Zepbound vs. Ozempic: Which is right for you?

Key Points

• Zepbound is a weight loss drug and Ozempic is a diabetes medication, though both drugs can help you lose weight.
• Zepbound’s active ingredient is tirzepatide whereas Ozempic’s is semaglutide.
• Initial research indicates that tirzepatide is more effective for weight loss than semaglutide, but more research is needed.

Are you looking into diabetes and weight loss drugs to manage your type 2 diabetes or lose weight? Feeling overwhelmed by all the different options?

Zepbound® and Ozempic® are two of the most popular drugs on the market right now, with Ozempic being prescribed for the treatment of type 2 diabetes and Zepbound being prescribed for weight loss. They're manufactured by different companies and have different ingredients. So: which is right for you?

Let's break down Zepbound vs. Ozempic and see how they each work.

The differences between Zepbound and Ozempic

Zepbound and Ozempic both work on blood sugar, but officially, Zepbound is a weight loss medication and Ozempic is a diabetes medication. They use different active ingredients and are prescribed for different reasons.

Here are more differences between Ozempic and Zepbound:

How semaglutide works with blood sugar

Ozempic's active ingredient is semaglutide. Semaglutide is a GLP-1 agonist, which means that it activates GLP-1 (a hormone) receptors in the pancreas. This triggers a release of insulin, helping to lower blood sugar. It also prevents your liver from producing too much sugar.

As a GLP-1, Ozempic also slows gastric emptying, meaning food moves through your digestive system slower, leading you to feel fuller faster. Ozempic users can also experience reduced appetite due to how these hormones interact in the brain. This can help reduce food cravings as well.

Due to these effects, Ozempic can help you lose weight, but it is not officially a weight loss drug.

Ozempic also lowers the risk of major cardiovascular events such as stroke, heart attack, or death in adults with known heart disease.

How tirzepatide works for weight loss

Zepbound's active ingredient is tirzepatide. Tirzepatide is a GLP-1 agonist as well, but it is also a glucose-dependent insulinotropic polypeptide (GIP) agonist.

This dual-action drug influences blood sugar and food intake in a few ways:

• Decreasing glucagon and releasing insulin, which helps lower blood sugar levels
• Slowing digestion
• Signaling a sense of fullness during and after meals
• Reducing "food noise" in your mind, helping you be less fixated on food

Can Ozempic help you lose weight?

While Ozempic is not a weight loss drug, it may help you lose weight due to effects on your appetite and intake. In a study conducted by Novo Nordisk, Ozempic users lost up to 14 pounds.

Another study comparing semaglutide and tirzepatide found that semaglutide users at a 1 mg dose lost an average of 12.5 pounds over 40 weeks. Tirzepatide users lost between 16.7 and 24.7 pounds. While these results are significant, it's important to note that semaglutide can now be administered up to a 2 mg dose, so additional direct comparison is needed.

Can Zepbound help with weight loss?

Zepbound is FDA-approved to treat obesity in adults, as well as to treat obstructive sleep apnea (OSA) in adults with obesity. Its active ingredient is tirzepatide. Zepbound is produced by Eli Lilly, which also manufactures Mounjaro.

Mounjaro also uses tirzepatide but is indicated to help treat type 2 diabetes. Zepbound and Mounjaro are not interchangeable prescription medications.

In a 17-month study by Eli Lilly, Zepbound users lost up to 21% of their body weight. Results vary by dose and diet and exercise must be utilized in concert with the medication regardless of dose. It is a very promising weight management medication.

Ozempic dosing & administration

Zepbound and Ozempic have different dosing. When taking Ozempic to manage blood sugar levels and diabetes, the schedule is as follows:

• Start at a weekly .25 mg dose for four weeks
• Increase to a .5 mg weekly dose for four weeks
• Increase to a 1 mg weekly dose if needed for additional blood sugar control
• Increase further to a 2 mg weekly dose if needed

Your doctor will determine your dose based on your A1C levels and side effects. You may experience additional side effects as you increase doses.

