Wegovy® vs. Zepbound® for weight loss: Which one works best in 2025?

What you’ll learn:          

• Wegovy® and Zepbound^® are powerful, FDA-approved weight loss medications that come as weekly injections.
• Clinical studies show that Zepbound^® (tirzepatide) may help people lose slightly more weight over time. 
• Neither is a quick fix, but when combined with lasting lifestyle changes, both can be part of a long-term plan to lose weight and keep it off.

If you’ve looked into weight loss medications, you’ve probably heard of Ozempic^®. Originally approved to manage type 2 diabetes, it became a household name after people began using it off-label for weight loss, with impressive results. But Ozempic^® isn’t the only option. Since its rise in popularity, other medications have been FDA-approved specifically for weight management. Two of the most effective options are Wegovy^® and Zepbound^®.

Wegovy^® and Zepbound^® belong to the same drug family as Ozempic^®—GLP-1 receptor agonists. This means they mimic a hormone called GLP-1 that helps regulate appetite, digestion, and blood sugar. Wegovy^® contains the same active ingredient as Ozempic^®, semaglutide, and is nearly identical, aside from some differences in dosing. Zepbound®, on the other hand, contains tirzepatide, which mimics both GLP-1 and another hormone called GIP and might offer even greater weight loss benefits.

As promising as these medications are, they can also be costly, especially if your insurance doesn’t cover them. The good news? There are several ways to reduce out-of-pocket costs and make these treatments more accessible. In this guide, we’ll compare Wegovy® and Zepbound®, explain what makes them different, and help you figure out—with your doctor’s guidance—which one might be right for your weight loss journey.

Wegovy^® vs. Zepbound^®: How do they work?

Wegovy® and Zepbound^®  both mimic hormones that affect appetite and metabolism, but they do this in different ways.

The semaglutide in Wegovy® mimics just this one hormone, GLP-1. The tirzepatide in Zepbound® takes things a step further. In addition to GLP-1, it also targets a hormone called GIP (glucose-dependent insulinotropic polypeptide). GIP helps regulate insulin and may support fat metabolism. This dual action is unique to tirzepatide, and early research suggests it could lead to more weight loss and potentially better metabolic outcomes than GLP-1 medications alone.

Wegovy^® vs. Zepbound^®: What are the similarities?

While Wegovy^® and Zepbound^® are made with two different ingredients, they share a lot of similarities. Let’s take a look at a few:

FDA-approved for weight loss

Both Zepbound^® and Wegovy^® have been FDA-approved for weight loss. This means they’ve been put through their paces in clinical trials to make sure they’re safe and effective when used as directed.

Rarely covered by insurance

Getting coverage for these medications isn’t typical. Most insurance plans won’t cover weight loss treatments, even if they are FDA-approved. With both, you’ll likely have to pay out of pocket, look for savings programs, or explore other options. Since both medications work in similar ways, the right choice comes down to what fits your needs—your weight loss goals, budget, insurance coverage, and how your body responds to the medication.

Once-a-week injections

Both medications are taken as injections that you give yourself once a week on your chosen day. Wegovy^® comes only in a prefilled injector pen. With Zepbound^®, you can choose the prefilled injector pen or single-use vials that pair with a syringe. Below, we’ll go through the main reasons you’d choose one over the other. Hint: It has a lot to do with whether your insurance covers them.

Wegovy^® vs. Zepbound^®: What are the differences?

While Wegovy^® and Zepbound^® have similarities, they also have distinct features that set them apart. Understanding these differences can help you determine which medication will align better with your weight loss goals:

They have different active ingredients

Both Wegovy^® and Zepbound^® belong to the GLP-1 receptor agonist class, but they have different active ingredients.

• Wegovy^® contains semaglutide: As we said, semaglutide works by mimicking GLP-1. Semaglutide is also the active ingredient in Ozempic^® and the GLP-1 pill Rybelsus^®.
• Zepbound^® contains tirzepatide. Tirzepatide mimics GLP-1 and GIP. It’s the active ingredient in Mounjaro, which is approved for type 2 diabetes and can be prescribed off-label for weight loss.

