid C-cell tumor risk (animal data); pancreatitis; gallbladder disease | Thyroid C-cell tumor risk (animal data); pancreatitis; diabetic retinopathy risk | Thyroid C-cell tumor risk (animal data); pancreatitis; gallbladder disease | Thyroid C-cell tumor risk (animal data); pancreatitis; gallbladder disease |
| Retail Cost/Month | ~$1,300–$1,400 | ~$850–$950 | ~$1,000–$1,100 | ~$1,000–$1,060 |
| With Insurance | $0–$500/mo Novo savings card eligible |
$25–$200/mo Strong diabetes coverage |
$25–$150/mo Strong diabetes coverage |
$25–$150/mo Savings card available |
| Availability | Available | Available | Available | Available |
Average percentage of body weight lost at end of trial in participants without type 2 diabetes, at maximum approved dose. Sources: STEP 1 (Wegovy), STEP 1 (Ozempic 1mg arm), SURMOUNT-1 (Mounjaro & Zepbound 15mg).
Your ideal medication depends on your health goals, insurance, and whether you have type 2 diabetes. Use this guide as a starting point — always discuss options with your prescriber.
Both have FDA approval for T2D and strong insurance coverage. Mounjaro lowers A1c more and produces greater weight loss. Ozempic has the longest track record and best cardiovascular data.
Tirzepatide consistently outperforms semaglutide in head-to-head data. Zepbound is FDA-approved for obesity; Mounjaro requires a T2D diagnosis for covered use.
Coverage varies enormously by plan. Ozempic and Mounjaro have the best coverage rates for T2D. Wegovy and Zepbound are more often covered for obesity, but many plans still exclude it. Always check your formulary before prescribing.
Lilly's self-pay Zepbound program starts at ~$349/mo. Ozempic has the lowest retail price of the branded options. Compound semaglutide from licensed pharmacies is another cost option — see our cost comparison tool.
Semaglutide has the strongest CV outcome data. Wegovy's SELECT trial showed a 20% reduction in major cardiovascular events in people with obesity but without diabetes. Ozempic also has strong CV data from the SUSTAIN-6 trial.
All four medications have similar side effect profiles. Your prescriber will weigh your BMI, comorbidities, insurance, and goals. Many providers start with Ozempic or Wegovy given the longer safety track record.
Semaglutide (Wegovy, Ozempic) activates one receptor — GLP-1. This slows gastric emptying, reduces appetite, and improves insulin secretion. Tirzepatide (Mounjaro, Zepbound) activates two receptors — GLP-1 and GIP (glucose-dependent insulinotropic polypeptide). The dual mechanism appears to produce greater appetite suppression and weight loss on average, though individual variation is high.
Yes and no. Both contain semaglutide, but Wegovy is dosed at 2.4mg/week (higher than any Ozempic dose) and is FDA-approved for weight management. Ozempic's max approved dose for diabetes is 2mg/week. The higher dose in Wegovy produces greater weight loss. Using Ozempic off-label for weight loss is common but may face insurance hurdles.
Mounjaro and Zepbound contain identical tirzepatide molecules at the same doses. The only differences are the FDA indication (diabetes vs. obesity), the brand name, and insurance coverage pathways. If you have both obesity and type 2 diabetes, your doctor and insurer will determine which label is appropriate.
Clinical data consistently shows that weight regain occurs after stopping GLP-1 medications — typically 50–70% of lost weight returns within 1–2 years. These are intended as long-term or indefinite treatments for most patients, similar to blood pressure medications. Discuss the long-term plan with your prescriber before starting.
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Weight loss data from: STEP 1 trial (semaglutide 2.4mg, NEJM 2021), SUSTAIN-6 (semaglutide 1mg), SURMOUNT-1 (tirzepatide, NEJM 2022). Costs are approximate U.S. national averages as of early 2026 and vary by pharmacy, region, and plan. This page does not constitute medical advice.
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