Tirzepatide vs Ozempic For Weight Loss

Deciding to go on weight loss medication is a hard enough decision; deciding which one to take makes things even more complicated. When it comes to drugs that may support weight loss, the choice can sometimes feel confusing.

Semaglutide — Ozempic®  and Wegovy® are brand names for this drug — and tirzepatide — Mounjaro® and Zepbound® are brand names for this one —  are two of your options. These drugs have different active ingredients, but they may both help those with overweight and obesity lose weight.  

Below, we dive into everything you need to know about tirzepatide vs. Ozempic, including how the drugs work, their side effects, and the costs. 

Tirzepatide and Ozempic (semaglutide) work in similar ways, but there are some differences. 

Ozempic is approved by the U.S. Food and Drug Administration (FDA) to help people with type 2 diabetes manage their blood glucose (sugar) levels. 

Ozempic is sometimes prescribed off-label for weight loss. When a doctor prescribes something off-label, it means they’re giving it to you for something other than what it was FDA-approved to treat. 

Semaglutide is also available under another brand name, Wegovy. Wegovy is FDA-approved for weight management in those with obesity or overweight and a weight-related health condition, like high blood pressure.

Tirzepatide is the active ingredient in the brand-name drugs Mounjaro® and Zepbound®. 

Mounjaro is FDA-approved as a diabetes drug. It can help people with type 2 diabetes control blood sugar levels. Like Ozempic, Mounjaro is sometimes prescribed off-label for weight loss. 

Like Wegovy, Zepbound is FDA-approved for weight loss. It’s designed to help with weight management in those with a body mass index (BMI) of 30 or more, or 27 or more with at least one weight-related health condition such as high blood pressure, high cholesterol or obstructive sleep apnea. 

Whew! Now that’s out of the way, we’ll take a look into how the drugs work.

How Does Ozempic Work? 

Ozempic (semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist. 

This means the drug mimics the GLP-1 hormone, which is made in your gastrointestinal tract when you eat. 

The GLP-1 hormone is linked to: 

• Reduced appetite 

• Feelings of fullness 

• Insulin production, which lowers blood sugar levels 

So, you can see how GLP-1 medications that mimic this hormone could help with weight loss. 

According to research sponsored by Novo Nordisk, semaglutide can: 

• Reduce calorie intake 

• Reduce hunger 

• Increase feelings of fullness

• Change your food preferences  

Combined with diet and exercise changes, semaglutide’s effects can help you eat fewer calories and lose significant amounts of weight. 

Ozempic and can also reduce the risk of major adverse cardiovascular events in those with type 2 diabetes and cardiovascular disease. 

How Does Tirzepatide Work? 

Tirzepatide is what’s known as a GIP/GLP-1 agonist (a dual glucose-dependent insulinotropic polypeptide (GIP) receptor agonist and GLP-1 receptor agonist).

According to studies sponsored by Eli Lilly, the GLP-1 side of tirzepatide works like other GLP-1s (like Ozempic) to reduce hunger and promote feelings of fullness. 

The GIP works very similarly. It mimics the GIP hormone, which your body releases after you eat to trigger insulin production. It’s also linked to feelings of fullness. 

Overall, this dual medication works to reduce appetite and food intake, which promotes weight loss. 

Both tirzepatide and semaglutide can help you lose weight, but how would they fare in a head-to-head match? 

Well, there aren’t any strong studies comparing the drugs directly against each other, but here’s what we know so far. 

In a 2021 study funded by Eli Lilly, nearly 1,900 participants with type 2 diabetes were assigned either a 1-mg dose of semaglutide or a 5-mg, 10-mg or 15-mg dose of tirzepatide. Participants took the drugs once a week for 40 weeks.

By the end of the experiment, the group taking tirzepatide saw greater reductions in body weight than those taking semaglutide. 

But, the weight loss was dose-dependent, with those taking higher doses losing more weight. 

Plus, only a 1-mg dose of semaglutide was studied. It’s unclear if higher doses would have been more effective. 

Other research has found similar results. 

A 2022 review (also funded by Eli Lilly), for example, did an adjusted indirect treatment comparison for 5-mg, 10-mg and 15-mg doses of tirzepatide compared to 2mg of semaglutide in patients with type 2 diabetes. This review included the 2021 study above. 

Weight reductions were significantly greater for 10-mg and 15-mg doses of tirzepatide compared to 2-mg doses of semaglutide. But 5mg of tirzepatide produced similar weight loss to 2mg of semaglutide. 

Tirzepatide vs Ozempic Effectiveness in People Without Type 2 Diabetes 

Both drugs can be effective for weight loss in those without type 2 diabetes. But again, there isn’t much direct comparison between the two. 

Want the specifics? 

• Tirzepatide: A 2022 study sponsored by Eli Lilly looked at more than 2,500 people with an elevated BMI. Participants took a once-a-week injection of either 5mg, 10mg or 15mg of tirzepatide or a placebo for 72 weeks. This included 20 weeks to slowly get up to the correct dose. By the end of the study, the mean percentage change in weight for those on the 5mg-dose of tirzepatide was 15 percent. It was 19.5 percent for those taking 10mg doses, almost 21 percent for those on 15-mg doses and just over three percent for those on the placebo.  

• Semaglutide: A 2021 Novo Nordisk study looked at almost 2,000 participants with a BMI of 30 or more, or 27 or more, with at least one weight-related health issue that wasn’t diabetes. They took a 2.4-mg dose of semaglutide for 68 weeks. By the end of the study period, the mean change in body weight was almost 15 percent in the group taking semaglutide compared to 2.4 percent for those on the placebo. 