How you take them

You take both Wegovy^® and Zepbound^® as once-weekly subcutaneous (under the skin) injections, but there are some differences. 

• Wegovy^® comes only in prefilled pens. 
• Zepbound^® offers prefilled pens and single-dose vials for certain doses. 

Manufacturers

Zebound^® and Wegovy^® are made by two different manufacturers. These two companies are leading competitors in the growing market for GLP-1 medications used for weight loss and diabetes. Let’s take a look at what they offer:

• Zepbound^® is made by Eli Lilly. Eli Lilly also makes Mounjaro^® (tirzepatide) and Trulicity® (dulaglutide), both of which are FDA-approved to treat type 2 diabetes. The company is also developing retatrutide, a next-generation medication that activates GIP, GLP-1, and glucagon receptors. 
• Wegovy^® is made by Novo Nordisk. Alongside Wegovy^®, Novo Nordisk also manufactures Ozempic^® and Rybelsus^®, both of which contain semaglutide and are approved to treat diabetes. The company also makes Saxenda^® (liraglutide), a GLP-1 receptor agonist approved for weight management, and Victoza^® (liraglutide), which is used to treat type 2 diabetes. Both can also be prescribed to prevent heart disease.

With these overlapping medications, Novo Nordisk and Eli Lilly are in direct competition as they continue to lead innovation in weight loss and metabolic health.

Wegovy^® vs. Zepbound^®: Which is better for weight loss?

If you’re looking for the most effective weight loss medication, Zepbound^® might have a slight edge over Wegovy^®. But Wegovy^® is still a powerful option. Ultimately, the right choice depends on how your body responds to the medication. Let’s take a look at how much weight people lose on average with both.

Wegovy^®  vs. Zepbound^®: How much weight can you lose? 

Studies show that people taking tirzepatide may lose more weight over the same time period. A recent trial comparing Zepbound^® (tirzepatide) and Wegovy^® (semaglutide) found that:

• People taking Zepbound^® lost an average of about 20% of their body weight (about 40 pounds for a person who starts at 200 pounds).
• People taking Wegovy^® lost an average of nearly 14% of body weight (about 33 pounds for a person who starts at 200 pounds).

Many lost even more. Nearly 32% of people taking Zepbound^® lost at least 25% of body weight, compared to 16% of people taking Wegovy^®. These results show that both medications are effective. It’s worth noting that the study was commissioned by Eli Lilly, the manufacturer of Zepbound^®.

How long does it take to see results?

Starting Wegovy^® or Zepbound^® is exciting, but you’re probably wondering when you’ll start noticing changes. Here’s a breakdown of what to expect in the short and long term, according to studies: 

Weight loss with both medications starts within the first few weeks. In clinical trials, here’s what the average person can expect in terms of the percentage of body weight lost. 

• At 3 months:
  • Zepbound^®: 8% 
  • Wegovy^®: 5%.
• At 6 months: 
  • Zepbound^®: 15% 
  • Wegovy^®: 10.5%.
• 1 year and beyond: 
  • Zepbound^®: 21%
  • Wegovy^®: 15%.

These results were at maximum approved doses: 15 mg of tirzepatide and 2.4 mg of semaglutide. 

Who can take Wegovy^® or Zepbound^® for weight loss?

Wegovy^® and Zepbound^®  are designed for people who meet certain health criteria. Here’s what you need to know.

• Both medications are regularly prescribed to people with a:
  • BMI of 30 or higher

or

• BMI of 27 or higher with at least one weight-related health condition, like high blood pressure or high cholesterol. 

• Wegovy^® is also approved to prevent heart disease.
• Zepbound^® is approved to treat obstructive sleep apnea (OSA). 

Who shouldn’t take Wegovy^® or Zepbound^®?

