Zepbound vs Wegovy: What’s the difference between the latest drugs approved for weight loss?

A massive shift is occurring as new weight loss drugs hit the shelves and we learn more about how biology influences body weight: There are now more options for treatment. Zepound® and Wegovy® are two of the latest FDA-approved drugs on the market to treat severe obesity and chronic weight management. Is one better for you than the other? Here’s all you need to know about Zepbound vs Wegovy.

Zepbound vs Wegovy: How do they work?

Zepbound’s active ingredient is tirzepatide, a synthetic peptide that mimics two of the body’s natural hormones—glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). 

Tirzepatide, a dual receptor agonist, activates the same receptors as the GLP-1 and GIP hormones, which helps lower blood sugar levels and reduce appetite. Until recently, tirzepatide was only available under the brand name Mounjaro®, which is approved by the U.S. Food and Drug Administration (FDA) for treating type 2 diabetes. Clinicians also prescribe Mounjaro off-label as an anti-obesity drug. 

Wegovy’s active ingredient is semaglutide—the same as in Ozempic. Semaglutide is receptor agonist—a drug that activates the same cell receptors as the body's natural hormones. However, unlike tirzepatide, semaglutide only mimics one hormone, GLP-1. When Wegovy mimics GLP-1, it targets the areas of the brain that affect appetite, helps regulate blood sugar levels, and makes the stomach empty more slowly, so you feel fuller longer. 

Eli Lilly manufactures Zepbound (tirzepatide), and Novo Nordisk produces Wegovy (semaglutide).

Wegovy vs Zepbound: How much weight can you lose?

In a study published in The New England Journal of Medicine (NEJM), 2,539 adults with obesity or excess weight and at least one weight-related health issue that was not diabetes were given varying doses of tirzepatide each week. Those on 15 mg, the highest dose, lost an average of 48 lbs., while those on a lower dose, 5 mg, lost an average of 34 lbs. (One in three patients taking 15 mg lost 25% of their body weight, almost 58 lbs.)  

Studies have also found that patients on Wegovy have experienced significant weight loss. A double-blind trial published in the NEJM looked at semaglutide for weight loss in 1,961 adults with obesity or excess weight and at least one related medical issue. Those on 2.4 mg of Wegovy lost an average of 14.9% of their body weight (about 35 lbs.), and one in three patients on Wegovy lost 20% of their original body weight (about 46 lbs.). Patients given the placebo only lost an average of only 2.4% of their starting body weight.

How long before you see weight loss results? 

When you take Zepbound for weight loss, you’ll typically see its full results about a year after taking the drug. Patients typically combine Zepbound with lifestyle changes, such as more physical activity and a healthy diet, for better weight loss results. On Zepbound, weight loss generally increases with the dosage. 

If you’re taking Wegovy, blood sugar levels usually decrease after the first dose. Weight loss typically occurs after a couple of weeks, with more significant weight loss about two months after starting the drug. Patients generally see full results within a year. (Doctors recommend losing 1-2 pounds weekly for long-term success.)

Zepbound vs Wegovy: How much do they cost?

Zepbound's list price is $1,059.87, but you may pay less out of pocket if you have health insurance. Patients whose insurance covers Zepbound may pay as low as $25 for a one-month or three-month prescription using the Zepbound Savings Card. If your commercial insurance doesn’t cover Zepbound, you may be eligible to pay as low as $550 for one month’s supply.

Wegovy’s list price is $1349.02 monthly. If your insurance provider covers Wegovy, you may have no out-of-pocket costs for a 28-day supply. If your insurance doesn’t cover Wegovy, you may be eligible for the Wegovy savings offer and pay nothing or save up to $225 per 28-day fill for 13 fills. Those with federal or state health coverage, including Medicaid, Medicare, or VA, are not eligible for Wegovy’s offer.

Common side effects & warnings

Like all drugs, Zepbound and Wegovy have side effects. It’s important to talk to your health care provider before you start taking any weight loss drugs.

Zepbound’s most common side effects include nausea, diarrhea, vomiting, constipation, abdominal pain, indigestion, injection site reactions, fatigue, heartburn, and hair loss. With Wegovy, the most common side effects are nausea, diarrhea, vomiting, constipation, stomach pain, headache, tiredness/fatigue, upset stomach, dizziness, feeling bloated, belching, gas, stomach flu, heartburn, and runny nose or sore throat.

Both Zepbound and Wegovy also carry more serious but less common side effects, including pancreatitis, gallbladder disease, gastroparesis (stomach paralysis), and worsening of diabetic eye disease. Those with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasias should not use these drugs. Find detailed side effects and risk information for specific medications on our dedicated medication page.

Wegovy vs Zepbound: Which is better for weight loss? 

While trials have shown significant weight loss for patients on Zepbound and Wegovy, each person’s results will vary. No study has compared these two weight loss drugs head to head. For information about which weight loss drug will work for you, talk to a health care professional trained in obesity medicine.

Choosing to try medical weight loss—and which weight loss drug you should take—is a big decision. At Found, we use a proprietary MetabolicPrint™ analysis to identify the underlying causes of your weight issues. Found-affiliated providers use this information, along with your medical and weight history, to personalize a prescription plan just for you.

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