Zepbound vs. Wegovy: Which Weight Loss Treatment Comes Out on Top?
Health ConditionsObesity

Zepbound vs. Wegovy: Which Obesity Treatment Might Be Right for You?

Zepbound vs. Wegovy: Which Obesity Treatment Might Be Right for You?
Eli Lilly; Adobe Stock
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Updated on January 15, 2026
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There’s no question that medications like semaglutide (Wegovy) and tirzepatide (Zepbound) make headlines. They’re two of the handful of medications approved specifically for weight loss.

While both can be effective, they’re not the same. Here’s how Zepbound and Wegovy compare and how to decide which one might be right for you.

How Zepbound and Wegovy Work

Both medications are lab-made versions of certain hormones your body naturally produces that help control appetite and fullness. They contain different ingredients and work in similar but slightly different ways

Wegovy

The U.S. Food and Drug Administration (FDA) has approved two versions of Wegovy: an injectable and an oral pill.

Wegovy is a glucagon-like peptide-1 (GLP-1) receptor agonist that activates and mimics your body’s natural GLP-1 hormone, says Brynna Connor, MD, a board-certified family medicine physician based in Austin, Texas. This hormone helps regulate appetite, digestion, and blood sugar.

 Wegovy works by activating GLP-1 receptors to reduce feelings of hunger, help you feel fuller faster, and decrease your overall calorie intake, says Dr. Connor. It may also reduce cravings for certain savory, sweet, and salty foods.

Zepbound

Zepbound was approved by the FDA in 2023.

 “It’s a ‘dual agonist’ medication, meaning it targets and activates two hormone receptors in the body: GLP-1 and glucose-dependent insulinotropic polypeptide (GIP),” says Connor.
Like GLP-1, GIP is a hormone the body naturally produces. By activating both receptors, Zepbound helps reduce hunger and food cravings, slows how quickly your stomach empties after eating, and increases the feeling of fullness, she says. Zepbound can also tell your pancreas to release insulin after you eat, which can lower your blood sugar.

Who Can Use Wegovy and Zepbound?

There are differences in who can use these medications, says Thomas So, PharmD, a clinical pharmacist and the senior manager of the consumer drug information group at First Databank.

Wegovy (Injection)

The injectable form of Wegovy is approved for weight loss management in these groups of people:

Wegovy is also approved to reduce the risk of serious heart and blood vessel problems, including heart attack, stroke, or cardiovascular death, in adults with heart disease who are overweight or have obesity.

Additionally, the FDA approved Wegovy to treat metabolic dysfunction–associated steatohepatitis (MASH) in adults who have moderate to advanced liver scarring.

Wegovy (Pill)

The oral tablet of Wegovy is approved for weight loss management in these people:

  • Adults with obesity
  • Adults who are overweight and have at least one weight-related comorbid condition
  • Adults with established heart disease who either have obesity or are overweight
It is not known if Wegovy tablets are safe and effective for people under age 18.

Zepbound

Zepbound is approved for weight management in these groups:

  • Adults with obesity
  • Adults who are overweight and have at least one weight-related condition
Zepbound is also approved to treat moderate to severe obstructive sleep apnea in adults with obesity.

Dosage

Wegovy and Zepbound injections are each given under the skin once a week, says Rekha Kumar, MD, an obesity medicine specialist and an associate professor of clinical medicine at Weill Cornell Medical College in New York City. Both begin with a low dose and are increased gradually. Their dosage schedules and maximum strengths differ, however. Zepbound’s maximum dose is 15 milligrams (mg), while Wegovy’s is 2.4 mg.

Compared with Zepbound, Wegovy has a slower, more gradual increase in dose over time, which may make it easier to tolerate, says Dr. So. Treatment starts at 0.25 mg weekly for four weeks, then increases every four weeks to a maintenance dose of 1.7 mg or 2.4 mg, as determined by your doctor.

Zepbound’s dosing ramps up more quickly, says So. It starts at 2.5 mg weekly for four weeks, then increases to 5 mg weekly. Some people stay at 5 mg, while others may increase to 10 mg or 15 mg once a week.

The oral version of Wegovy also begins with a low dose and increases gradually. The pill is taken once daily at 1.5 mg for the first 30 days, then increases to 4 mg for the next 30 days and 9 mg for the following 30 days, until it reaches a maintenance dose of 25 mg if it’s well tolerated.

Weight Loss

So how much weight can you expect to lose? In one large study, people taking the highest dose of Wegovy (2.4 mg weekly) who were also enrolled in a patient support program lost an average of 17 percent of their body weight after 12 months and over 20 percent at 24 months.

 To put that in perspective, someone who weighed 200 pounds (lb) at the start of treatment with Wegovy might lose about 40 lb over that time.
For Zepbound, results from clinical trials showed even more weight loss. A study funded by the medication’s manufacturer, Eli Lilly, found that participants taking the maximum 15 mg dose lost an average of 52 lb over 72 weeks (roughly a year and a half), while those on the 5 mg dose lost about 35 lb.

