In the event you’re contemplating taking a GLP-1 medicine for weight reduction, you’ve most likely heard of the 2 main manufacturers within the area: Wegovy and Zepbound. (Ozempic and Mounjaro are additionally GLP-1s, however are designed and primarily prescribed for these with Kind 2 diabetes.) Right here, get key insights from educators affiliated with every firm and a number one internist who prescribes these drugs frequently, so you’ll be able to resolve which possibility is greatest for you.
Featured Consultants
- Dr. Amanda Kahn, a board-certified internist and longevity skilled
- Dr. Luis-Emilio Garcia, vice chairman of International Medical Affairs and Cardiometabolic Well being at Eli Lilly and Firm
- Jason Brett, principal U.S. medical head at Novo Nordisk
Why Is Everybody Speaking About GLP-1s Proper Now?
“Within the U.S. alone, greater than 110 million persons are residing with weight problems, and by 2030, cardiometabolic ailments like weight problems, diabetes and heart problems may have an effect on one third of adults globally,” says Dr. Luis-Emilio Garcia, vice chairman of International Medical Affairs and Cardiometabolic Well being at Eli Lilly and Firm, the dad or mum firm of Zepbound. “For many individuals with weight problems, life-style modifications alone—food regimen, train, behavioral counseling—might not lead to ample and sustained weight discount.” That’s the place GLP-1 drugs come into play.
“GLP-1s have fully reworked the panorama of weight administration and metabolic medication,” says Dr. Amanda Kahn, a board-certified internist and longevity skilled. “For the primary time, now we have a remedy that not solely helps folks lose vital quantities of physique fats, but in addition does so by focusing on the foundation organic causes of overeating, insulin resistance and irritation fairly than counting on solely on life-style modification and willpower. From a long life standpoint, their affect goes far past the size. These drugs cut back continual irritation, enhance insulin sensitivity, assist vascular well being, and cut back the long-term threat of diabetes, heart problems dementia and even some cancers. They mimic pure hormones launched after consuming, serving to regulate blood sugar, urge for food and digestion, however additionally they seem to affect inflammatory and hormonal pathways linked to getting older and illness.”
The Key Variations to Know About When Contemplating a GLP-1
“Semaglutide (Wegovy, Ozempic) and tirzepatide (Zepbound, Mounjaro) are each highly effective instruments on this new period of metabolic medication, however they work a bit in a different way,” says Dr. Kahn. “Semaglutide is a pure GLP-1 receptor agonist that mimics the physique’s pure GLP-1 hormone. This hormone slows digestion, improves satiety and balances blood sugar. Tirzepatide is a twin agonist that acts on each GLP-1 and one other hormone known as GIP.” Under, we discover the important thing variations between them.
What’s Wegovy?
“Wegovy is an FDA-approved prescription medication used alongside a decreased calorie food regimen and elevated bodily exercise to assist folks residing with weight problems cut back extra physique weight and keep weight discount long-term,” says Jason Brett, principal U.S. medical head at Novo Nordisk, the dad or mum firm of Wegovy. “It really works by mimicking a naturally occurring hormone within the physique known as GLP-1—glucagon-like-peptide1—which helps regulate urge for food. By appearing on urge for food management facilities within the mind, Wegovy helps folks eat fewer energy and drop some weight.”
Wegovy® (semaglutide) injection 2.4 mg is FDA-approved, together with a decreased calorie food regimen and elevated bodily exercise, to:
- Scale back the danger of main cardiovascular occasions reminiscent of dying, coronary heart assault, and stroke in adults with recognized heart problems and both weight problems or obese
- Assist adults and youngsters aged 12 years and older with weight problems, or sure adults with obese who even have weight-related medical issues, lose extra physique weight and maintain it off
- Deal with adults with noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) who’ve average to superior liver fibrosis
What’s Zepbound?
“Zepbound is a once-weekly injection prescription medication,” says Dr. Garcia. “It’s a twin receptor agonist, which means it targets two receptors—GIP and GLP-1—present in areas of the human mind which can be vital for urge for food regulation. Zepbound reduces urge for food, meals consumption, physique fats and physique weight. By focusing on each GIP and GLP-1 receptors, Zepbound is in contrast to different incretins accredited for weight problems administration, which goal solely GLP-1 receptors.” Dr. Kahn provides that as a result of Zepbound additionally targets GIP, it gives further advantages for fats metabolism and insulin sensitivity. “This typically ends in extra vital fats focusing on with higher muscle preservation,” she explains.
