Zepbound vs Trulicity: How they compare for weight loss

If you’re exploring treatment options for obesity or excess weight, you might be wondering which medication works best for weight loss: Zepbound® (tirzepatide) or Trulicity® (dulaglutide)? 

While Zepbound is FDA-approved for weight loss, Trulicity is FDA-approved to treat type 2 diabetes and cardiovascular risk. But providers prescribe both of them, on and off label, for weight management.

To help understand the differences between these two brand-name drugs, let’s break down how each works and answer some common questions: How much weight loss do people experience on each drug, and how long does it typically take to see results?

Zepbound vs Trulicity: How do they work?

Eli Lilly and Company manufactures Zepbound and Trulicity, and both drugs are taken as once-weekly subcutaneous injections. These medications mimic the hormones found naturally in the gut that help regulate insulin, balance blood sugar (glucose), and curb appetite. 

Each drug contains a different active ingredient and works in slightly different ways. And, as noted above, the U.S. Food & Drug Administration (FDA) has approved each drug for different purposes. 

Here’s what to know about taking Trulicity for weight loss:

• What it’s prescribed for: Trulicity is FDA-approved to improve blood sugar levels and reduce the risk of major cardiovascular events in people with type 2 diabetes. It’s sometimes prescribed off-label for weight loss. 
• Active ingredient: Dulaglutide
• How it works: Trulicity is part of a class of drugs called glucagon-like peptide-1 or GLP-1 receptor agonists, including Ozempic® and Wegovy® (semaglutide). These medications mimic the GLP-1 hormone and slow digestion or “gastric emptying.” Slowing digestion helps you feel fuller longer, which can help with weight loss.

Here’s what to know about taking Zepbound for weight loss:

• What it’s prescribed for: Zepbound is FDA-approved for chronic weight management in people with obesity or those who are overweight with weight-related medical issues such as high blood pressure, high cholesterol, or heart disease. Obesity is defined as having a body mass index or BMI of 30 or greater. Overweight is defined as having a BMI of 27 or greater. 
• Active ingredient: Tirzepatide (the same active ingredient as in the type 2 diabetes drug Mounjaro®)
• How it works: Tirzepatide is a dual agonist drug, meaning it mimics not one but two gut hormones (GLP-1 and glucose-dependent insulinotropic polypeptide, aka GIP). Like Trulicity, Zepbound slows digestion and helps you feel fuller longer. By mimicking two hormones instead of one, it can be more effective at supporting weight loss for some people.

How much weight can you lose with Zepbound vs Trulicity?

Individual results vary, but here’s what research has shown.

Weight loss with Zepbound

Two clinical trials established the effectiveness of tirzepatide for weight loss for adults with overweight or obesity. In the larger 2022 phase 3 clinical trial—a double-blind, randomized, controlled study by manufacturer Eli Lilly—2,539 adults with obesity or overweight who didn’t have type 2 diabetes took the medication for 72 weeks while also making lifestyle changes (including attending counseling sessions, eating balanced meals, and exercising). At the end of the trial, participants taking tirzepatide lost about 18% of their body weight, on average. Those taking higher doses typically lost more weight than those taking lower doses. People taking a 5 mg dose lost an average of 35.5 pounds. Those taking a 10 mg dose lost about 49 pounds. And those on the highest dose (15 mg) lost an average of 52 pounds.

Weight loss with Trulicity

In a randomized controlled trial, researchers studied the effects of dulaglutide in people who’d been taking metformin for type 2 diabetes without success. These participants took dulaglutide weekly for 52 weeks, starting at 0.75 mg weekly and gradually increasing to 1.5 mg, 3 mg, or 4.5 mg a week. The results, published in 2021 in Diabetes Care, found that the dose size impacted the amount of weight loss. By the 36-week mark, people taking a 1.5 mg dose lost about 7 pounds on average, while those taking a 4.5 mg dose lost an average of about 10 pounds. 

How long does it take to see weight loss results with Zepbound vs Trulicity?

In the clinical trial mentioned above, people taking tirzepatide (Zepbound) started losing weight within the first four weeks. And, though Trulicity isn’t FDA-approved for weight loss, weight loss with Trulicity can occur over several months.

How much weight you lose, and how quickly, will vary depending on many factors—including your starting weight, how much you’re exercising, what you’re eating, and your individual biology and health status.

