Tirzepatide vs Ozempic For Weight Loss

Craig Primack, MD, FACP, FAAP, FOMA

Reviewed by Craig Primack, MD, FACP, FAAP, FOMA

Written by Vanessa Gibbs

Published 04/07/2024

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

Semaglutide — Ozempic®  and Wegovy are  brand names for this — and tirzepatide – Mounjaro and Zepbound are brand names for this–   are two of your options. These drugs have different active ingredients, but they can 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 semaglutide work in similar ways. But first, we need to make a quick distinction. 

Semaglutide is the active ingredient in Ozempic, as well as in other weight loss drugs like Wegovy® and Rybelsus®. 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 prescribed “off-label” for weight loss, which means that  it isn’t FDA-approved for weight loss, but it’s sometimes prescribed for this reason. Wegovy, on the other hand, is FDA approved for weight management.

Tirzepatide is the active ingredient in Mounjaro® and Zepbound®. Like Ozempic and other drugs with semaglutide, Mounjaro is FDA-approved as a diabetes drug. It can help people with type 2 diabetes control blood sugar levels. Mounjaro is also prescribed off-label for weight loss. 

Zepbound, on the other hand, 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 Semaglutide Work? 

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. 

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 other semaglutide-containing drugs 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 a dual glucose-dependent insulinotropic polypeptide (GIP) receptor agonist and a GLP-1 receptor agonist — known as a GIP/GLP-1 receptor agonist.

In simpler terms, it’s targeting two receptors in the body, whereas semaglutide drugs like Ozempic are only targeting one. 

The GLP-1 receptor agonist side works the same as semaglutide, reducing hunger and promoting feelings of fullness. 

The GIP receptor agonist side works very similarly. It mimics the GIP hormone, which is also released after eating to trigger the production of insulin and is linked with feelings of fullness. 

They work together to produce the same effects — reduced appetite and food intake, which promote weight loss. 

So, when it comes to tirzepatide vs Ozempic, weight loss happens in very similar ways.

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, 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. 

The semaglutide group lost 13 pounds, whereas those taking the 5-mg tirzepatide dose lost almost 17 pounds. Those taking the 10-mg tirzepatide dose lost almost 21 pounds and those taking the 15-mg tirzepatide dose lost almost 25 pounds. 

The researchers concluded that all doses of tirzepatide were “superior to semaglutide.” 

We’ve got to take these results with a pinch of salt, though. 

This study’s participants were people with type 2 diabetes, so it’s not clear if tirzepatide would help people without the condition lose more weight than semaglutide. 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, 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. 

Another 2022 review compared clinical trials on semaglutide and tirzepatide on type 2 diabetics but concluded, “Considering the dissimilar backgrounds and methods of these studies, a direct comparison of the two medications is still required.” 

Tirzepatide vs Ozempic Effectiveness on People Without Type 2 Diabetes 

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

Want the specifics? 

  • For tirzepatide: A 2022 study looked at more than 2,500 people with a BMI of 30 or more, or 27 or more with at least one weight-related health condition that wasn’t diabetes. 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.  

  • For semaglutide: A 2021 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.

Prescribed online

Weight loss treatment that puts you first

Both tirzepatide and Ozempic are once-a-week subcutaneous (under the skin) weight loss 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 a tirzepatide drugs are usually prescribed alongside lifestyle interventions — that is, diet and exercise changes — to promote weight loss. 

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

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. 

The 2021 study we mentioned above — the one that compared 1mg of semaglutide to 5mg, 10mg or 15mg of tirzepatidetirzepatide — found the percentage of people who experienced side effects was similar across all groups. The most commonly reported side effects were gastrointestinal events. 

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 very 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 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 can cost $1000 to $1100 per month

  • Zepbound can cost $1000 to $1100 per month

  • Ozempic can cost $900 to $1000 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 if you’re exploring weight loss treatments. 

There are other weight loss injections such as: 

  • Wegovy® — the higher-dose cousin of Ozempic

  • Saxenda® — liraglutide

  • Victoza® — liraglutide 

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

  • 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 are 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 speaking to a healthcare provider. They can take into account your weight and individual health and talk through the pros and cons of each treatment. 

Keep in mind these aren’t your only options. There are weight loss treatments that don’t require needles or injections that can still be effective.

17 Sources

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