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You’ve most likely heard of Wegovy® because of its success in helping people lose weight. It may also be top of mind because it’s been hard to get since 2021, when the U.S. Food and Drug Administration (FDA) approved it for chronic weight management. Wegovy’s been in high demand—and on and off the FDA’s drug shortages list—ever since. And in late 2023, Novo Nordisk, which manufactures Wegovy, released a study showing that it can prevent heart attacks and strokes so effectively, many believe it will have a major impact on how doctors treat obesity and heart disease.
Trulicity® is also a household name for many people with type 2 diabetes or who know someone who does. Trulicity, which Eli Lilly manufactures, is FDA-approved to treat type 2 diabetes. But it’s also shown promising results for those who are prescribed it off-label to treat excess weight and obesity.
If you’re starting a weight loss journey, which do you take? Having the support of a provider who understands obesity medicine can help you navigate all of the medications available.
Found-affiliated health care providers specialize in obesity medicine and can match your prescription to target the root causes of your inability to lose weight. As you and your provider decide what drug will work best given your unique biology and needs, it’s helpful to learn about the options and their differences.
Here’s what we know about Wegovy vs Trulicity for weight loss and how they work to support weight loss.
Wegovy is a brand name for the drug semaglutide. It’s FDA-approved for weight loss in adults with obesity or overweight with a (a BMI of 30 or higher) or those with a BMI of 27 or above and a weight-related condition like high blood pressure, high cholesterol, or type 2 diabetes.
Semaglutide is a glucagon-like peptide 1 (GLP-1) receptor agonist. It mimics the GLP-1 hormone your body naturally makes, which helps regulate hunger and cravings, blood sugar levels, and slows stomach emptying. By diminishing your appetite, Wegovy (semaglutide) can help support weight loss.
Dulaglutide is the active ingredient and drug name for the brand name Trulicity. It was FDA-approved in September 2014 for the treatment of type 2 diabetes. Used off-label, it can also successfully treat overweight and obesity.
If Trulicity sounds familiar, you may also recognize other GLP-1 meds used to treat type 2 diabetes like Byetta® and Bydureon BCise® (exenatide), Victoza® (liraglutide), and Rybelsus® (semaglutide).
Like Wegovy, Trulicity’s part of the GLP-1 receptor agonist drug class. It promotes weight loss by helping with satiety and stimulating the pancreas’s insulin secretion after eating to stabilize blood sugar levels. Along with regulating appetite, dulaglutide works by slowing stomach emptying, which helps you feel fuller longer.
Both medications have shown significant weight loss when combined with lifestyle changes like a reduced-calorie diet and physical activity.
However, in clinical trials of semaglutide and dulaglutide, people taking semaglutide lost more weight. For example, a 68-week study of semaglutide published in 2021 in The New England Journal of Medicine found that of 1,961 patients, those given a weekly 2.4-mg dose of semaglutide lost an average of 34 pounds (14.9% of body weight) compared to 6 pounds (2.4%) in the placebo group.
In another study, published in Diabetes Care in 2021, patients taking 4.5 mg of dulaglutide (Trulicity), the highest dose in the trial, lost an average of 10 pounds after 36 weeks.
Because the two drugs act similarly, it’s important to work with a health care provider who specializes in obesity medicine to choose the most effective treatment for you.
In addition to improving blood sugar and supporting weight loss, Trulicity is also FDA-approved for heart health. It reduces the risk of adverse cardiovascular events like death, heart attack, and stroke in people with type 2 diabetes who have heart disease or cardiovascular risk factors.
And although it’s not FDA-approved to reduce cardiovascular risk yet, Wegovy has also demonstrated significant cardiovascular benefits. In a 2023 study, Wegovy reduced the risk of cardiovascular events by 20% for people with a BMI of 27 or greater who don’t have type 2 diabetes. We know that weight loss can improve cardiovascular health, so it’s not surprising that people who lose weight with Wegovy may also improve their heart health.
Like many drugs in the GLP-1 receptor agonist family, some of the most common side effects for Wegovy and Trulicity are nausea, diarrhea, and vomiting. But, there are more serious side effects you should be aware of before taking them. Here’s what to look out for:
Serious side effects:
Risk of Thyroid C-cell Tumors
Pancreatitis
Hypoglycemia
Hypersensitivity reactions
Acute kidney injury
Severe gastrointestinal disease
Diabetic retinopathy complications
Acute gallbladder disease
Heart rate increase
Novo Nordisk also warns in its safety prescribing info that those who are pregnant or thinking about becoming pregnant in the next two months shouldn’t take Wegovy. Neither should patients who are breastfeeding or planning to breastfeed.
