Side by side · Updated April 2026

Zepbound vs. Wegovy

Both are GLP-1 receptor agonists. Beyond that they differ in molecule, FDA indication, dose ceiling, and — most importantly to most people reading this — what the scale actually does over the long run.

Tirzepatide vs SemaglutideChronic weight management;… vs. Chronic weight management…

Tirzepatide

Zepbound

GIP + GLP-1 (dual agonist)

Made by: Eli Lilly
FDA approval: November 2023 (obesity); December 2024 (obstructive sleep apnea in obesity)
Indication: Chronic weight management; OSA in adults with obesity (added Dec 2024)
Dose ceiling: 15 mg weekly
Typical loss: ~20.9% mean body weight at 72 weeks in SURMOUNT-1 (15 mg arm) vs. 3.1% placebo; ~26.6% in SURMOUNT-3 (with intensive lifestyle); ~23% in SURMOUNT-5 head-to-head vs. semaglutide (vs. ~15%)
Cash list: $1,060 list; $499–$649 via LillyDirect self-pay vials (2024+)

Semaglutide

Wegovy

GLP-1

Made by: Novo Nordisk
FDA approval: June 2021 (obesity); March 2024 (cardiovascular risk reduction)
Indication: Chronic weight management in adults with BMI ≥30, or ≥27 with comorbidity; cardiovascular risk reduction
Dose ceiling: 2.4 mg weekly
Typical loss: ~14.9% mean body weight at 68 weeks in STEP-1 (vs 2.4% placebo); ~17% in adolescents (STEP TEENS)
Cash list: $1,350 list (often $0–$25 with commercial coverage)

The honest answer

Which one actually wins

Both are FDA-approved for obesity. Tirzepatide produced ~50% more mean weight loss than semaglutide in the first head-to-head trial (SURMOUNT-5, 2024). Coverage and tolerability are the practical tiebreakers — some people respond better to one molecule than the other, and you only learn which by trying.

Side by side

Zepbound vs Wegovy, ten metrics

MetricZepboundWegovy

Molecule

ZepboundTirzepatide

WegovySemaglutide

Receptor(s)

ZepboundGIP + GLP-1 (dual agonist)

WegovyGLP-1

Manufacturer

ZepboundEli Lilly

WegovyNovo Nordisk

FDA approval

ZepboundNovember 2023 (obesity); December 2024 (obstructive sleep apnea in obesity)

WegovyJune 2021 (obesity); March 2024 (cardiovascular risk reduction)

Indication

ZepboundChronic weight management; OSA in adults with obesity (added Dec 2024)

WegovyChronic weight management in adults with BMI ≥30, or ≥27 with comorbidity; cardiovascular risk reduction

Delivery

ZepboundSubcutaneous injection, once weekly

WegovySubcutaneous injection, once weekly

Dose ceiling

Zepbound15 mg weekly

Wegovy2.4 mg weekly

Titration

Zepbound4 weeks per step

Wegovy4 weeks per step (16 weeks to maintenance)

Typical loss

Zepbound~20.9% mean body weight at 72 weeks in SURMOUNT-1 (15 mg arm) vs. 3.1% placebo; ~26.6% in SURMOUNT-3 (with intensive lifestyle); ~23% in SURMOUNT-5 head-to-head vs. semaglutide (vs. ~15%)

Wegovy~14.9% mean body weight at 68 weeks in STEP-1 (vs 2.4% placebo); ~17% in adolescents (STEP TEENS)

Cash list

Zepbound$1,060 list; $499–$649 via LillyDirect self-pay vials (2024+)

Wegovy$1,350 list (often $0–$25 with commercial coverage)

On patent until

Zepbound2036 (US)

Wegovy2031 (US composition of matter)

Where to get it