Wegovy and Zepbound are both FDA-approved for weight loss. They use different drugs and work in different ways.
Here's how they stack up.
Quick Comparison
| Wegovy | Zepbound | |
|---|---|---|
| Active drug | Semaglutide | Tirzepatide |
| Drug class | GLP-1 agonist | Dual GIP/GLP-1 agonist |
| FDA approval | Weight management | Weight management |
| Dose range | 0.25 mg – 2.4 mg (7.2 mg Wegovy HD for eligible patients) | 2.5 mg – 15 mg |
| Injection | Once weekly | Once weekly |
| Maker | Novo Nordisk | Eli Lilly |
How They Work
Wegovy uses semaglutide, which mimics one hormone (GLP-1) that signals fullness and slows digestion.
Zepbound uses tirzepatide, which mimics two hormones (GLP-1 and GIP). Two signals can mean stronger results.
Products for GLP-1 users:
- Smart scale - track weight loss
- Protein powder - maintain muscle mass
Weight Loss Results
From clinical trials:
| Medication | Average Weight Loss | Trial Length |
|---|---|---|
| Wegovy (2.4 mg) | ~15% of body weight | 68 weeks |
| Wegovy HD (7.2 mg) | ~20.7% of body weight | trial in patients who plateaued on 2.4 mg |
| Zepbound (15 mg) | ~21% of body weight | 72 weeks |
Zepbound (15 mg) and Wegovy HD (7.2 mg) show roughly similar average weight loss. But these come from separate trials with different patient populations, not head-to-head comparisons. Your results may differ. See our Wegovy HD guide for more on the step-up option.
Side Effects
Both cause similar side effects:
- Nausea (most common)
- Diarrhea or constipation
- Vomiting (less common)
- Stomach pain
- Decreased appetite
- Fatigue
Side effects are usually worst during the first few weeks and after each dose increase. Most people adjust over time.
Cost
Wegovy:
- List price: ~$1,350/month
- Covered by some insurance plans for weight loss
- Novo Nordisk savings cards available
Zepbound:
- List price: ~$1,060/month
- Covered by some insurance plans for weight loss
- Eli Lilly savings cards available
Zepbound has a lower list price, but your actual cost depends on your insurance. Check your formulary.
Who Should Choose Wegovy?
- Your insurance covers it and not Zepbound
- You've used semaglutide before (as Ozempic) and did well
- You want the longer track record
- Your doctor recommends it
- You're also considering Saxenda vs Wegovy
Who Should Choose Zepbound?
- You want the option of higher average weight loss
- You tried semaglutide and didn't get enough results
- Your insurance covers it
- Your doctor recommends tirzepatide
Can You Switch?
Yes. Some people switch from Wegovy to Zepbound if they plateau or want more weight loss. You'll start at the lowest Zepbound dose and titrate up.
Bottom Line
Both are effective weight loss medications. Zepbound showed higher average results in trials, but Wegovy has been on the market longer.
For a full breakdown of all GLP-1 drug names and brand names, see GLP-1 Medications Explained. Comparing with Saxenda? See Wegovy vs Saxenda.
The right choice depends on your insurance, your health history, and what your doctor recommends.
Work with your healthcare provider to determine which medication is right for you. Individual results and experiences vary.
