Semaglutide vs Tirzepatide: Full Comparison for Weight Loss & Diabetes Control

Weight loss can be challenging. We’ve all been there. If you’ve tried everything with no luck, you may be considering weight loss medication. With so many options available on the market, there are two names you’ve probably heard: semaglutide or tirzepatide. 

However, how do you know which one is better for you?

Here, we are going to break down everything you need to know about tirzepatide vs semaglutide. We will cover their efficacy, safety, and costs. In the end, you’ll understand which one is better based on your goals and needs. 

With that said, remember that any medication should be prescribed by a healthcare professional. So, make sure you talk to your doctor to understand if any of these medications can get you the desired results.

What Are These Drugs?

What is Semaglutide? 

Semaglutide ^[2] is a medication that belongs to a class of drugs known as GLP-1 receptor agonists. They are designed to mimic the action of a hormone your body produces called glucagon-like peptide-1, which assists in regulating blood sugar levels and appetite. 

This medication has been widely studied, and it is commonly used for managing type 2 diabetes since it helps promote significant weight loss in people with obesity or weight-related health issues. 

Additionally, semaglutide has received approvals for its cardiovascular ^[3] and kidney benefits, making it an ideal choice for patients with specific health conditions. 

You can find semaglutide under the brand names Ozempic, Wegovy, and Rybelsus. It was FDA approved in 2017 for its use in treating diabetes and in 2021 as a weight loss medication. Additionally, semaglutide can also be used to reduce cardiovascular risks in people with diabetes. 

What is Tirzepatide?

Tirzepatide ^[4] is a newer medication that combines the actions of two separate incretin hormones, GLP-1 and GIP (glucose-dependent insulinotropic peptide). That is why it’s called a dual-agonist medication. 

This unique mechanism of action makes it a great option for blood sugar control and enhanced weight loss (even greater than what is observed with GLP-1 agonists alone). That is why tirzepatide has gained some popularity among those who want to achieve substantial weight loss results and lower their A1C levels ^[5]. 

You can find tirzepatide under the names Mounjaro or Zepboud. Both options are FDA-approved for helping regulate blood sugar levels. However, keep in mind that Zepbound is the only FDA-approved option when it comes to weight loss. 

Mechanism of Action

We already mentioned a little about how these medications work when it comes to weight loss and blood glucose control, but how exactly can they help? 

Semaglutide works as a GLP-receptor agonist ^[6]. Thanks to this effect, it mimics a hormone that can help reduce appetite, slow digestion, and improve insulin sensitivity, all of which can help improve blood glucose levels and promote weight loss. 

Tirzepatide goes one step further as a dual agonist of GLP-1 and GIP. The addition of GIP may enhance satiety, promote greater weight loss, and boost insulin secretion. This dual action gives it a slight edge in terms of efficacy for better weight loss. 

Efficacy & Head-to-Head Results

When it comes to weight loss and blood glucose management, studies have shown that tirzepatide has greater weight loss results. 

In a 2024 study, 18,386 people were given either semaglutide or tirzepatide ^[7]. Researchers found that those taking tirzepatide experienced 5% (or more) weight loss compared to those taking semaglutide. 

Another 40-week study (SURPASS-2) showed similar results ^[8]. Those taking tirzepatide experienced better A1c levels and experienced a 2-5 kg weight loss difference compared to those taking semaglutide. 

Now, do you need to have diabetes to get weight loss results from both medications? 

The answer is no. 

A study (SURMOUNT-5) showed that people with obesity but without diabetes had bigger weight loss results with tirzepatide compared to those taking semaglutide ^[9]. Additionally, they seem to have better waist circumference changes. 

In addition, it seems that tirzepatide may have better results when it comes to long-term weight loss. One study showed that 80% of people taking tirzepatide can maintain their weight loss reduction compared to those not taking the medication ^[10]. 

While both drugs are effective when it comes to weight loss and blood sugar regulation, tirzepatide seems to have a slight advantage, particularly at higher doses. 

Here is a table comparing the expected weight loss of each medication. Keep in mind that individual results may vary. 

Drug	Moderate Dose	High-Dose
Semaglutide	10-13%	15%
Tirzepatide	17-20%	>20%

Dosing & Administration

Both medications are administered as weekly subcutaneous injections using pre-filled pens. Semaglutide usually starts at a 0.25 mg weekly dose, and it can be increased to a maximum of 2.4 mg (Wegovy) or 1 mg (Ozempic). 