Mild side effects include nausea, diarrhea, vomiting, abdominal pain, decreased appetite, indigestion, and fatigue.
Eli Lilly recommends following a few tips to help manage these side effects:
Eat smaller meals.
Stop eating when full.
Avoid fat or fatty foods.
Try eating bland foods like toast, crackers, or rice.
Serious side effects:
Risk of thyroid tumors
Pancreatitis
Hypoglycemia
Severe allergic reactions
Acute kidney injury
Severe gastrointestinal problems
Changes in vision (diabetic retinopathy complications)
Acute gallbladder problems
Wegovy and Trulicity carry warnings that if you or any in your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or an endocrine system condition called multiple endocrine neoplasia syndrome type 2 (MEN 2), you shouldn’t take these drugs.
Wegovy and Trulicity are both subcutaneous injections (under the skin). You’ll inject yourself in your upper arm, upper thigh, or abdomen once a week. Your health care provider will walk you through exactly how and when to take the drug when you start it.
Wegovy and Trulicity each have step-up dosing schedules that start you off at a lower dose and increase as your body shows it can tolerate it.
The recommended starting dose for Trulicity is 0.75 mg once weekly. After four weeks, your provider may increase your dose, depending on tolerability and weight loss, to a recommended maximum dose of 4.5 mg weekly.
The recommended starting dose for Wegovy is 0.25 mg once weekly. After four weeks, depending on tolerability and weight loss, your provider may increase your dose, up to a maximum maintenance dose of 2.4 mg weekly in month five.
Weight loss results aside, cost is one of the significant differences between these drugs. Trulicity has been around for almost a decade, allowing it time to funnel through the health insurance approval system. Because of this, many insurance companies cover a majority of the cost of Trulicity when prescribed as indicated. According to Eli Lilly, about 92% of monthly co-pays are between $0 and $30 if your insurance plan covers the medication. If you don’t have insurance or your plan doesn’t cover it, the out-of-pocket cost is $977.42 per month.
On the other hand, getting a prescription for Wegovy may include more hurdles when it comes to cost. First, not all health insurance policies cover the cost of prescription medicine for chronic weight management. Medicare part D can cover the costs of weight-loss medications if they are prescribed to people with heart disease, for the purpose of preventing serious events like heart attacks and strokes. The prescribed medication has to be FDA-approved for preventing major adverse cardiovascular events (MACE). Second, insurance companies that do cover Wegovy may require step therapy—a process of trying other, less costly treatments first, before approving Wegovy.
While the list price for Wegovy is $1,349.02 per package, which is a 28-day supply, Novo Nordisk maintains that most people don’t pay the list price because of the Wegovy coupons it offers through its savings program.
If you and your provider decide that Trulicity or Wegovy are right for you, check your insurance coverage before filling your prescription to get an estimate on how much you may pay out-of-pocket.
Many other medications are approved for weight loss, including several other GLP-1 drugs. Other drugs are prescribed off-label for weight management; these are medicines that are FDA-approved for another use but have been shown to also aid weight loss.
Navigating the many choices for medication-assisted weight loss is easier when you understand the unique biological barriers you face in attaining your goal weight. An obesity medicine specialist can tailor a prescription and treatment plan to work with your body’s biology to help you lose weight. Found Health’s affiliated providers use MetabolicPrint™, a proprietary assessment, to help you and your provider understand the challenges of your biology so together you can choose the best medication to support your goals.
Clinical studies can only tell you averages: They can’t tell you how a specific medication will work for you. Several factors will influence your decision when choosing medication-assisted weight loss. These factors could include side effects, which you may experience with one drug but not with another. They can also include cost, which could depend on your insurance provider.
At Found Health, you’ll have access to a Found-affiliated health care provider trained in obesity medicine who understands all the options available, and can use your personal MetabolicPrint to tailor a prescription for you. Found offers a science-backed approach to weight care that's based on your unique biology, psychology, lifestyle, and prescription medication needs.
GLP-1*
GLP-1 prescriptions, filled through your local pharmacy, are now available as part of Found's weight-loss toolkit. While GLP-1s can be effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a thorough evaluation of your medical history and lab work. If a GLP-1 is not appropriate for you, our providers will work with you to determine an effective medication for your health profile.
About Found
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.