While Zepbound^® and Wegovy^® are generally considered safe, they aren’t for everyone. Your doctor won’t prescribe these medications if you have certain medical conditions or risk factors, including:

• A personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2).
• A past serious allergic reaction to tirzepatide (Zepbound^®), semaglutide (Wegovy®), or any of their ingredients.

Before starting Zepbound^® or Wegovy^®, inform your healthcare provider if you:

• Have or have had pancreatitis, kidney problems, or gallbladder disease, including gallstones.
• Have type 2 diabetes with a history of diabetic retinopathy.
• Have or have had depression, suicidal thoughts, or other mental health concerns.

People who are pregnant, trying to become pregnant, or breastfeeding should also not take Zepbound^® or Wegovy^®.

For more detailed safety information, visit the Wegovy^® safety page or the Zepbound^® safety page.

Can you switch between Wegovy^® and Zepbound^®?

Yes, switching between Wegovy^® and Zepbound^® is possible, but it’s important to consult your healthcare provider before making any changes. Your doctor can help determine whether switching is the right move based on your weight loss progress, side effects, and medical needs.

• Why switch? People switch for different reasons, including cost, insurance coverage, side effects, or the need for a more effective medication to continue losing weight. 
• What happens when you switch? Transitioning between medications can lead to changes in appetite suppression, side effects, and blood sugar regulation. 
• How to switch safely? The dosing schedules for Wegovy^® and Zepbound^® differ. Your doctor will decide which dose to start you on of the other medication, depending on which dose you’re currently taking and how you’ve responded. A close match will help minimize side effects and ensure your body adjusts properly. 

If you’re considering switching, talk to your doctor about the potential benefits, risks, and the best way to transition based on your individual health needs.

If you take Zepbound^® or Wegovy^® to lose weight, will you need to keep taking them forever?

Zepbound^® (tirzepatide) and Wegovy^® (semaglutide) are designed for long-term weight management. Clinical trials show that people can safely use these medications for over a year, with sustained weight loss observed over 68 weeks for semaglutide and 72 weeks for tirzepatide.

These medications help regulate appetite and slow digestion, making it easier to lose weight and keep it off. The thing is, they don’t permanently change how the body regulates weight, so for many, continued use is necessary to maintain results. Stopping treatment, especially without first making lifestyle adjustments you can maintain, can lead to weight regain.

What happens if you stop taking it?

• Regaining weight is common – Studies show that while over half of people maintain their weight loss after stopping GLP-1 medications like semaglutide, about 18% regain all or more of the weight they lost within a year.
• Tapering off may help – Slowly lowering your dose rather than stopping suddenly may make it easier to maintain results. The same study found that patients who tapered off semaglutide over nine weeks continued to lose an additional 2% of their body weight and maintained that loss for 26 weeks after stopping. More research is needed to confirm these results in larger groups.
• Your habits make a difference – Regular exercise, balanced eating, and structured programs like Noom can help you maintain weight loss even after stopping the medication. One study found that people who followed structured weight-loss programs kept off more than 3% of their original body weight, even five years after finishing the program. 
• Restarting may be an option – If weight regain becomes a concern, your doctor may recommend resuming the medication or exploring alternative treatments to help you stay on track. Some people cycle back onto Zepbound^® or Wegovy^® after stopping, especially if they struggle to maintain their results on lifestyle changes alone. In one large study of over 41,000 people, nearly 47% of those with type 2 diabetes and 36% without diabetes restarted GLP-1 therapy within a year of discontinuation. Even a 1% weight gain increased the odds of restarting treatment by nearly 3%
• Some people may need long-term treatment: For many, staying on Wegovy^® or Zepbound^® long-term helps prevent weight regain, just like how medications for high blood pressure or diabetes are used to manage chronic conditions. In some cases, personalized dosing strategies, such as adjusting the dose based on your response and tolerance, may help maintain results while minimizing side effects. Your doctor can help you decide whether to continue, taper off, or explore other options based on your health goals and progress.

These medications can be an effective part of a sustainable weight management plan, but they work best when combined with lasting lifestyle changes. If you’re thinking about stopping, talk to your doctor and consider joining Noom to help maintain your progress.

