Both FDA-Approved for Weight Loss
Zepbound (tirzepatide) and Wegovy (semaglutide) are the only two GLP-1-based medications with specific FDA approval for chronic weight management. This sets them apart from Ozempic and Mounjaro, which are approved for diabetes but widely used off-label for weight loss. Having FDA approval for weight loss means these drugs went through rigorous clinical trials specifically measuring their effectiveness for weight management.
How They Work Differently
Wegovy targets one receptor: GLP-1. Zepbound targets two: GLP-1 and GIP. This dual-agonist approach gives Zepbound a broader metabolic effect. For a deeper explanation, see our article on how GLP-1 medications work and our tirzepatide vs semaglutide comparison.
Clinical Trial Results
Wegovy (STEP trials): ~15% average weight loss over 68 weeks. Zepbound (SURMOUNT trials): up to 22.5% average weight loss over 72 weeks. While these come from different trials and direct comparison requires caution, the trend is consistent — tirzepatide-based medications produce greater average weight loss in clinical research.
Cost and Insurance
Both are expensive at retail — Wegovy at $1,300–$1,400/month and Zepbound at $1,000–$1,100/month. Insurance coverage is limited for both. Compounded alternatives through telehealth providers offer significant savings: compounded semaglutide from ~$200/month and compounded tirzepatide from ~$350/month. See our cost guide for details. Compare affordable options.
What To Know Before Starting GLP-1 Treatment
Before starting GLP-1 treatment, it's important to understand a few key things. These medications require a prescription from a licensed clinician and aren't suitable for everyone. Some people may experience side effects, especially during the first few weeks as the body adjusts.
GLP-1s also tend to work best when combined with basic lifestyle habits like balanced nutrition and regular physical activity.
That's why choosing a provider that offers proper medical screening and ongoing follow-up support is essential for both safety and long-term success.
Which Is Right for You?
If you want the maximum weight loss potential and can access it, Zepbound has a clinical edge. If you prefer a longer track record, broader compounded availability, and slightly lower compounded pricing, Wegovy/semaglutide is the more established path. Many telehealth providers offer both — take our quiz to find the best match, or compare providers directly.
Dosing Schedule Compared
Wegovy titrates from 0.25 mg to 2.4 mg over about 16 weeks. Zepbound starts at 2.5 mg and can go up to 15 mg. Both are once-weekly injections. Zepbound's wider dose range gives providers more room to optimize treatment. For details on what starting either medication feels like, see our first month guide.
Compounded Alternatives
Both Wegovy (semaglutide) and Zepbound (tirzepatide) have compounded versions available through telehealth providers at significantly lower prices. Compounded semaglutide starts at ~$199/month, compounded tirzepatide at ~$349/month. Read our compounded vs brand-name guide for details on quality and safety.
How to Access Either Medication Online
Both are available through licensed telehealth providers without in-person visits. Compare semaglutide providers or tirzepatide providers. For a step-by-step walkthrough, see our guide to getting GLP-1 medications online.