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GLP-1 comparison

Zepbound vs Wegovy

The two FDA-approved once-weekly injections for chronic weight management. One produced more average weight loss in trials. The other has proven cardiovascular protection. Which one wins depends on you.

Zepbound

Tirzepatide — biggest average loss

~20% average weight loss at the highest dose. Also approved for obstructive sleep apnea. Cardiovascular outcomes trial still ongoing.

Wegovy

Semaglutide — proven CV benefit

~15% average weight loss. FDA-labelled to reduce major cardiovascular events (SELECT trial). Longer safety record for the class.

Side by side

Active ingredient
ZepboundTirzepatide
WegovySemaglutide
Drug class
ZepboundDual GIP + GLP-1 receptor agonist
WegovyGLP-1 receptor agonist
Manufacturer
ZepboundEli Lilly
WegovyNovo Nordisk
FDA-approved use
ZepboundChronic weight management + OSA in adults with obesity
WegovyChronic weight management + reduce MACE in adults with CVD and obesity
Eligibility (BMI)
ZepboundBMI ≥30, or ≥27 with weight-related condition
WegovyBMI ≥30, or ≥27 with weight-related condition
Dosing frequency
ZepboundOnce weekly, subcutaneous injection
WegovyOnce weekly, subcutaneous injection
Starting dose
Zepbound2.5 mg once weekly (4 weeks)
Wegovy0.25 mg once weekly (4 weeks)
Maintenance / maximum dose
Zepbound5, 10, or 15 mg once weekly
Wegovy2.4 mg once weekly
Full titration length
Zepbound20 weeks to 15 mg (5 dose steps)
Wegovy16 weeks to 2.4 mg (5 dose steps)
Average weight loss (highest dose, 72 wks)
Zepbound~20.9% of baseline body weight (SURMOUNT-1)
Wegovy~14.9% of baseline body weight (STEP 1, 68 wks)
Head-to-head weight-loss trial
ZepboundSURMOUNT-5: tirzepatide −20.2%
WegovySURMOUNT-5: semaglutide −13.7%
Cardiovascular outcomes evidence (weight-loss use)
ZepboundOngoing (SURMOUNT-MMO)
WegovySELECT: 20% relative reduction in MACE
Sleep apnea indication
ZepboundApproved for moderate-to-severe OSA in obesity (Dec 2024)
WegovyNot approved for OSA
Most common side effects
ZepboundNausea, diarrhea, constipation, vomiting, injection-site reactions
WegovyNausea, diarrhea, vomiting, constipation, headache
Boxed warning
ZepboundRisk of thyroid C-cell tumors (MTC/MEN 2 contraindication)
WegovyRisk of thyroid C-cell tumors (MTC/MEN 2 contraindication)
US list price (28-day supply)
Zepbound~$1,060
Wegovy~$1,350
Pen device
ZepboundSingle-dose vial or pre-filled autoinjector
WegovySingle-dose pre-filled autoinjector
Insurance coverage in the US
ZepboundGrowing but limited for weight-loss indication
WegovyImproving; CVD indication broadens coverage

Highlighted cells indicate the clearer choice on that row. Sourced from FDA prescribing information and the SURMOUNT, STEP, and SELECT pivotal trials — see references below.

How much would you lose on each?

Project your expected weight loss on tirzepatide or semaglutide from your own starting weight.

Open the projection calculator

Which one is right for you?

Weight loss is the primary goal

SURMOUNT-5 favored Zepbound (tirzepatide) by ~6.5 percentage points on average weight loss versus Wegovy. If maximum average weight loss matters most, this is where the evidence points.

You have established cardiovascular disease

Wegovy has SELECT trial evidence for a 20% reduction in major cardiovascular events and an FDA label to match. That is a real, patient-oriented outcome that tirzepatide has not yet demonstrated.

You have moderate-to-severe sleep apnea

Zepbound is now FDA-approved for OSA in adults with obesity — the only GLP-1 with that indication. It may enable insurance coverage where weight-loss alone would not.

Cost is decisive

Zepbound's list price is currently lower ($1,060 vs $1,350). Manufacturer savings cards and direct-from-Lilly / Wegovy pen options can shift the calculus. Confirm your out-of-pocket before you commit.

This is educational information, not a prescription or medical advice. The right medication — and whether one is appropriate at all — is a decision for you and a licensed clinician.

Mounjaro vs Ozempic

Same molecules, but for type 2 diabetes.

Compare

Tirzepatide vs Semaglutide

The molecule-level comparison.

Compare

Weight-Loss Timeline

Month-by-month, by medication.

Open

Related in your GLP-1 journey

Full GLP-1 hub →
Mounjaro vs Ozempic
Tirzepatide vs semaglutide for type 2 diabetes.
Compounded vs Brand Semaglutide
Cost, safety and regulation compared honestly.
Ozempic vs Wegovy
Same drug, different indications.
Tirzepatide vs Semaglutide
Dual agonist vs single agonist.
GLP-1 Progress Tracker
Track your journey week over week.
GLP-1 Dose Calculator
Convert mg to units on a U-100 insulin syringe.

Frequently Asked Questions

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Sources

Tool Information

Last reviewed

August 5, 2026

Reviewed by

Dr. Jaydeep Sanghani

Created by

Meet Akabari

Dr. Jaydeep Sanghani

Dr. Jaydeep Sanghani

MBBS, MD, DNB(Anaesth.), PDCC(CCM), DrNB(CCM)

AIIMS Bhubaneswar · AIIMS Rishikesh

Critical care specialist and anesthesiologist with advanced training from AIIMS. Reviews health calculators at Calqulate to ensure medical accuracy and evidence-based standards.

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