Wegovy^® vs. Zepbound^®: How much do they cost?

When considering weight loss medications like Zepbound^® and Wegovy^®, cost is an important factor. Both medications have high list prices, but discounts, insurance coverage, and manufacturer savings programs can help lower out-of-pocket expenses

Brand name	Cost (monthly)
Wegovy®	List price: $1,350  When purchased through the NovoCare® Pharmacy; $499  Learn more about the cost of Wegovy®.
Zepbound®	List price: $1,087 (pens) When purchased through Lily Direct as single-use vials: $349 (2.5 mg), $499 (5 mg, 7.5 mg,10 mg doses)  Learn more about the cost of Zepbound®.

Does insurance cover Wegovy^® or Zepbound^®?

Insurance coverage for Wegovy^® and Zepbound^® is rare. Some private insurance plans cover these medications for weight loss, but many have strict eligibility rules. Let’s take a look at a few cases:

• Employer-sponsored insurance: Some employers offer coverage, but it depends on the plan. If Wegovy^® or Zepbound^® isn’t covered, talk to HR or your benefits team to see if there are options.
• Private insurance: Coverage is rare. It’s always best to check with your insurance provider.

Insurance policies change all the time, so checking directly with your provider is the best way to know what’s covered.

To stay up to date on the latest costs and insurance coverage for these medications, check out this guide on Wegovy^® pricing and this breakdown of Zepbound^® costs.

Does Medicare cover Wegovy^® or Zepbound^®?

Right now, Medicare doesn’t cover weight loss medications, including Wegovy^® and Zepbound^®. There is the potential for these medications to be covered if they are treating another condition: 

• Wegovy^® might be covered to prevent heart disease. While it’s not included under Medicare Part D for weight loss, some plans may cover it if prescribed for cardiovascular benefits.
• Zepbound^® may be covered for obstructive sleep apnea (OSA). Medicare Part D doesn’t cover Zepbound^® for weight loss, but some plans may approve it when prescribed for OSA.

The Inflation Reduction Act could help bring prices down for some. Medicare will cap annual out-of-pocket drug costs at $2,000, which could make some medications more affordable.

If you’re on Medicare and hoping for coverage, check with your provider or explore Medicare Advantage plans, which sometimes offer different benefits.

Wegovy^® vs. Zepbound^®: Side effects and safety

If you’re considering Wegovy^® or Zepbound^®, you need to know about the potential side effects. Both medications can come with uncomfortable GI symptoms, like nausea, vomiting, diarrhea, and pain. They are also associated with more severe, though rare, effects that you should go through with your doctor.

Common side effects

Most people experience some mild to moderate side effects as their digestion changes. One thing you’ll probably notice is that side effects tend to be more noticeable when you first start taking the medication or when your doctor increases your dose. These might include:

• Nausea
• Vomiting
• Changes in bowel habits, like diarrhea or constipation
• Stomach aches
• Feeling tired
• Indigestion

Serious side effects and warnings

While Wegovy^® and Zepbound^® are generally considered safe for most people, they pose serious risks in certain cases. It’s important to monitor your body’s response and consult your healthcare provider about any concerns.  

Boxed Warning for Zepbound^® and Wegovy^®:

Both Wegovy^® and Zepbound^® carry an FDA-boxed warning regarding the potential risk of thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). This risk has been observed in animal studies, but its applicability to humans is unknown.

Seek immediate medical attention if you experience any of the following:

• Pancreatitis: Symptoms include severe abdominal pain that may radiate to the back, with or without vomiting.
• Vision changes: Any sudden changes in vision should be addressed immediately.
• Hypoglycemia (low blood sugar): Symptoms include dizziness, tremors, blurred vision, rapid heartbeat, and anxiety. Being aware of the potential for hypoglycemia is important for those also taking diabetes medications.
• Kidney problems: Dehydration from gastrointestinal side effects can exacerbate kidney function. Seek emergency care for decreased urination, swelling, fatigue, or shortness of breath.
• Gallbladder issues: Symptoms include upper abdominal pain, fever, jaundice, or changes in stool color.
• Allergic reactions: If you experience facial swelling, difficulty breathing or swallowing, and rapid heartbeat, seek immediate emergency care.

