Wegovy vs. Zepbound: Which Is Right for Me?
Which one’s better—Zepbound or Wegovy?
That’s the big question, and today, we’re breaking it all down. Which one should you take? What are the pros and cons? And there’s some interesting new info on both—changes in what they’re approved for, pricing updates, and more.
Before we get into it, a quick heads-up. I’m recording this on March 12, 2025, and things are changing fast with these medications. New indications, label updates—it’s a moving target. So if you’re listening to this months or years from now, double-check for the latest info.
Also, just to be fully transparent—I do have a financial interest in these medications, specifically Zepbound. I believed in it early on and invested in Eli Lilly before it launched. I also work as a speaker for Zepbound, which means I share information with doctors. But my goal here isn’t to push one over the other—it’s to lay out the facts so you can make the best decision for yourself.
Alright, let’s get into it—Zepbound vs. Wegovy, what you need to know, and which one might be the right fit for you.
Wegovy vs. Zepbound: A Guide to Choosing the Right Weight Loss Medication
When it comes to weight loss medications, two big names in the game are Wegovy (semaglutide) and Zepbound (tirzepatide). While both help curb appetite, they work in slightly different ways.
Wegovy is a GLP-1 receptor agonist, meaning it targets the GLP-1 hormone, which helps regulate appetite. It slows down digestion, helps people feel fuller for longer, and may even reduce cravings by acting on the brain. GLP-1 medications have been around for decades, making them a well-established option for weight loss.
Zepbound, on the other hand, works on both GLP-1 and another hormone receptor called GIP. While GIP alone was initially linked to weight gain, combining it with GLP-1 actually enhances appetite suppression and leads to greater weight loss. This dual-action approach makes Zepbound a newer option compared to traditional GLP-1 medications.
Both medications are weekly injections, making them more convenient than daily pills. They come in prefilled, single-use pens with hidden needles, so the process is pretty straightforward. Zepbound also offers a single-dose vial option, which can be a more budget-friendly choice while still being brand-name and regulated.
When deciding between the two, it really comes down to personal preference and comfort with newer treatments. Some might feel more at ease with the long-established track record of GLP-1 medications like Wegovy, while others may be interested in Zepbound’s dual-action approach. Either way, proper administration is key, and healthcare providers or online resources can help with that.
Right now, weight loss pills in this category aren’t available yet, though oral versions of semaglutide for diabetes exist and are being studied for obesity treatment. Until then, injections remain the go-to option for GLP-1 and GIP-based weight loss treatments.
At the end of the day, choosing between Wegovy and Zepbound depends on what works best for each person. Consulting a healthcare provider can help determine the right fit based on individual goals and medical history.
Approved Uses
Both medications are approved for people who are overweight and have a related health condition—like high blood pressure, high cholesterol, sleep apnea, or fatty liver disease—or for those with obesity.
Wegovy also has the added approval for lowering the risk of cardiovascular disease in people with a history of heart disease. Research shows it can cut the risk of heart attack, stroke, or other major events by 20%.
Zepbound, on the other hand, has an additional approval for treating obstructive sleep apnea in people with obesity. In clinical trials, about half of the participants saw their sleep apnea improve to the point where it was no longer a medical concern.
Another key difference is who can use them—Wegovy is approved for individuals 12 and older, while Zepbound is only approved for adults.
Which Leads to Greater Weight Loss?
For a lot of people considering weight loss medications, the big question is simple: Which one works best? Most want to know how much weight they can actually lose, especially when comparing options like Wegovy and Zepbound.
Recent research gives us some answers. Wegovy, at its highest approved dose of 2.4 mg, has been shown to help people lose around 15% of their body weight in clinical trials. There’s even some research on higher doses that could mean bigger results down the line.
Zepbound, though, seems to take things a step further when it comes to pure weight loss numbers. At its highest dose of 15 mg, studies show an average weight loss of 20% to 25%. Even at its lowest dose (5 mg), Zepbound delivers roughly the same weight loss—15%—as the highest dose of Wegovy.
