Weight Loss Medications Compared: Ozempic, Wegovy, Mounjaro & More

Medically reviewed | Published: | Evidence level: 1A
Complete comparison of semaglutide (Ozempic/Wegovy), tirzepatide (Mounjaro/Zepbound), and liraglutide (Saxenda) for weight management in 2026.
📅 Published:
Reviewed by iMedic Medical Editorial Team
📄 Treatment

Quick Facts

Wegovy
~15%
Zepbound
20-22%
Saxenda
~8%
Ozempic (off-label)
10-14%
Nausea Rate
40-50%
Monthly Cost
$900-1,350

What Is the Difference Between These Medications?

Quick answer: Ozempic/Mounjaro are for diabetes. Wegovy/Zepbound are higher-dose counterparts for weight management.

Semaglutide

  • Ozempic: 0.25-2.0 mg weekly. For T2D. Off-label for weight.
  • Wegovy: 2.4 mg weekly. For weight management.
  • Rybelsus: Oral 3-14 mg daily. For T2D. Modest weight loss (~4-5%).

Tirzepatide

  • Mounjaro: 2.5-15 mg weekly. Dual GIP/GLP-1. For T2D.
  • Zepbound: Same drug. For weight management.
Key point:

Ozempic and Mounjaro are diabetes drugs. Wegovy and Zepbound are the same ingredients approved for obesity.

Efficacy Comparison

Quick answer: Tirzepatide (Zepbound) produces 20-22% loss vs semaglutide (Wegovy) ~15%. Saxenda ~8%.

Weight Loss

  • Zepbound 15 mg: 20-22% at 72 weeks (SURMOUNT-1)
  • Wegovy 2.4 mg: ~15% at 68 weeks (STEP 1)
  • Ozempic (off-label): 10-14%
  • Saxenda: ~8% at 56 weeks (SCALE)

Achieving 20%+ Loss

  • Zepbound: ~57% of participants (SURMOUNT-1)
  • Wegovy: ~32% of participants (STEP 1)
  • Saxenda: ~6% of participants

Side Effects and Costs

Quick answer: Similar GI side effects across all. US costs approximately $900-1,350/month without insurance.

Side Effects

  • Nausea: Wegovy ~44%, Zepbound ~50%, Saxenda ~39%
  • Diarrhea: Wegovy ~30%, Zepbound ~33%
  • Discontinuation: Wegovy ~7%, Zepbound ~6%, Saxenda ~10%

Estimated US Costs

  • Wegovy: ~$1,350/mo
  • Zepbound: ~$1,060/mo
  • Ozempic: ~$935/mo
  • Mounjaro: ~$1,023/mo
Insurance:

Many plans cover with prior authorization. Check with your insurer for current coverage, as policies vary.

Frequently Asked Questions

Same drug (semaglutide) but different indications and max doses. Ozempic for diabetes (max 2.0 mg), Wegovy for weight management (2.4 mg).

Depends on diabetes status, goals, injection preference, insurance, and tolerance. Discuss with your doctor.

Yes, under supervision. Same drug is straightforward. Different drugs need new titration.

Long-term recommended. Studies show most patients regain a significant portion of lost weight within a year of stopping.

FDA warns against them. May differ in purity and potency. Use FDA-approved products.

References

  1. Wilding JPH, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). NEJM. 2021;384(11):989-1002.
  2. Jastreboff AM, et al. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1). NEJM. 2022;387(3):205-216.
  3. Knop FK, et al. Oral Semaglutide 50 mg Taken Once Daily (OASIS 1). Lancet. 2023;402:705-719.
  4. Pi-Sunyer X, et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management (SCALE). NEJM. 2015;373(1):11-22.
  5. FDA. Medications Containing Semaglutide Marketed for Weight Loss. FDA Safety Communication. 2023.