For a comprehensive review of potential risks, refer to the Wegovy^® safety information and Zepbound^® safety information.

Lesser-known side effects of Wegovy^® and Zepbound^®

While Wegovy^® and Zepbound^® have well-documented side effects, some less common effects have been reported. These may include:  

• Muscle loss (Sarcopenia): Rapid weight loss can lead to muscle loss, particularly without adequate protein intake and strength training. Be sure to increase your lean protein intake and follow a resistance training program while taking the medication to preserve muscle. 
• Hair thinning: Some people may experience temporary hair thinning or increased shedding, potentially related to rapid weight loss.
• Feeling cold: Some people report feeling colder than usual, likely due to changes in metabolism and reduced body fat.

These side effects don’t happen to everyone but are worth considering when starting treatment. Maintaining a balanced diet, staying active, and working with a healthcare provider can help manage potential side effects and boost the effectiveness of your medication.

Which is safer: Wegovy^® or Zepbound^®?

There’s no clear “winner” when it comes to safety. Both medications are considered safe when used as directed. Whether one is right for you depends on your health history and how your body responds. Some people tolerate Wegovy^® better, while others may have fewer side effects with Zepbound^®. The best way to know is to talk to your doctor about your medical history and goals.

Both medications can be effective for weight loss, but the safest approach is the one that fits your health needs. If you’re unsure which is right for you, working with a healthcare provider can help you make the best choice.

Wegovy^® vs. Zepbound^®: Dosage and Administration

Both Wegovy^® and Zepbound^® are administered via a once-weekly injection in the upper arm, stomach, or thigh on your choice of day. They both follow a step-up dosing schedule. With both, you will start on the lowest dose to minimize side effects. Your doctor will increase your dose as needed to reduce side effects and keep you losing steady weight. Here’s a look at the doses and how they are taken:

• Weogvy^®: Starts at 0.25 mg once weekly and is increased as needed and tolerated up to 2.4 mg per week. 
• Zepbound^®: Begins at 2.5 mg once weekly and is increased as needed and tolerated up to a maximum of 15 mg weekly.
  • Zepbound^® also comes in a vial and syringe format through LillyDirect^®. You’ll have to draw the medication into the syringe yourself, but the single-use vials don’t require any measuring. 

Your healthcare provider will determine the appropriate vial strength based on your individual needs and the prescribed dose.

Choosing between Wegovy^® or Zepbound^®: Which is right for me?

Deciding between Wegovy^® (semaglutide) and Zepbound^® (tirzepatide) depends on weight loss goals, insurance coverage, cost, and availability. Let’s go through everything we’ve talked about side by side.

Medication	Wegovy®  (semaglutide)	Zepbound®  (tirzepatide)
Pricing per month (without insurance)	$1,350 per month: 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, 2.4 mg. If you get Wegovy® through NovoCare Pharmacy, you will pay $499 per month.	$1,086 per month : 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg. If you get your medication in vial and syringe format through LilyDirect, you’ll pay $349 (2.5 mg) and $499 (5, 7, 10 mg).
Manufacturer	Novo Nordisk	Eli Lilly
Insurance coverage	Insurance coverage for weight loss is rare. It might be covered if prescribed for cardiovascular benefits.	Insurance coverage for weight loss is rare. Some plans may approve it when prescribed for obstructive sleep apnea (OSA).
Sister medication	Ozempic®: Contains the same active ingredient (semaglutide) as Wegovy® but is approved for type 2 diabetes and can be prescribed off-label for weight loss.  Rybelsus®: An oral form of semaglutide, also FDA-approved for type 2 diabetes and sometimes prescribed off-label for weight loss.	Mounjaro®: Contains the same active ingredient (tirzepatide) as Zepbound® but is FDA-approved for type 2 diabetes and often used off-label for weight loss.
Effectiveness	People lose an average of 15% of their body weight in about 16 months.	People lose an average of  21% of their weight after 18 months.

