Zepbound vs. Wegovy for Weight Loss: 6 Differences to Consider
Key takeaways:
Zepbound (tirzepatide) and Wegovy (semaglutide) are two once-weekly injectable medications for weight loss. Wegovy is approved for certain adults and adolescents ages 12 and older. Zepbound is approved only for adults. Both medications work in similar but slightly different ways.
Zepbound may result in greater weight loss compared with Wegovy. It has also proven benefits for people with obstructive sleep apnea. If you need more help managing your weight, it’s possible to switch from Wegovy to Zepbound. But Wegovy may be a good option if you have heart disease.
There are ways to save on Zepbound and Wegovy, which are available as brand-name medications. If you’re eligible, manufacturer copay cards can help make your prescription more affordable.
Table of contents
When the FDA approved Wegovy (semaglutide) in 2021, it was the first new weight-loss medication since 2014. It was also the first once-weekly medication of its kind. Today a newer medication called Zepbound (tirzepatide) is also on the market.
Zepbound and Wegovy share a few similarities. Both are injected once a week and can cause similar side effects. But there are some key differences between them that may make one a better fit over the other.
1. Zepbound and Wegovy work in similar but slightly different ways for weight loss
For many people, Zepbound and Wegovy are effective medications for weight management. Both work on your appetite, hunger, and food cravings so you eat fewer calories. They achieve this effect in similar but slightly different ways.
Wegovy belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists. It acts like a natural gut hormone called GLP-1, which has effects on your gut and the appetite center of your brain. This results in decreased appetite, increased feelings of fullness, and reduced cravings.
Similar to Wegovy, Zepbound has these effects by acting like GLP-1. But it also acts like a second gut hormone called glucose-dependent insulinotropic polypeptide (GIP). Because of this, Zepbound is considered a dual GIP/GLP-1 receptor agonist. GIP is thought to work together with GLP-1 in some ways for additive effects.
Good to know: Tirzepatide and semaglutide, the active ingredients in Zepbound and Wegovy, also have beneficial effects on blood glucose (sugar) levels. They do this by telling the pancreas to release insulin and lowering glucose production in the liver. For this reason, they’re used to treat Type 2 diabetes under the brand names Mounjaro (tirzepatide), Ozempic (semaglutide), and Rybelsus (semaglutide).
2. Zepbound and Wegovy have different dosage schedules
When starting Zepbound or Wegovy, your dosage is slowly raised on 4-week intervals to help manage side effects and find the right dose. But each medication’s dosage schedule looks a bit different. For example, it may take longer to reach your target Wegovy dose compared with Zepbound.
For Wegovy, the once-weekly starting dosage is 0.25 mg for 4 weeks. After that, the dosage is increased on 4-week intervals to 0.5 mg, 1 mg, and 1.7 mg. If it’s tolerated, the dosage is increased to 2.4 mg weekly (the highest dosage). The recommended maintenance dosage is 1.7 mg or 2.4 mg weekly.
GLP-1 side effects: Concerned about nausea after starting a medication like Zepbound or Wegovy? Here’s what you should know about GLP-1 side effects.
Savings guide: Glucagon-like peptide-1 (GLP-1) medications don’t have to break the bank. Explore this savings guide for information on how to save on GLP-1s.
Paying for Zepbound: Zepbound can cost over $1,000 per month, but there are ways to save with or without insurance.
For Zepbound, the once-weekly starting dosage is 2.5 mg for 4 weeks. After that, the dosage is increased to 5 mg once weekly. Some people may continue the 5 mg dose long term. If needed, the dosage may be increased on 4-week intervals to 10 mg or 15 mg weekly.
3. Zepbound may result in greater weight loss compared with Wegovy
Zepbound and Wegovy have been studied in a head-to-head clinical trial to see how they compare for weight loss in people without diabetes. Topline results currently show greater weight loss with Zepbound compared with Wegovy (20% versus 14%) at 72 weeks (16.5 months).
Individual clinical trials also suggest that Zepbound may result in greater weight loss than Wegovy.
Zepbound trial: People receiving the highest Zepbound dose (15 mg) lost nearly 21% of their starting body weight on average after 72 weeks.
Wegovy trial: People receiving the highest Wegovy dose (2.4 mg) lost nearly 15% of their starting body weight on average after 68 weeks (15.5 months).
However, Wegovy’s manufacturer has been studying a 7.2 mg dose, which is 3 times higher than the current highest available dose. Study results indicate that after 72 weeks, this higher dose led to an average weight loss of nearly 21%.
