Medical Weight Loss, Tirzepatide vs Semaglutide

Medical Weight Loss

It is a very exciting time in medicine for weight loss treatment! There are several good new medications that have been shown to be effective for weight loss and there are many more in the research pipeline.

The two medications at the forefront of weight loss treatment and conversations right now are tirzepatide (Zepbound, Mounjaro) and semaglutide (Ozempic, Wegovy) and both have shown promise for weight loss in addition to their primary indication for the treatment of type 2 diabetes. Here’s a comparison of their efficacy and characteristics regarding weight loss:

Mechanism of Action:

Semaglutide works by mimicking the action of the hormone GLP-1, which has multiple effects including reducing appetite, increasing feelings of fullness, and slowing gastric emptying, all of which can contribute to weight loss.

        Tirzepatide is an agonist of both glucose-dependent insulinotropic polypeptide (GIP) and the GLP-1 receptor, and influences appetite control and satiety, thereby promoting weight loss.


Clinical trials have shown that both semaglutide and tirzepatide are associated with significant weight loss in patients with type 2 diabetes, even in those without obesity.

        Tirzepatide has shown potentially greater weight loss efficacy compared to semaglutide in some studies. In Phase 3 trials, tirzepatide demonstrated weight loss superiority compared to both semaglutide and placebo.

Dosage and Administration:

Both semaglutide and tirzepatide have a range of doses that are titrated per medication protocols or patient response. The doses start very low and are generally evaluated every 4 weeks depending on clinical results or side effects. The most common drug form is a subcutaneous injection that is given weekly. Also, note, the clinical studies on these medication took place over long periods of time (56 to 72 weeks), so these are not intended to be used for rapid quick weight loss.

Side Effects:

Both medications may cause gastrointestinal side effects such as nausea, vomiting, and diarrhea, especially when starting treatment. These side effects may contribute to weight loss but can also impact tolerability. Other common side effects may include hypoglycemia, injection site reactions, and potential weight loss due to reduced appetite. The side effects can be severe enough that patients may have to discontinue using the medication.

Cardiovascular Effects:

Both semaglutide and tirzepatide have shown a bonus of cardiovascular benefits in clinical trials, including reductions in the risk of major adverse cardiovascular events (MACE) such as heart attack, stroke, and cardiovascular death. These benefits are particularly notable in patients with pre-existing cardiovascular disease.

Cost and Availability:

Cost and availability may vary depending on factors such as location, healthcare coverage, and manufacturer discounts. Currently, the cash price of these medications is very high and can be cost prohibitive to some patients as insurance coverage is not universally approved. In addition, immediate availability has been problematic at times when the manufacturers have been unable to keep up with demand. While there is a shortage of medication, providers may offer medication from compounding pharmacies which can be a more affordable option.

Long-term Studies and Safety:

Long-term safety and efficacy data for both medications are still being evaluated, as they are relatively new drugs. Continued monitoring for adverse effects is essential, particularly regarding potential effects on weight loss maintenance over time.


Which medication is right for you? Both tirzepatide and semaglutide have demonstrated significant weight loss efficacy. However, individual responses to treatment may vary, and factors such as dosing frequency, side effect profile, patient preferences, cost, provider familiarity, and availability should be considered when selecting the appropriate medication for weight loss


If you are interested in discussing medications for weight loss, give us a call today and schedule your free consultation!

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