Alternatives to Wegovy^® and Zepbound^®

So, you’re looking into weight loss medications, but maybe Wegovy^® or Zepbound^® aren’t quite the right fit for you. Cost can be a big factor, or perhaps you’re interested in exploring different options. That’s perfectly fine! There are other medications out there that might be a better match for your needs. Let’s take a look:

Medication	Brand names and uses	Cost per month (without insurance)	Effectiveness	How it’s taken
Tirzepatide – GLP-1/GIP receptor agonist – Same active ingredient as Zepbound®	Mounjaro®: type 2 diabetes, off-label weight loss	Mounjaro®: $1,080 Learn more	People lost an average of 21% of body weight at 72 weeks.	Mounjaro®: Weekly injection
Semaglutide – GLP-1 receptor agonist – Same active ingredient as Wegovy®	Ozempic®: type 2 diabetes, off-label weight loss Rybelsus®: type 2 diabetes, off-label weight loss	Ozempic®: $998 Learn more Rybelsus®: $998 Learn more	Ozempic®: People lost an average of 15% of body weight in 68 weeks  Rybelsus®: People lost about 4% of their body weight	Ozempic®: Weekly injection Rybelsus®: Daily pill
Liraglutide – GLP-1 receptor agonist	Victoza®: type 2 diabetes, heart disease, off-label weight loss  Saxenda®: weight loss, heart disease Generic liraglutide: type 2 diabetes, heart disease, off-label weight loss	Victoza®: $800 to $1,400 Saxenda®: $1,349.02 Learn more Generic liraglutide: $470 – $700	People lost an average of 5-6% of body weight in one year.	Daily injection

Other weight loss medications

If GLP-1 medications aren’t an option for you, there are other medications that can help you lose weight in different ways.

Medication	Brand names	Cost per month (without insurance)	Effectiveness	How it’s taken
Metformin (off-label weight loss)	Glucophage®, Fortamet®, Glumetza®	Generic: $4–$15Brand name: $100–$500+ Learn more.	People lost an average of about 6% of their body weight over six months while taking metformin.	Pill taken up to two times daily
Phentermine	Lomaira®, Adipex-P®	$27-$100	About 80% of people with a BMI of 30 or more lost at least 5% of their body weight in 6 months.	Daily pill
Diethylpropion	Tenuate®, Tenuate Dospan®	$40-$85	People lost an average of 10% of their body weight in 6 months.	Pill taken one to three times daily
Naltrexone and bupropion	Contrave®	$600-$800 CurAccess™: $99 Learn more.	People lost an average of 7 to 8% of their body weight in a year.	Pill taken up to twice daily
Orlistat	Xenical®, Alli®	$50-$800	People in a study lost about 10% of their body weight after taking Orlistat for 1 year.	Pill taken three times daily with meals

Making the right choice: Wegovy^® vs. Zepbound^®

If you’re thinking about a prescription to help with weight loss, both Wegovy^® and Zepbound^® are strong options worth considering. They work in similar ways—helping you feel full longer and curb appetite—but they’re not identical. 

Zepbound^® may have a slight edge when it comes to clinical trial results, but Wegovy® is still highly effective for many people. The best choice really comes down to your personal goals, how your body responds, and which feels easier to stick with.

At the end of the day, there’s no one-size-fits-all answer. That’s why it’s so important to talk things through with your doctor or see if you qualify for Noom Med. Our clinicians can help you figure out which medication might be the better fit, prescribe it if needed, and guide you on pairing it with lifestyle habits. Whether you go with Wegovy^®, Zepbound^®, or something else entirely, long-term success comes from a combo of the right tools and sustainable changes you can stick with.

Note: Ozempic^®, Mounjaro^®, Rybelsus^®, Victoza^®, and metformin are not FDA-approved to treat obesity or for weight loss.