Zepbound is obtainable in an autoinjector (a single-dose pen) and a single-dose vial, and is FDA-approved for the therapy of weight problems, in addition to for moderate-to-severe obstructive sleep apnea (OSA) in adults with weight problems. This medicine is supposed to be prescribed by a health care provider as a part of a long-term therapy plan, alongside food regimen and train.
What are the unwanted side effects of Wegovy and Zepbound?
Each drugs share related potential unwanted side effects, which Dr. Kahn says can embody delicate gastrointestinal signs reminiscent of nausea, bloating, constipation and/or reflux. “These results happen as a result of GLP-1s gradual gastric emptying and alter intestine motility,” she explains. “Nonetheless, in apply, Zepbound typically causes fewer or milder preliminary GI unwanted side effects in comparison with Wegovy. That is doubtless because of the addition of the GIP pathway, which seems to modulate digestion extra easily and buffer a few of the nausea or bowel motion modifications seen with pure GLP-1 agonists.”
“The gastrointestinal unwanted side effects are often delicate to average, however generally might be extreme, and have a tendency to happen early, when beginning therapy or rising the dose,” Brett provides. “Typically, they’re transient, which means they typically go away with time.” Dr. Kahn recommends “beginning low and titrating slowly, staying hydrated and guaranteeing satisfactory dietary fiber, which may also help decrease discomfort, in addition to working with a supplier who could be very skilled with the nuances of GLP-1 remedy.” She additionally says supplementing with vitamin B12 might be useful, as GLP-1 drugs might barely cut back B12 absorption over time. “When launched thoughtfully, most sufferers tolerate these drugs very properly and expertise solely temporary adjustment signs.”
Which one is more practical?
Each drugs are extremely efficient, Dr. Kahn says, however scientific research present tirzepatide (Zepbound) sometimes produces extra substantial outcomes. “On common, sufferers utilizing tirzepatide lose about 22 to 25 % of their complete physique weight, in comparison with roughly 15 % with semaglutide [Wegovy],” she explains. The scientific examine Dr. Kahn is referencing is the SURMOUNT-5 scientific trial (revealed in Might 2025) of 751 adults with weight problems or obese however with out sort 2 diabetes. This examine straight in contrast the outcomes of Wegovy and Zepbound on these people, and Zepbound led to superior weight discount in comparison with Wegovy: 20.2 % or 50.3 lbs vs. 13.7 % or 33.1 lbs, respectively.
“Tirzepatide’s twin mechanism, focusing on each GLP-1 and GIP receptors, seems to create a extra balanced metabolic impact, enhancing fats burning whereas higher preserving lean muscle,” says Dr. Kahn. With the addition of GIP, we discover fewer of the gastrointestinal side-effects seen with semaglutide. For these causes, I sometimes prescribe Zepbound as a first-line agent for a metabolic reset. That mentioned, each drugs dramatically cut back insulin resistance, irritation and cardiovascular threat components. The selection typically relies on particular person tolerance, response and private well being objectives fairly than a easy stronger versus weaker comparability.”
“That mentioned, if a brand new affected person is already doing properly on Wegovy and seeing constant progress, I usually don’t swap them except they specific curiosity in attempting a special strategy or in the event that they plateau on their present routine,” Dr. Kahn continues. “Each drugs might be efficient when customized to the person, however Zepbound tends to supply broader metabolic and longevity advantages total. Finally, I tailor therapy to the person. Longevity medication is about personalization.”
Who ought to and shouldn’t take these GLP-1 drugs?
“Initially, these drugs had been developed for folks with weight problems—a BMI over 30—or those that are obese—BMI over 27—with associated well being points reminiscent of excessive ldl cholesterol or hypertension,” explains Dr. Kahn. “Nonetheless, in longevity medication, the perfect candidate isn’t all the time outlined by BMI alone. Sufferers can have a standard BMI however can have a excessive physique fats share on physique composition testing. I additionally contemplate GLP-1s for people with visceral fats accumulation, indicators of insulin resistance, fatty liver or inflammatory situations, so even in those that seem lean externally however have inner metabolic or inflammatory imbalances.”
Nonetheless, Dr. Kahn says there are vital exclusions. “Folks with a historical past of medullary thyroid most cancers, a number of endocrine neoplasia sort 2 (MEN2) or extreme gastrointestinal motility issues shouldn’t take these drugs,” she advises. “They need to even be used cautiously in people who’re already underweight or have a historical past of disordered consuming. The purpose is to revive steadiness and enhance metabolic flexibility, to not simply push for weight reduction, or to take weight reduction to an excessive.”