And a head-to-head trial comparing Wegovy and Zepbound showed that people who took Zepbound for about a year and a half lost an average of 20 percent of their body weight, compared with 14 percent for Wegovy.

 This trial was also funded by Eli Lilly, the maker of Zepbound.

Other Benefits

Beyond weight loss, both medications offer additional health benefits, says Dr. Kumar. They’re tools that can improve your overall health, not just help you see a lower number on the scale, she says.

Both Wegovy and Zepbound can improve blood sugar control by increasing insulin secretion and reducing insulin resistance. They can also support better blood pressure and cholesterol levels, often as a result of weight loss, he says. Plus, both medications may help with health issues related to being overweight or having obesity, such as joint pain, sleep apnea, and fatigue, says Connor.

Wegovy has also shown significant benefits for heart health. In a clinical trial funded by Novo Nordisk (the drug’s manufacturer), adults with existing heart disease who were overweight or had obesity but didn’t have diabetes took Wegovy for an average of about three years. Those taking Wegovy had a 20 percent lower risk of serious heart problems, including heart attack, stroke, or death from heart-related causes, than those taking a placebo (a treatment that doesn’t contain medication).

Side Effects

Because Wegovy and Zepbound work in similar ways, their side effects often overlap. The most common issues are stomach related:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Bloating
  • Indigestion
  • Stomach pain
  • Burping

These side effects usually occur when you first start the medication or increase the dose, but tend to improve as your body adjusts, says Connor. Eating smaller meals, avoiding greasy foods, and staying hydrated can help manage them, she says. “In some cases, we slow down the dose increase to help patients tolerate the medication better,” says Kumar.

So notes that since nausea, vomiting, or diarrhea can lead to dehydration, drinking enough fluids is important to protect your kidneys. Some people also notice temporary hair thinning, especially with rapid weight loss.

Less common but more serious risks include the following:

  • Inflammation of the pancreas (pancreatitis)
  • Gallbladder problems
  • Hypoglycemia
  • Gastrointestinal reactions
  • Kidney issues
  • Mood changes
There have also been reports of suicidal thoughts in people taking these medications, says Connor, though a study found that semaglutide was associated with a lower risk of suicidal thoughts than other weight loss or diabetes medications.

Wegovy and Zepbound should not be used if the following factors apply:

  • A personal or family history of medullary thyroid cancer
  • Multiple endocrine neoplasia syndrome type 2
  • A known allergy or hypersensitivity to either medication or any of its ingredients

Because of potential risks to the baby, neither medication is recommended during pregnancy, nor are they recommended for people with severe stomach issues like gastroparesis, says So.

Cost

The list price (the original price set by the manufacturer before any discounts) is $1,349.02 per month for Wegovy (pill and pen) and $1,086.37 per month for Zepbound.

 But most people don’t pay these prices. What you actually pay depends on your insurance coverage.

“Many plans still do not cover anti-obesity medications, such as Zepbound and Wegovy, even though strong evidence shows these treatments can improve long-term health outcomes and reduce future costs related to diabetes and heart disease,” says Kumar.

Even with insurance, coverage varies widely from plan to plan, says So. Differences can include which medication is covered, prior authorization requirements, copays, and deductibles. Some insurance plans have started covering Wegovy more widely, particularly after it gained FDA approval to reduce cardiovascular risk.

If your insurance doesn’t cover these medications or the cost is still too high, both manufacturers offer ways to buy directly from them at reduced prices through LillyDirect or NovoCare Pharmacy.

Wegovy (injectable)
Zepbound
Wegovy (oral)
Initial FDA Approval
2021
2023
2025
How It Works
GLP-1 receptor agonist 
Dual agonist (activates GLP-1 and GIP receptors)
GLP-1 receptor agonist
Who It’s For
Adults and children 12 and older — for weight management, cardiovascular risk reduction, MASH treatment
Adults only — for weight management, obstructive sleep apnea treatment
Adults only — for weight management, cardiovascular risk reduction
Dosing Schedule
Once-weekly injection, gradually increasing from 0.25 mg to 2.4 mg
Once-weekly injection, starting at 2.5 mg with the option of increasing to 15 mg 
Once daily tablet, starting at 1.5 mg, gradually increasing to 25 mg
Average Weight Loss
About 15 percent of body weight after 68 weeks
About 15 to 22.5 percent of body weight after 72 weeks
About 15 percent of body weight after 68 weeks
Common Side Effects
Nausea, vomiting, diarrhea, constipation, bloating, indigestion
Nausea, vomiting, diarrhea, constipation, stomach pain, fatigue
Nausea, vomiting, diarrhea, constipation, bloating, indigestion
List Price (per Month)
$1,349.02
$1,086.37
$1,349.02
Direct-to-Consumer Pricing
$349 per month through NovoCare Pharmacy
$449 per month through LillyDirect
$299 per month through NovoCare Pharmacy

Things to Consider Before Choosing

Choosing between Wegovy and Zepbound comes down to finding the option that fits your health goals, lifestyle, and what feels right for you. Here are a few things to consider as you discuss these with your doctor.