Zepbound vs Trulicity: How much do they cost?

As of February 2025, The list price for Zepbound is about $1,086 for a month’s supply of prefilled single-dose injector pens.

Eli Lilly also makes Zepbound available in single dose vials at different doses and prices: 

• A 2.5 mg vial is $349 per month
• 5 mg vial for $499 per month 
• 7.5 mg vial for $599 per month 
• 10 mg vial for $699 per month

For Trulicity, the list price is about $987 per month for prefilled single-dose pens. (List prices are subject to change.)

But the cost for these drugs isn’t straightforward. There’s the list price, and then there’s what you’ll actually pay, which will vary depending on how much your pharmacy charges, whether you have insurance coverage, and whether you use manufacturer’s coupons or other discounts.

Can you use Zepbound and Trulicity together?

No, it’s not safe to use Zepbound and Trulicity together or with any other GLP-1 medication. 

Common side effects and warnings 

The most common side effects for Zepbound include:

• Nausea
• Diarrhea
• Constipation
• Vomiting
• Indigestion
• Upset stomach 
• Abdominal pain

Some people also report experiencing injection site reactions, fatigue, belching, hair loss, allergic reactions, and/or heartburn.

The most common side effects for Trulicity include:

• Nausea
• Diarrhea
• Vomiting
• Decreased appetite
• Upset stomach 
• Abdominal pain
• Fatigue

Though less common, using Zepbound or Trulicity can lead to more serious side effects, including severe stomach problems, kidney failure, gallbladder problems, pancreatitis, serious allergic reactions, hypoglycemia, vision changes (in people with type 2 diabetes). If you are going under general anesthesia or deep sedation, GLP-1s may make you accidentally breathe food or liquid into your lungs (pulmonary aspiration). And using Zepbound can lead to depression or thoughts of suicide. 

Tell your health care provider if you experience severe stomach problems that won’t go away, including abdominal bloating or pain, acid reflux, a feeling of fullness after eating just a few bites of food, nausea, and vomiting (including vomiting undigested food eaten a few hours earlier). These may be symptoms of gastroparesis (stomach paralysis).

People with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 should not take Zepbound or Trulicity. Do not take Zepbound or Trulicity if you have ever had thyroid cancer. Both drugs can cause fetal harm, so if you are pregnant, breastfeeding, or planning to become pregnant, do not take either of these medications. Follow the links for more detailed side effect and risk information for Zepbound and Trulicity.

Zepbound vs Trulicity: Which is better for weight loss? 

In clinical trials, people taking tirzepatide (the active ingredient in Zepbound) had higher average rates of weight loss than those taking dulaglutide (the active ingredient in Trulicity). However, these two drugs are approved by the FDA for different purposes in different populations and prescribed at different dosages, so it’s not an apples-to-apples comparison. 

Plus, a medication that works well for one person might not work as well for another for a wide variety of reasons, including individual biology, other health conditions, and how well a person tolerates the medication. Talking to a health care provider trained in obesity care is likely the best way to determine which option, if either, is a fit for you. 

At Found, board-certified clinicians trained in obesity medicine help you customize a plan to suit your unique biology and weight loss needs. Any prescription decisions are ultimately up to the provider.t Found-affiliated clinicians have a broad range of medications to choose from—including Zepbound, Trulicity, and others—when it comes to personalizing your best treatment plan.

About Found

Found is among the largest medically-supported telehealth weight care platforms in the country, having served more than 250,000 members to date. To discover your MetabolicPrint™ and start your journey with Found, take our quiz.

Found is not affiliated with Eli Lilly and Co., the owner of the registered trademark Zepbound® and Trulicity®, nor is it affiliated with Novo Nordisk A/S., the owner of the registered trademarks Wegovy® and Ozempic®. While GLP-1s and GLP-1/GIPs are effective for weight loss, they are not clinically appropriate for everyone. Eligibility for medications is based on a provider’s evaluation of your medical history, MetabolicPrint, and lab work. If a GLP-1 or GLP-1/GIP is not appropriate for you, a provider will work with you to determine an effective medication for your health profile. This content does not provide medical advice and does not substitute for a consultation with a doctor or healthcare provider, nor should it be relied upon for determining actual costs incurred to you as a patient Certain medications are only FDA approved to treat conditions other than weight but may be prescribed to help aid in weight loss. For key risk information by drug, visit the Found medication page.