Dardano A, Bianchi C, Garofolo M, Del Prato S
Eli Lilly, the maker of tirzepatide, recently published results of a head-to-head trial comparing weight loss of Zepbound (tirzepatide) and Wegovy (semaglutide)

A Decision Framework Choose Semaglutide If: You are starting GLP-1 therapy for the first time and want to begin with the more established, longer-studied option Cost is a tighter constraint and the $50 per injection pricing is important Your weight loss goal is moderate (10-15% of body weight) and semaglutides proven efficacy range is sufficient Your insurance covers Wegovy or Ozempic, making brand-name semaglutide accessible through a separate pharmacy benefit Choose Tirzepatide If: Maximum weight loss is the priority and you want the most clinically effective option currently available You have tried semaglutide and found the results plateaued before reaching your goal You have Type 2 diabetes, as tirzepatides dual mechanism produces stronger glycemic control alongside weight loss The cost difference between semaglutide and tirzepatide is manageable within your budget You are comfortable using HSA funds to offset the cost of the higher dose tiers What About Compounded Semaglutide and Tirzepatide

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