# GLP-1 Medication Comparison: Ozempic vs Wegovy vs Mounjaro vs Zepbound

Source: https://www.dietglp.com/blog/glp1-medication-comparison/
Published: 2026-04-23
Keywords: ozempic vs wegovy vs mounjaro, glp-1 comparison, best glp-1 weight loss, glp-1 chart

**TL;DR:** For diabetes: Mounjaro (most effective) > Ozempic > older options. For weight management: Zepbound (~21% loss) > Wegovy (~15%) > Saxenda (~8%). Insurance coverage often dictates choice. Side effect profiles are similar within drug class. Cost varies widely; cash-pay manufacturer programs are an option.

The GLP-1 medication landscape can be confusing — multiple molecules, brand names that overlap by indication, similar dosing schedules. Here is the practical side-by-side comparison.

## The molecules

There are essentially three molecules currently approved in the U.S.:

1. **Semaglutide** (sold as Ozempic, Wegovy, Rybelsus)
2. **Tirzepatide** (sold as Mounjaro, Zepbound)
3. **Liraglutide** (sold as Victoza, Saxenda)

A few others (dulaglutide, exenatide) are less commonly used for weight loss.

## Quick comparison table

| | **Wegovy** | **Zepbound** | **Ozempic** | **Mounjaro** | **Saxenda** | **Rybelsus** |
|---|---|---|---|---|---|---|
| Molecule | Semaglutide | Tirzepatide | Semaglutide | Tirzepatide | Liraglutide | Semaglutide |
| FDA indication | Weight | Weight | Diabetes | Diabetes | Weight | Diabetes |
| Frequency | Weekly inj | Weekly inj | Weekly inj | Weekly inj | Daily inj | Daily oral |
| Max dose | 2.4 mg | 15 mg | 2.0 mg | 15 mg | 3.0 mg | 14 mg |
| Avg weight loss | ~15% | ~21% | ~10% | ~18% | ~8% | ~5–8% |
| List price/mo | ~$1,350 | ~$1,060 | ~$1,000 | ~$1,070 | ~$1,400 | ~$900 |
| Manufacturer | Novo Nordisk | Eli Lilly | Novo Nordisk | Eli Lilly | Novo Nordisk | Novo Nordisk |

## Decision framework

### "I want maximum weight loss"

**Best choice:** Zepbound (or Mounjaro if diabetic)
- Average ~21% weight loss at maximum dose
- More patients lose 25%+ of body weight than on semaglutide
- Side effect profile similar to semaglutide

### "I want the best-studied option"

**Best choice:** Wegovy (or Ozempic if diabetic)
- Largest body of clinical data
- SELECT trial shows cardiovascular benefit independent of weight
- Available longer; more real-world experience

### "I have type 2 diabetes"

**Best choice:** Mounjaro > Ozempic
- Mounjaro typically produces stronger HbA1c reduction
- Both produce significant weight loss
- Coverage usually better for diabetes-indicated drugs

### "I have severe side effects on stronger options"

**Best choice:** Saxenda > Rybelsus
- Saxenda's gentler appetite suppression may be more tolerable
- Rybelsus has milder GI effects (oral, lower absorption)
- Less effective for weight loss but easier to tolerate

### "I can't or won't inject"

**Best choice:** Rybelsus
- Only oral GLP-1 currently available
- Strict morning timing required (fasted, 4 oz water, 30 min before food)
- Less effective than injectable options

### "Insurance only covers one"

Take it. Don't fight your insurance for a marginal upgrade. Whichever they cover, it works — the core mechanisms are the same.

### "I have cardiovascular disease"

**Best choice:** Wegovy
- Specifically approved for cardiovascular event reduction in CVD patients with obesity (post-SELECT)
- Strongest data for non-diabetic CV benefit

## Side effect comparison

Generally similar across the class:

| Side effect | Semaglutide | Tirzepatide | Liraglutide |
|---|---|---|---|
| Nausea | Common | Common | Common |
| Diarrhea | Common | More common | Common |
| Constipation | Common | Common | Common |
| Sulfur burps | Some | More common | Some |
| Vivid dreams | Some | Some | Less common |
| Injection reactions | Mild | Mild | More common |
| Pancreatitis risk | Rare | Rare | Rare |
| Thyroid C-cell warning | Yes | Yes | Yes |
| Gallbladder issues | Some | Some | Less common |

The profile is more similar than different.

## Cost comparison (for self-pay)

Approximate monthly out-of-pocket through manufacturer programs:

- **Zepbound (LillyDirect, vials):** ~$400–500
- **Wegovy (NovoCare):** ~$500–650
- **Mounjaro:** ~$500–650 (Lilly programs)
- **Ozempic:** ~$500–650
- **Saxenda:** ~$700–1,000
- **Rybelsus:** ~$900–1,000

Compounded options (with safety caveats) can be lower.

## What about new agents?

In development:

- **Retatrutide** (triple agonist — GLP-1 + GIP + glucagon): showing 24%+ weight loss in trials
- **CagriSema** (semaglutide + cagrilintide combination): higher weight loss than semaglutide alone
- **Orforglipron** (oral non-peptide GLP-1): may rival injectable effectiveness in pill form
- **Survodutide, mazdutide** (other dual/triple agonists)

Most are 1–3+ years from FDA approval.

Orforglipron is now approved as Foundayo, a daily pill; see our [Foundayo guide](/blog/foundayo-orforglipron-guide/) for how it compares.

## Switching between medications

Patients commonly switch:

- Insurance coverage changes
- Side effects don't resolve on one
- Plateau on one — try another
- Supply issues
- Cost changes

The transition is usually smooth. Your prescriber will start you at an equivalent or starter dose on the new drug.

## What's the same across all of them

Regardless of which GLP-1 you're on:

- The protein floor is the same (0.7–1.0 g/lb goal weight)
- Resistance training requirement is the same
- Side effect management is similar
- Maintenance and rebound considerations apply
- The off-ramp protocol is similar

The drug differences matter for absolute weight loss; the lifestyle protocol matters for what you keep.

## Bottom line

For maximum weight loss in non-diabetics: Zepbound. For diabetes: Mounjaro. For most-studied with cardiovascular benefit: Wegovy. For oral or maximum tolerability: Rybelsus or Saxenda. Insurance coverage is often the deciding factor in practice. Whatever you take, the protein and lifting protocol determines what you keep.