Of course, results vary from person to person, but based on the data, Zepbound appears to be the stronger option for weight loss. If hitting a 20% or greater reduction is the goal, it might be the better choice. But weight loss isn’t the only factor to consider—side effects, availability, and personal health needs all play a role. That’s why it’s always best to talk things over with a healthcare provider before making a decision.
Side Effects of Wegovy and Zepbound: What to Consider
When choosing a weight loss medication, it’s not just about how well it works—side effects matter too. Both Wegovy and Zepbound come with potential risks, so understanding them can help people make the best decision for their health.
One big concern is the boxed warning about thyroid cancer risk. This comes from animal studies where rats showed a higher risk of thyroid cancer after taking these medications. But here’s the thing—this hasn’t been proven in humans. Experts believe the risk is more theoretical because rat and human thyroids don’t work the same way. Still, these medications aren’t recommended for anyone with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia type 2. For most people without those conditions, there’s no clear evidence that these meds increase thyroid cancer risk.
Aside from that, Wegovy and Zepbound should only be used for medically necessary weight loss. They’re designed for people with obesity or those who are significantly overweight and dealing with health issues like sleep apnea or heart disease. They’re not meant for someone just trying to drop a few pounds.
Key Differences in Side Effects
While Wegovy and Zepbound share some side effects, there are notable differences. One unique concern with Zepbound is its interaction with oral contraceptives. Because it slows down gastric emptying, it may reduce the effectiveness of birth control pills. Patients relying on pills for contraception should consider a backup method or switch to options like IUDs, patches, or implants. Once a patient has been on a stable Zepbound dose for over four weeks, this issue may lessen, but changes in dosage can still affect absorption. Since pregnancy is not recommended while taking these medications, using additional protection is advised.
The most common side effect for both medications is nausea. Clinical trials showed nausea rates of 44% for Wegovy and 25-30% for Zepbound, though differences in study design may have influenced these numbers. In practice, nausea occurs with both, but many patients report it improving over time. Doctors can also prescribe medication to help manage it.
Another frequent issue is constipation, which appears to be more common with Wegovy (23%) than Zepbound (15%). For some patients, constipation becomes severe enough to stop treatment. Increasing water intake, fiber, and using stool softeners or laxatives can help, but in some cases, switching medications may be necessary.
On the flip side, some patients experience diarrhea instead of constipation. While rare with Wegovy, it has been more problematic for some on Zepbound. If diarrhea is persistent, switching to Wegovy may be a better option.
The Role of Cost and Insurance Coverage
For many, the choice between Wegovy and Zepbound often comes down to practical factors like insurance coverage and cost. Clinical trials suggest Zepbound leads to greater weight loss on average, but affordability remains a major concern.
If a medication is covered by insurance, patients usually go with the option that has the lowest out-of-pocket cost, which can be as low as $25 to $60 per month. Without coverage, however, both medications can be expensive—typically around $500 per month.
Recently, both manufacturers have introduced cash-pay options to make the medications more accessible. Zepbound now offers a $499 per month vial option, which requires self-injection with a needle. This price is available to everyone, including those without insurance or those on Medicare, Medicaid, or health-sharing plans. Similarly, Wegovy has launched a $500 per month cash-pay option for its prefilled pen injectors. With these competitive pricing strategies, there’s hope that costs may continue to decrease as more weight-loss medications enter the market.
Exploring Other Options
Even with new pricing models, these medications remain expensive. For those looking for more affordable alternatives, older weight-loss treatments that have been used successfully for years may still be a viable option. Consulting with a healthcare provider can help determine the best approach based on health needs, budget, and insurance coverage.
Ultimately, the right medication varies from person to person. While effectiveness matters, it’s just as important to consider additional health benefits, cost, and accessibility when making a decision.
To get the full breakdown of Wegovy vs. Zepbound and what might work best for you, be sure to listen to the full episode. We dive deeper into the pros and cons, real-world experiences, and what to consider beyond just weight loss numbers. Choosing the right medication isn’t just about the stats—it’s about finding the best fit for your health, lifestyle, and long-term goals. Tune in now to get all the details and make the most informed decision!
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