Weight Loss Medications · Tool Face-Off

Wegovy vs Zepbound

Quick answer

Both are weekly injectables that crush appetite, but Zepbound's dual-action mechanism edges out Wegovy on average weight loss. Wegovy has more long-term cardiovascular data. Your doctor and insurance will likely make the final call.

Our pick

Wegovy

The OG celebrity shot — proven, trusted, heart-friendly

3.9★

Zepbound

The new dual-threat — hits two hunger hormones for less

3.9★

Drug Class

GLP-1 receptor agonist (semaglutide)

GIP + GLP-1 dual agonist (tirzepatide)

Avg. Weight Loss (trial peak)

~15% body weight (STEP trials)

~20-22% body weight (SURMOUNT trials)

Injection Frequency

Once weekly

Starting Dose

0.25 mg/week

2.5 mg/week

Max Dose

2.4 mg/week

15 mg/week

List Price (without insurance)

~$1,350/month

~$1,060/month

Manufacturer Savings Card (eligible patients)

As low as $0/month (Novo Nordisk program)

As low as $25/month (Lilly program)

FDA Approval for Obesity

Yes (2021)

Yes (2023)

Proven CV Risk Reduction

Yes — SELECT trial (26% reduction in major events)

CV outcome trial ongoing (SURMOUNT-MMO)

Common Side Effects

Nausea, vomiting, diarrhea, constipation

Supply Availability

Improved; periodic shortages still possible

Generally available; newer so fewer shortage reports

Years of Obesity-Specific Data

~3+ years post-approval

~1-2 years post-approval

Wegovy

Cost Accessibility★★★☆☆

Dosing Flexibility★★★½☆

Insurance Coverage★★★½☆

Weight Loss Efficacy★★★★☆

Side Effect Tolerance★★★½☆

Cardiovascular Benefits★★★★★

Clinical Evidence Depth★★★★½

Zepbound

Cost Accessibility★★★½☆

Dosing Flexibility★★★★☆

Insurance Coverage★★★☆☆

Weight Loss Efficacy★★★★★

Side Effect Tolerance★★★½☆

Cardiovascular Benefits★★★★☆

Clinical Evidence Depth★★★★☆

Worth knowing

Zepbound's SURMOUNT-1 trial showed ~22% average weight loss at max dose — some participants lost over 50 lbs.
Wegovy is the only obesity drug with an FDA-approved label claim for reducing heart attacks and strokes.
Neither drug is recommended if you have a personal or family history of medullary thyroid carcinoma.
Both drugs require a slow dose escalation over 16-20 weeks to minimize GI side effects.
Medicare Part D began covering Wegovy for cardiovascular risk reduction in 2024 — a historic shift for obesity drug coverage.

Tirzepatide (Zepbound) was originally approved as the diabetes drug Mounjaro — so it essentially crashed a different party and became the hottest guest.

If you want

You have existing heart disease or high cardiovascular risk

Wegovy is the only one with proven, FDA-labeled cardiovascular event reduction from the SELECT trial.

→ Pick Wegovy

If you want

You want maximum average weight loss potential

Zepbound's dual GIP+GLP-1 mechanism consistently produces ~5-7% more body weight loss in head-to-head data.

→ Pick Zepbound

If you want

You're paying out of pocket and need the lower sticker price

Zepbound lists roughly $300/month cheaper and Lilly's savings card floor is lower for eligible patients.

→ Pick Zepbound