Wegovy® and Mounjaro® are making headlines again: Wegovy’s not only a powerful weight loss drug, but recently released research shows it can reduce the risk of some of the most frightening consequences of excess weight: heart attacks and strokes.
And in November 2023, tirzepatide, the active ingredient in Mounjaro, became the latest medication to receive U.S. Food and Drug Administration (FDA) approval for treating obesity, under the brand name Zepbound™. (Mounjaro is FDA-approved for type 2 diabetes treatment and prescribed off-label for chronic weight management.) Zepbound’s weight loss results in clinical trials are the most impressive yet, with participants losing an average of 20.9% of body weight.
It’s easy to get confused about Wegovy vs tirzepatide when it comes to weight loss, and you may wonder which one you should take if you want to lose weight. Even though both drugs are known for helping people lose weight—sometimes in remarkable amounts—they don’t work for everyone.
Scientists now know there are multiple causes for excess weight, some biological. A single, one-size-fits-everyone approach is no longer enough: Medication for weight loss should be personalized. Health care providers specializing in obesity medicine–such as those affiliated with Found—can identify the underlying causes of weight gain and prescribe medicine to target them.
If you’re considering Wegovy or Mounjaro (tirzepatide), here are some things to consider to make an educated decision when discussing options with your health care provider.
Wegovy (semaglutide) is a glucagon-like peptide-1 receptor agonist (GLP-1 receptor agonist or GLP-1) that mimics the GLP-1 hormone your body releases after eating. GLP-1s help lower blood sugar and slow the digestive process resulting in reduced appetite and encouraging weight reduction.
Wegovy comes as a once-weekly injection. You typically start Wegovy at a weekly 0.25 mg dose and your provider may increase the dose over time until you reach a weekly dose of 1.7 or 2.4 mg (the maximum). Your health care provider may adjust the dose and schedule depending on how your body reacts.
Tirzepatide is a dual agonist (a drug that works as an agonist activates the same cell receptors as the body's natural hormones). It mimics the body’s GLP-1 hormone and it also acts as a GIP (glucose-dependent insulinotropic polypeptide) receptor agonist. GIP is a hormone that complements GLP-1 by helping regulate blood sugar and affecting how your body uses calories. These two agonists work together to bolster weight loss.
Mounjaro (tirzepatide) is an injectable medication indicated for patients with type 2 diabetes. However, medical professionals also prescribe it for off-label use in weight management. It’s administered subcutaneously once weekly with a recommended starting dosage of 2.5 mg. Every four weeks, if clinically appropriate, your health care provider may increase your tirzepatide doses in 2.5 mg increments to a maximum of 15 mg weekly. (Zepbound is the same medication, available in the same doses but specifically indicated for weight loss.)
Wegovy is a very effective medication for weight loss; in a 2022 clinical trial, participants lost an average of 15.2% of body weight and maintained that loss for two years while taking Wegovy and making lifestyle changes. Wegovy also worked quickly; participants lost 2% of body weight during the first month and continued losing until they plateaued at 68 weeks.
Wegovy is also good for cardiovascular health. A 2023 study found that a weekly 2.4 mg dose of semaglutide reduced the risk of cardiovascular events by 20%. It also helps improve other weight-related health conditions like high cholesterol and blood pressure.
Mounjaro was even more effective for weight loss. In a clinical trial published in 2022, participants at the highest dose, 15 mg, experienced an average loss of 20.9% of body weight. Like Wegovy, Mounjaro starts to work quickly, with participants losing almost 4% of body weight by the end of the first month of the trial.
Weight loss on Mounjaro slowed for participants on lower doses. Among participants taking the lowest weekly dose for the tirzepatide injection, 5 mg, weight loss plateaued at an average of 15% of body weight.
Mounjaro has also been shown to improve heart health in patients with type 2 diabetes, but it’s not approved as a treatment for cardiovascular disease.
Wegovy is manufactured by Novo Nordisk. According to the manufacturer's website, the list price for Wegovy is $1,349.02 per monthly fill. Each package has 4 pens or 4 weekly doses. Some insurance plans cover Wegovy, either in full or with a copay. Novo Nordisk also has a Wegovy savings offer that can lower your payments to as little as $0 per month, depending on your insurance coverage.
Mounjaro is manufactured by Eli Lilly. Themanufacturer list price is $1,069.08 per fill, and each package has 4 pens with one weekly dose each.
One area where the Wegovy vs Mounjaro comparison is similar is the gastrointestinal side effects for both drugs. Nausea, vomiting, constipation, diarrhea, and abdominal pain are the most common side effects of both.
A 2022 review article comparing the two medications found that side effects were more common at higher doses of the drugs. Side effects would usually occur when a person started the drug or increased to a higher dose. At the highest dose of Wegovy (2.4 mg), 87.6% of participants experienced side effects, and 6.2% quit the trial due to side effects.
At the highest dose of Mounjaro (15 mg) up to 68.9% of people experienced side effects, and up to 8.5% of participants quit the trial.
Both drugs can also cause more serious side effects, including pancreatitis, gallbladder problems, low blood sugar, or severe allergic reactions.
Although rare, in animal studies, semaglutide, which is also the active ingredient in Ozempic®, caused thyroid c-cell tumors. Wegovy’s “black box” warns of the risk of thyroid tumors. If you have trouble swallowing, develop hoarseness, or feel swelling or a lump in your neck, contact your health care provider immediately.
The FDA also warns not to take Wegovy if you have or have a family history of multiple endocrine neoplasia syndrome type 2, medullary thyroid cancer, insulin-dependent diabetes, or diabetic ketoacidosis. So, if that’s you, Wegovy isn’t the right fit. Find detailed side effect and risk information for Wegovy here.
People with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 should not take Mounjaro. Do not take Mounjaro if you have ever had thyroid cancer. Mounjaro can cause fetal harm. If you are pregnant, breastfeeding, or planning to become pregnant, do not take Mounjaro. Find detailed side effect and risk information for Mounjaro here.
So, which is better for weight management, Wegovy or Mounjaro? The answer to the Wegovy vs Mounjaro debate comes down to what you and your health care provider decide. Both can be very effective at supporting your journey toward better health. The best choice for your situation depends not only on your insurance, budget, and preferences but also on your genetic and metabolic makeup.
Found uses a proprietary MetabolicPrint™ assessment to give you and your provider insights into your unique biology, which your provider can use to personalize your treatment.
To discover your MetabolicPrint and start your journey with Found, take our quiz. Found is among the largest medically supported weight care clinics in the country, having served more than 200,000 members to date.
GLP-1 and tirzepatide prescriptions, filled through your local pharmacy, are now available as part of Found's weight-loss toolkit. While these medications can be effective for weight loss, they are not clinically appropriate for everyone. Eligibility for these drugs is based on a thorough evaluation of your medical history and lab work. If GLP-1s or tirzepatide are not appropriate for you, our providers will work with you to determine an effective medication for your health profile.