Your Weight Loss Goals

If the goal is significant weight loss, say around 20 percent or more of body weight, Zepbound might be the stronger choice, says So. “For moderate weight loss of about 10 percent to 15 percent, Wegovy may be enough,” he says.

Your Overall Health

Additional health conditions you’re managing can help guide your choice. For example, if you have heart disease, Wegovy’s cardiovascular benefits may make it a better fit. If you live with obstructive sleep apnea, Zepbound could offer an added advantage, says So.

Tolerance

Kumar suggests thinking through how well you tolerate medications. Some people find Wegovy’s slower dose increase easier on their stomach, while others do fine with Zepbound’s faster ramp-up.

Coverage and Cost

Check what your insurance covers and whether you’d need prior authorization for either medication. If you’re paying out of pocket, compare the savings programs and direct-to-consumer prices from both manufacturers.

Long-Term Success

“Starting medication for a chronic condition, such as obesity and diabetes, should be viewed as a long-term commitment,” says Kumar. Even after reaching your weight goal, staying on the medication helps maintain those results.

 Work with your healthcare provider to adjust the maintenance dose, if needed, and continue monitoring your health.

The best and most sustainable long-term outcomes occur when these medications are combined with lifestyle changes, such as healthy eating, physical activity, adequate sleep, stress management, and ongoing follow-up, says So.

It also helps to talk openly with your healthcare provider about your goals, challenges, and concerns. Consider connecting with others who’ve used these medications or read discussions in trusted forums or support groups. Getting different perspectives can help you feel more informed and confident about which option might be the best fit for you.

The Takeaway

  • Wegovy and Zepbound are both FDA-approved weight loss medications that work in similar but slightly different ways, though clinical trials suggest that Zepbound may lead to greater weight loss than Wegovy.
  • Choosing between Wegovy and Zepbound depends on several factors. Wegovy offers heart health benefits for people with cardiovascular disease, while Zepbound is approved to treat obstructive sleep apnea in people with obesity.
  • Side effects for both medications are mostly stomach-related and usually improve over time. If you experience severe abdominal pain, vomiting, or mood changes, contact your healthcare provider right away.
  • These medications work best when paired with sustainable lifestyle habits like balanced eating, regular activity, good sleep, and stress management, along with ongoing support from a healthcare provider.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
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  3. Astrup A. Reflections on the Discovery GLP-1 as a Satiety Hormone: Implications for Obesity Therapy and Future Directions. European Journal of Clinical Nutrition. June 18, 2024.
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  5. FDA Approves New Medication for Chronic Weight Management. U.S. Food and Drug Administration. November 8, 2023.
  6. Dutta P et al. Tirzepatide: A Promising Drug for Type 2 Diabetes and Beyond. Cureus. May 1, 2023.
  7. WEGOVY- Semaglutide Injection, Solution WEGOVY- Semaglutide Tablet. DailyMed. December 22, 2025.
  8. FDA Approves Treatment for Serious Liver Disease Known as ‘MASH’. U.S. Food and Drug Administration. August 15, 2025.
  9. Frequently asked questions. Wegovy.
  10. Zepbound- Tirzepatide Injection, Solution. DailyMed. December 29, 2025.
  11. FDA Approves First Medication for Obstructive Sleep Apnea. U.S. Food and Drug Administration. December 20, 2024.
  12. Toliver JC et al. Real-World Weight Loss Among Patients Initiating Semaglutide 2.4 mg and Enrolled in WeGoTogether, a Digital Self-Support Application. Advances in Therapy. August 6, 2025.
  13. Jastreboff AM et al. Tirzepatide Once Weekly for the Treatment of Obesity. The New England Journal of Medicine. June 4, 2022.
  14. Aronne LJ et al. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. The New England Journal of Medicine. May 11, 2025.
  15. Lincoff AM et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. The New England Journal of Medicine. November 11, 2023.
  16. Ituarte BE et al. Cross-Sectional Analysis of Adverse Dermatologic Events Reported to the FDA After Use of GLP-1 Agonists. Journal of Drugs in Dermatology. August 19, 2024.
  17. Wang W et al. Association of Semaglutide With Risk of Suicidal Ideation in a Real-World Cohort. Nature Medicine. January 5, 2024.
  18. How Much Should I Expect To Pay for Zepbound (Tirzepatide)? Lilly.
  19. Understanding List Price. NovoCare.
  20. Quarenghi M et al. Weight Regain After Liraglutide, Semaglutide or Tirzepatide Interruption: A Narrative Review of Randomized Studies. Journal of Clinical Medicine. May 28, 2025.
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