On the other hand, the doses typically start at 2.5 mg weekly, and they can increase up to 15 mg weekly. 

If you are switching between these two medications, there is normally a washout period that is recommended due to their long half-lives. Make sure to talk with your healthcare provider to determine the best dose for you (to avoid side effects) and the best washout period to prevent complications. 

Safety & Side-Effects

Both drugs can cause gastrointestinal issues, including nausea, upset stomach, diarrhea, fatigue, headaches, low blood sugar levels, and constipation. These side effects are minor and typically short-lived. 

However, at higher doses, both medications can have more severe side effects, such as increasing the risk of thyroid C-cell tumors, muscle mass loss, bone health issues, pancreatitis, and gallbladder complications ^[11]. 

If you experience any of the previous side effects, make sure you speak with your healthcare provider. 

Cost, Insurance & Access

The Wholesale Acquisition Cost (WAC) for medications like Wegovy, Ozempic, Mounjaro, and Zepbound typically ranges between $1,000 and $1,400 per month, depending on the product and clinic. However, actual out-of-pocket costs vary depending on your insurance coverage. 

For people with commercial insurance, the co-pays are typically $20 to $150. For those with Medicare, co-pays tend to start at $250, making it an affordable option for those trying to manage their blood glucose levels or lose weight. 

Another option is prescription coupons. They offer financial relief for people with commercial insurance, ensuring they get access to these medications at a reduced cost. However, keep in mind that Medicare does not allow using coupons, leaving older people reliant on rebates, savings programs, or other alternative assistance options. 

One common issue is supply shortages, particularly for compounded versions of these medications, which are often marketed as cost-saving alternatives. While compounded products are an appealing option, the FDA occasionally issues warnings about the potential risks associated with unregulated compounded products. 

That is why, for long-term health and safety, always make sure to choose FDA-approved prescriptions from reputable pharmacies. 

Who Might Choose Which?

When it comes to choosing the best medication for your goals and needs, it’s important to start by talking with a qualified healthcare provider. They can evaluate your medical history, symptoms, and any pre-existing conditions to prescribe the most effective treatment. 

Additionally, make sure to talk about any known allergies and any other medications or supplements you are taking. 

Now, if you want a bit more guidance on what is the best medication based on goals or medical history, here is a decision tree to guide you through the process of selecting the right medication for your needs. 

• Heart or kidney failure with health focus: Choose semaglutide
• Higher weight loss goals: Choose tirzepatide due to its dual action. 
• White-knuckle budget: Semaglutide may arrive generically sooner. 

Lifestyle & Monitoring Tips

To have the best outcomes from any weight loss medication, it’s important that you adopt healthy lifestyle habits. Here are some key practices to follow if you want long-term weight loss results. 

FAQs 

Is tirzepatide stronger than semaglutide?

Yes, when it comes to weight loss, tirzepatide shows greater results due to its dual-agonist advantages compared to semaglutide. In some studies, tirzepatide has a 5% difference for weight loss. 

How quickly will I see weight loss?

In most cases, people often notice significant results within the first 12 weeks. However, keep in mind that individual results may vary based on personal medical history and current lifestyle habits. 

Can I take either while pregnant?

No, both options are not recommended when pregnant. 

Do I need to be diabetic?

No, people without diabetes can still take this medication, especially if it’s for weight loss purposes. Still, talk to your healthcare provider to determine if it’s ideal based on your needs. 

Can I stop after hitting the goal weight?

Yes, you can stop taking the medication once you reach your weight goal. However, to keep the weight off, make sure you are working on promoting healthy lifestyle habits. 

Key Takeaways & Next Steps

• Medications like semaglutide are FDA-approved for weight loss, even for people who don’t have diabetes. 
• Tirzepatide shows superior weight loss and blood glucose control over semaglutide due to its dual-agonist action. 
• While discontinuing the treatment may result in weight gain, modifying lifestyle habits like focusing on protein, doing strength training, and staying hydrated can promote long-term results. 

Are you ready to discuss semaglutide as your weight loss medication? Our telehealth team can prescribe FDA-approved Wegovy if it’s appropriate for your needs. 

Disclaimer: Always consult with your healthcare provider to determine if this medication is right for you.