GLP-1 Medication Comparison
Comparing semaglutide to tirzepatide head-to-head is tempting, but the SURMOUNT and STEP trials used different populations, different endpoints, and different dosing schedules. What we can say: Zepbound leads on weight loss, Ozempic has the widest payer coverage, and Rybelsus is the only one you swallow. Below is what the data actually supports, medication by medication.
Which GLP-1 produces the most weight loss, and does that make it the best choice?
On raw numbers, Zepbound (tirzepatide) leads at 18-22.5% body weight loss, then Mounjaro (15-21%), Wegovy (15-17%), and Ozempic (10-15%). But the best choice is whichever one your insurance actually covers and your body tolerates. A medication that produces 22% weight loss in a trial does not help you if your plan denies it and you cannot afford $1,200/month out of pocket.
Zepbound and Wegovy carry FDA weight-loss approvals, which matters for insurance. Ozempic and Mounjaro are diabetes drugs used off-label for weight loss — and insurers know the difference. If you have type 2 diabetes, Ozempic or Mounjaro will be easier to get covered. If weight loss is the primary goal, start with Wegovy or Zepbound and check your formulary before your doctor writes the script.
Full Comparison
All GLP-1 Medications Side by Side
| Medication | Weight Loss | Frequency | Cost (No Insurance) | FDA Approved For | Availability | Details |
|---|---|---|---|---|---|---|
| OzempicsemaglutideNovo Nordisk | 10-15% body weight | Once weeklyInjection | $900-$1,200/monthWith insurance: $25-$150/month | type 2 diabetescardiovascular | Limited Supply | View Details |
| WegovysemaglutideNovo Nordisk | 15-17% body weight | Once weeklyInjection | $1,300-$1,500/monthWith insurance: $25-$200/month | weight losscardiovascular | Limited Supply | View Details |
| MounjarotirzepatideEli Lilly | 15-21% body weight | Once weeklyInjection | $1,000-$1,200/monthWith insurance: $25-$150/month | type 2 diabetes | Available | View Details |
| ZepboundtirzepatideEli Lilly | 18-22.5% body weight | Once weeklyInjection | $1,000-$1,200/monthWith insurance: $25-$200/month | weight loss | Available | View Details |
| Rybelsussemaglutide (oral)Novo Nordisk | 5-8% body weight | Once dailyOral pill | $900-$1,100/monthWith insurance: $25-$100/month | type 2 diabetes | Available | View Details |
| SaxendaliraglutideNovo Nordisk | 5-10% body weight | Once dailyInjection | $1,300-$1,500/monthWith insurance: $25-$150/month | weight loss | Available | View Details |
| TrulicitydulaglutideEli Lilly | 3-5% body weight | Once weeklyInjection | $900-$1,100/monthWith insurance: $25-$100/month | type 2 diabetescardiovascular | Available | View Details |
| VictozaliraglutideNovo Nordisk | 3-5% body weight | Once dailyInjection | $900-$1,200/monthWith insurance: $25-$100/month | type 2 diabetescardiovascular | Available | View Details |
| Compounded Semaglutidesemaglutide (compounded)Various Compounding Pharmacies | 10-15% body weight (estimated) | Once weeklyInjection | $150-$500/monthWith insurance: Not covered | Not FDA-approved | Available | View Details |
Head-to-Head
Key Matchups
These are the comparisons patients ask about most. The short version: same-molecule pairs (Ozempic/Wegovy, Mounjaro/Zepbound) differ by FDA label and insurance path, not pharmacology.
Ozempic vs Wegovy
Same molecule (semaglutide), different labels. Ozempic is for diabetes; Wegovy is for weight loss at a higher dose.
Mounjaro vs Zepbound
Same molecule (tirzepatide), different labels. Mounjaro treats diabetes; Zepbound treats obesity. Both hit GIP and GLP-1 receptors.
Ozempic vs Mounjaro
Semaglutide vs tirzepatide. Mounjaro delivers more weight loss, but insurance coverage differs.
Wegovy vs Zepbound
Both FDA-approved for weight loss. Zepbound edges ahead on weight loss in head-to-head trial data.
By Category
Which GLP-1 is Best For...
Maximum Weight Loss
Zepbound (18-22.5%) and Mounjaro (15-21%) show the highest weight loss in clinical trials. Both use tirzepatide, a dual GIP/GLP-1 agonist.
Best Insurance Coverage
Trulicity and Victoza sail through prior auth most often (10-15% denial rate) because they have been on formularies for years. For a weight-loss-approved GLP-1, Wegovy has the broadest commercial coverage, but expect a prior auth fight — denial rates for obesity indications run 25-40% on first pass.
Lowest Cost (Cash Pay)
Compounded semaglutide ($150-$500/month) is the cheapest option, full stop. It is also not FDA-approved, and the FDA has issued multiple warnings about potency and sterility at compounding pharmacies. Among brand-name drugs, Trulicity and Victoza have the lowest list prices at $900-$1,100/month — but with manufacturer savings cards, Mounjaro and Zepbound can drop to $25/month for commercially insured patients.
No Injections (Oral Option)
Rybelsus is the only GLP-1 you swallow instead of inject. Weight loss is lower (5-8%), but for people who will not do weekly shots, it is the only option in this class.
GLP-1 Medication Denied by Insurance?
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Comparison FAQs
What is the difference between Ozempic and Wegovy?
Ozempic and Wegovy are the same molecule — semaglutide — but with different FDA approvals. Ozempic tops out at 2 mg and is approved for type 2 diabetes. Wegovy goes up to 2.4 mg and is approved for weight loss. That higher dose means Wegovy typically produces more weight loss. The big difference is insurance: most plans cover Ozempic for diabetes, but Wegovy coverage for weight loss varies widely by plan.
Is Mounjaro or Ozempic better for weight loss?
Mounjaro wins on the numbers. In clinical trials, tirzepatide (Mounjaro) produced 15-21% body weight loss versus 10-15% for semaglutide (Ozempic). Mounjaro hits two receptors — GIP and GLP-1 — while Ozempic targets only GLP-1. The catch: Mounjaro is only FDA-approved for diabetes, not weight loss. If you want an FDA-approved weight loss drug, look at Wegovy or Zepbound.
Which GLP-1 has the fewest side effects?
No GLP-1 avoids GI side effects entirely — nausea, vomiting, and diarrhea are common across the class. That said, Rybelsus (oral semaglutide) and Trulicity (dulaglutide) tend to be slightly easier on the stomach at their standard doses. The single best way to reduce side effects with any GLP-1: start at the lowest dose and increase slowly.
Which GLP-1 is cheapest without insurance?
Compounded semaglutide is the cheapest option at $150-$500/month, but it is not FDA-approved and carries safety risks. Among brand-name drugs, Trulicity and Victoza have the lowest list prices at $900-$1,100/month. If you qualify for manufacturer coupons, Mounjaro and Trulicity can drop to $25/month.
Disclaimer
This comparison is for informational purposes only and is not medical advice. Your results will depend on your health conditions, insurance coverage, and how you tolerate side effects. Talk to your doctor before starting or switching any medication.