Ozempic is administered subcutaneously with a multi-dose pen. The pen automatically ejects the proper dose and keeps track of how many doses you have used already. Each pen has four doses, so you use one pen per month.

Zepbound dosing & administration

With Zepbound, you’ll begin treatment at a recommended 2.5 mg weekly dose. After four weeks, your dose will increase to 5 mg.

After another four weeks, your doctor may keep you at the 5 mg dose or, if needed, increase the dosage in 2.5 mg increments after at least four weeks on the current dose. The maximum dose of Zepbound is 15 mg.

Zepbound also comes in a single-use pen or in a vial for weekly injections.

Diabetes & weight loss medication costs

Both Zepbound and Ozempic cost around $1,000 per month. Your individual cost will depend on your health insurance and other factors.

There are options to reduce the cost of these weight loss drugs. There is an Ozempic savings card and a Zepbound coupon as well. You may be eligible for additional assistance too. Ask your doctor about your options.

How much weight can you lose with Ozempic vs. Zepbound?

In one 40-week trial, tirzepatide was found superior to semaglutide at every dose, with tirzepatide users losing up to 11.2 kg and semaglutide users having an average weight loss of 5.7 kg. It's important to note, however, that this study used the 1 mg dose of semaglutide when the highest recommended dose is now 2 mg. Tirzepatide also lowered hemoglobin A1C levels more than semaglutide did, which is significant for diabetes management.

In a clinical trial of Ozempic, participants lost an average of 16% of body weight over 68 weeks while also making necessary lifestyle and diet changes.

A similar clinical trial of Zepbound found that the medication is nearly 20% more effective than diet and exercise changes alone, with participants losing 24% of body weight over 72 weeks.

Another study by Eli Lilly found that, after 72 weeks, Zepbound users without diabetes lost as much as 20.9% of their body weight or 48 pounds (based on an average starting weight of 226-231 pounds. Their studies have also found that Zepbound can improve cholesterol and blood pressure levels as well, although the weight loss medication is not indicated for the treatment of cholesterol or blood pressure.

It's important to note that at least 10% of users in all of these trials lost 5% or less of their body weight, signaling that weight loss medications might not work for everyone.

What are the side effects of new weight loss drugs?

Just like most medications, weight loss drugs come with side effects. Despite having different ingredients, Zepbound and Ozempic have similar side effects.

Common side effects with weight loss drugs include nausea, diarrhea, vomiting, constipation, stomach (abdominal) pain, indigestion, injection site reactions, feeling tired, allergic reactions, belching, hair loss, and heartburn. These symptoms may ease as your body adjusts to the medication. Your symptoms may change as you increase your dose.

If your side effects are unmanageable or concerning, talk to your doctor. Do not stop taking your medication without medical supervision.

Both Zepbound and Ozempic come with warnings about a risk of developing thyroid tumors from the medication, as well as an increased risk of pancreatitis and pancreatic cancer. Do not use these weight loss drugs if you have a personal or family history of MTC or MEN2.

Due to how GLP-1s slow down digestion, your risk of GI issues increases. This may include bowel obstructions and gastroparesis (when food gets stuck in your digestive system).

Zepbound vs. Ozempic: How to find success with weight loss drugs with a registered dietitian

Whether you're taking Zepbound or Ozempic, when it comes to weight management, things can get confusing and overwhelming really quickly. Losing weight is hard enough, but navigating a new weight loss drug alongside it can feel even more complicated.

One of the best ways to succeed with weight loss or a weight-related health condition like type 2 diabetes is with the support of a registered dietitian. A dietitian comes along with you every step of your weight loss journey, from an initial intake assessing your current lifestyle and goals to creating a personalized meal plan to answering any question you may have along the way.

And it's never been easier to find a qualified weight loss dietitian thanks to Fay. Fay has a database of vetted, board-certified RDs, many of whom specialize in weight loss and diabetes. With their support and expertise, you can achieve sustainable weight loss outcomes with or without weight loss medication.

Connect with a dietitian specializing in GLP-1s and weight loss now.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.