4. Wegovy may be a better option if you have heart disease, while Zepbound can be a good choice for sleep apnea
Both Zepbound and Wegovy are approved for weight loss. But Wegovy is also approved for its cardiovascular benefits in certain people with heart disease. And in late 2024, the FDA approved Zepbound for moderate-to-severe obstructive sleep apnea (OSA). Because of this, your health history may make one medication a better fit over the other.
If you have heart disease and a larger body size, your prescriber may recommend Wegovy. Studies show that it can help lower the risk of serious cardiovascular problems in this group. Zepbound is also being studied for cardiovascular benefits, but it isn’t approved for this use yet.
If you have moderate-to-severe OSA, your prescriber may recommend Zepbound. Studies have shown that Zepbound can help lessen OSA severity. And some people’s symptoms improved so much that their OSA was considered “resolved.”
5. Wegovy is approved for use in adolescents, while Zepbound is approved only for adults
Wegovy is one of two medications of its kind approved for adults and adolescents age 12 and older. The other option is Saxenda (liraglutide). Zepbound is being studied for adolescents but is approved only for adults.
Adolescents who are considered obese may be eligible for Wegovy. This typically means that they have a body mass index at or above the 95th percentile for their sex and age.
6. Wegovy and Zepbound may have benefits for other health conditions
Wegovy and Zepbound are being studied for additional uses beyond weight loss and cardiovascular risk reduction. And the results have been promising, so these medications may be approved for other health conditions in the near future.
Wegovy has shown positive results for certain people with heart failure. And a recent analysis found potential kidney-related benefits for people with heart disease. Wegovy is also being studied for metabolic dysfunction-associated steatohepatitis, or MASH (also known as non-alcoholic steatohepatitis). This is a health condition caused by excess fat buildup in the liver.
Zepbound is also being studied in certain people with heart failure, MASH, and chronic kidney disease. And a recent study looking at people with prediabetes showed that it lowered the risk of progression to Type 2 diabetes by 94%.
Wegovy or Zepbound? Test your knowledge!
Can you switch from Wegovy to Zepbound?
Yes. If you need more help managing your body weight, it’s possible to switch from Wegovy to Zepbound. In this case, your prescriber may have you start with a lower Zepbound dose and slowly work your way up. This gives your body time to adjust to Zepbound and find the right dose for you.
Can you take Zepbound and Wegovy together?
No, it’s not recommended to take both Zepbound and Wegovy. You’ll typically be prescribed one or the other — but not both at the same time. Since Zepbound and Wegovy work in similar ways, this combination could increase the risk of side effects.
If your prescribed dose isn’t working well enough for you, talk to your healthcare team. In some cases, they may be able to raise it or switch you to a different medication.
How to save on Zepbound and Wegovy
The best way to save on Zepbound or Wegovy is to use your health insurance. Which medication is more affordable can depend on your specific plan and health history. For example, your plan may cover Wegovy if you have heart disease. In other cases, Zepbound may be preferred.
But if you don’t have coverage, or if your cost is still high, there are ways to save on Zepbound and Wegovy.
Manufacturer copay card with coverage: You could pay as little as $25 for Zepbound if you have a commercial insurance plan that covers the medication. If you’re eligible for Wegovy’s copay card, you could pay as little as $0 for your prescription.
Manufacturer copay card without coverage: If your plan doesn’t cover Zepbound, you may be able to pay $650 for a 30-day supply. If your plan doesn’t cover Wegovy or you’re uninsured, you could pay $650 for a 28-day supply.
Lower-cost vials: Lower-cost single-dose Zepbound vials are available through LillyDirect for $349 (2.5 mg) and $499 (5 mg, 7.5 mg, and 10 mg) per month.
Discounts through NovoCare Pharmacy: If your commercial insurance plan doesn’t cover Wegovy, or if you’re uninsured, you could pay as little as $499 per month for Wegovy through NovoCare Pharmacy.
Frequently asked questions
No, Zepbound and Wegovy work in a similar way, but they contain different ingredients. Zepbound contains tirzepatide, while Wegovy contains semaglutide.
The bottom line
Zepbound (tirzepatide) and Wegovy (semaglutide) are injectable medications for weight loss. Both work on your appetite, hunger, and food cravings. They achieve this effect in similar but slightly different ways.
Wegovy is approved for adults and adolescents age 12 and older, while Zepbound is approved only for adults. Zepbound may result in greater weight loss and has proven benefits for people with obstructive sleep apnea. But Wegovy has proven cardiovascular disease benefits in certain people with heart disease.
Your prescriber may consider your health history, age, and other factors when deciding whether Zepbound or Wegovy is the better option for you.
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References
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