With multiple GLP-1 medications now available for weight loss, choosing the right one can be overwhelming. This guide compares all the major options—including tirzepatide and semaglutide—to help you understand which might work best for your weight loss goals.
The Short Answer
Tirzepatide (Mounjaro/Zepbound) produces the most weight loss in clinical trials—up to 25% of body weight. However, semaglutide (Wegovy/Ozempic) is also highly effective at 15-17% and may be more affordable. The "best" choice depends on your goals, budget, and how your body responds.
GLP-1 Medications Ranked by Weight Loss
| Rank | Medication | Active Ingredient | Avg Weight Loss | Mechanism |
|---|---|---|---|---|
| #1 | Zepbound/Mounjaro | Tirzepatide | 20-25% | GLP-1 + GIP dual agonist |
| #2 | Wegovy | Semaglutide 2.4mg | 15-17% | GLP-1 agonist |
| #3 | Ozempic | Semaglutide 1-2mg | 10-14% | GLP-1 agonist |
| #4 | Saxenda | Liraglutide | 5-10% | GLP-1 agonist |
| #5 | Rybelsus | Semaglutide (oral) | 5-8% | GLP-1 agonist |
#1: Tirzepatide (Zepbound/Mounjaro) — Most Effective
Pros
- Highest weight loss in clinical trials (20-25%)
- Dual mechanism (GLP-1 + GIP) for enhanced effect
- Excellent blood sugar control
- Once-weekly injection
- May have slightly fewer GI side effects than semaglutide
Cons
- • More expensive than semaglutide
- • Brand-name often in shortage
- • Newer medication (less long-term data)
- • Not yet approved for cardiovascular benefits
Clinical Trial Results (SURMOUNT-1)
At the highest dose (15 mg), participants lost an average of 22.5% of body weight over 72 weeks. About 1 in 3 participants lost more than 25% of their body weight—results approaching what was previously only achievable with surgery.
#2: Semaglutide (Wegovy) — Best Established Option
Pros
- Proven weight loss of 15-17%
- More long-term safety data available
- Proven cardiovascular benefits
- Generally more affordable (especially compounded)
- Once-weekly injection
Cons
- • Less weight loss than tirzepatide
- • GI side effects common (nausea, vomiting)
- • Brand-name versions often in shortage
- • May cause more nausea than tirzepatide
Clinical Trial Results (STEP 1)
Wegovy (2.4 mg) produced an average weight loss of 14.9% of body weight over 68 weeks. About 1 in 3 participants lost 20% or more of their body weight.
Head-to-Head: Tirzepatide vs Semaglutide
| Factor | Tirzepatide | Semaglutide | Winner |
|---|---|---|---|
| Weight Loss | 20-25% | 15-17% | Tirzepatide |
| GI Side Effects | Moderate | Moderate-High | Tirzepatide |
| Cost (Compounded) | $199-$449/mo | $99-$299/mo | Semaglutide |
| Long-term Data | Limited (newer) | More extensive | Semaglutide |
| CV Benefits Proven | Studies ongoing | Yes (SELECT trial) | Semaglutide |
| A1C Reduction | ~2.4% | ~1.8% | Tirzepatide |
Which GLP-1 Should You Choose?
- You want maximum weight loss potential
- You have significant weight to lose (50+ lbs)
- You have type 2 diabetes and want superior blood sugar control
- You've tried semaglutide and plateaued
- Budget isn't your primary concern
- You want proven, effective weight loss at a lower cost
- You have cardiovascular concerns (proven heart benefits)
- You're new to GLP-1 medications and want to start affordable
- You prefer a medication with more long-term safety data
- Budget is a significant factor
Where to Get GLP-1 Medications
Both tirzepatide and semaglutide are available through telehealth providers as compounded medications at a fraction of brand-name prices. Here are our top-rated providers:
| Provider | Semaglutide | Tirzepatide | Our Rating |
|---|---|---|---|
| CoreAge Rx | $99-$299/mo | $199-$449/mo | |
| Medvi | $149-$349/mo | $249-$549/mo | |
| Henry Meds | $249-$449/mo | $399-$699/mo |
We recommend CoreAge Rx for the best combination of quality and affordability. They source from FDA-registered 503B pharmacies and offer both semaglutide and tirzepatide at competitive prices.
Other GLP-1 Options
Saxenda (Liraglutide)
An older GLP-1 that requires daily injections rather than weekly. Produces 5-10% weight loss on average. Generally not recommended unless you can't tolerate semaglutide or tirzepatide, as the newer options are more effective and more convenient.
Daily injection requiredRybelsus (Oral Semaglutide)
A pill form of semaglutide approved for diabetes. Less effective for weight loss (5-8%) due to lower absorption compared to injections. May be an option if you absolutely cannot do injections, but results will be more modest.
Oral tablet (less effective)Frequently Asked Questions
Can I switch from semaglutide to tirzepatide?
Yes, many people switch to tirzepatide after plateauing on semaglutide. Your provider will help determine the equivalent starting dose. Most people see renewed weight loss after switching.
Which has fewer side effects?
Clinical trials suggest tirzepatide may cause slightly less nausea than semaglutide, possibly due to the GIP component. However, both medications cause GI side effects in most people, especially during dose titration. Side effects typically improve over time.
Is compounded GLP-1 as effective as brand-name?
When sourced from a reputable 503B pharmacy, compounded semaglutide and tirzepatide contain the same active ingredients and should produce the same results. Many patients report identical effects after switching from brand-name to compounded.
How long do I need to take GLP-1 medications?
GLP-1 medications are typically taken long-term for weight maintenance. Studies show that most people regain weight after stopping. Some people successfully maintain weight loss with lifestyle changes, while others stay on a maintenance dose indefinitely.
Learn More
For detailed dosing information, see our dosage guides:
Ready to start? Browse our complete provider reviews to find the best telehealth program for your needs.
The Bottom Line
For maximum weight loss, tirzepatide is the most effective GLP-1 medication available, producing up to 25% weight loss in clinical trials. However, semaglutide remains an excellent choice—especially for those on a budget—with proven 15-17% weight loss and established cardiovascular benefits. Both are available affordably through telehealth providers like CoreAge Rx. The best medication is the one you can afford and tolerate long-term.