The final verdict? When comparing tirzepatide vs. semaglutide for weight loss, it appears tirzepatide may be more effective if you take it in higher doses. But more research directly comparing the two is needed to understand the full effects.

Both tirzepatide and Ozempic are once-a-week subcutaneous (under the skin) injections. You can inject them into your stomach, thigh or upper arm at any time of day, with or without food.

For Ozempic, a healthcare provider may get you started on a 0.25mg dose. If you’re tolerating the drug well after four weeks, they may increase this to 0.5mg. Your dose may slowly increase from there to up to 2mg.

For tirzepatide, you may get started on a 2.5mg dose. This could increase to a 5mg dose after four weeks and slowly increase from there up to 15mg. 

Both Ozempic and tirzepatide drugs are usually prescribed alongside lifestyle interventions — that is, diet and exercise changes. 

As with any drug, weight loss medications come with side effects. Tirzepatide vs. semaglutide side effects are pretty similar. Here’s how they compare. 

According to the drug label for Zepbound, common side effects of tirzepatide include: 

• Nausea 

• Vomiting

• Constipation

• Diarrhea

• Abdominal pain 

• Decreased appetite

• Dyspepsia (indigestion) 

These side effects were reported in five percent or more of people taking tirzepatide in clinical trials. 

More serious side effects of tirzepatide include: 

• Pancreatitis (inflammation of the pancreas) 

• Hypersensitivity reactions 

• Hypoglycemia (low blood sugar) if used alongside insulin secretagogues or insulin 

• Severe gastrointestinal disease 

• Acute kidney injury 

• Diabetic retinopathy complications in people with a history of the diabetic retinopathy (an eye disease) 

Common side effects of Ozempic include: 

• Nausea 

• Vomiting

• Constipation  

• Diarrhea

• Abdominal pain 

These side effects occurred in five percent or more of people treated with Ozempic in clinical trials. 

More serious side effects of Ozempic include: 

• Pancreatitis 

• Hypersensitivity reactions — such as anaphylaxis and angioedema (swelling)

• Hypoglycemia 

• Acute kidney injury 

• Diabetic retinopathy complications 

• Acute gallbladder disease 

Both tirzepatide and semaglutide come with a black box warning stating that there’s a risk of thyroid C-cell tumors. Both drugs have caused these thyroid tumors in rats, but it’s unclear whether there’s a risk in humans. 

Serious adverse events were also reported and were more common in those taking tirzepatide. About five percent to seven percent of participants taking tirzepatide reported serious side effects, compared to about three percent of those on semaglutide. 

As you can see, the side effects of tirzepatide and Ozempic are similar. But how your body reacts to a drug is unique to you, so you may find you can tolerate one drug better than the other.  

Let’s get down to business. How much do tirzepatide and Ozempic cost exactly? 

Tirzepatide and Ozempic aren’t usually covered by insurance when they’re prescribed for weight loss, and as you may end up taking them for a long period of time, they can rack up quite a bill. 

• Mounjaro costs around $1,000 to $1,400 per month

• Zepbound can cost around $1,000 to $1,400 per month

• Ozempic can cost about $900 to $1,300 per month 

So, when it comes to cost, there’s not too much difference between semaglutide and tirzepatide. 

BTW, if you’re looking for more affordable options, our comprehensive weight loss programs start at $79 per month. 

Tirzepatide and Ozempic aren’t your only options. 

Hers offers access to compounded weight loss injections, which (while not FDA-approved) can be an affordable alternative to brand-name drugs. 

Compounded semaglutide through Hers starts at $165 per month (for a 12-month supply, paid in full). 

There are other injections that may support weight loss, such as: 

• Wegovy® — the higher-dose cousin of Ozempic

• Saxenda® — liraglutide

• Victoza® — liraglutide 

And if needles aren’t your thing, don’t sweat it. You can get non-injection weight loss alternatives such as these: 

• Rybelsus® — with the same active ingredient (semaglutide) as Ozempic 

• Metformin 

• Contrave® — Naltrexone-bupropion

• Qsymia® — Phentermine-topiramate

• Xenical® — Orlistat  

• Topamax® — Topiramate

You can also explore drug-free weight loss interventions such as diet and exercise plans and behavioral change tools. There are plenty of options out there to help.

Ding ding. The fight is over. Tirzepatide and Ozempic can both help with weight loss, but which one is the winner? Well, the jury’s still out on that one. 

The TL;DR on Ozempic vs tirzepatide: 

• Both Ozempic and tirzepatide can be effective for weight loss. Research shows they both produce significant weight loss when taken alongside diet and exercise changes. Tirzepatide may be more effective than Ozempic, but there aren’t any strong studies directly comparing the two. 

• Side effects of Ozempic and tirzepatide are similar. Nausea, vomiting, diarrhea. It ain’t pretty, but gastrointestinal events are the most common side effects of both drugs. 

• The cost of Ozempic and tirzepatide are similar. We can’t really differentiate on cost, either. Both drugs are not usually covered by health insurance and may set you back around $1000 a month.

So, how are you meant to choose between Ozempic and tirzepatide drugs like Mounjaro and Zepbound? Your best bet is to consult a healthcare provider. They can take into account your weight and individual health and walk you through the pros and cons of each treatment.