DECISION GUIDE · UPDATED 2026-06-07
Best GLP-1 for Weight LossWegovy · Zepbound · Compound semaglutide · Compound tirzepatide
TL;DR. For pure trial weight-loss magnitude, Zepbound (tirzepatide) leads at approximately 20.9% mean body weight loss at 72 weeks. Wegovy (semaglutide) is the most studied and most insurance-friendly GLP-1 mono-agonist at approximately 14.9% mean at 68 weeks. Compound semaglutide remains the lowest-cost option historically but the legal scope narrowed after the FDA declared the shortage resolved in early 2025.
Top Pick · Highest Weight Loss
Zepbound (Tirzepatide)
Largest mean weight loss in published trials (SURMOUNT-1: ~20.9% at 72 weeks at 15 mg dose). Dual GIP and GLP-1 receptor agonism; the GIP component drives additional reduction beyond GLP-1 mono-agonists. FDA-approved 2023 for chronic weight management.
Full Zepbound reference →
Runners-up
Wegovy
Most Studied
Semaglutide for weight management. STEP-1: ~14.9% mean weight loss at 68 weeks. Strongest real-world evidence base and most clinician familiarity. 2.4 mg maintenance dose.
Full Wegovy reference →
Compound Semaglutide
Lowest Cost
Same active molecule as Wegovy/Ozempic, historically $200-400 per month vs $1,350 for the brand. Legal scope tightened after FDA shortage resolution in 2025; supply is narrower in 2026.
Full compound semaglutide reference →
Mounjaro
Same Molecule as Zepbound
Tirzepatide labeled for Type 2 diabetes. Mean weight loss off-label tracks Zepbound. Insurance coverage is better than Zepbound because the diabetes indication is on most formularies.
Full Mounjaro reference →
Compound Tirzepatide
Budget Tirzepatide
Same active as Zepbound/Mounjaro. Historically $250-500 per month from 503A pharmacies. Legal scope narrowed after FDA tirzepatide shortage resolution in late 2024.
Full compound tirzepatide reference →
Decision tree
- Maximum weight loss is the top priority and budget is open: Zepbound. Verified largest trial effect.
- Insurance only covers Type 2 diabetes: Mounjaro (tirzepatide) if you have a T2D diagnosis; Ozempic if you prefer semaglutide.
- Cost is the dominant constraint and a prescriber will support it: Compound semaglutide or compound tirzepatide while supply is available. Verify the pharmacy's Certificate of Analysis at every refill.
- Established record with longest real-world data trail: Wegovy. Most clinician familiarity.
- Already on semaglutide and plateauing: Switch to tirzepatide. Restart titration at 2.5 mg per week and step up.
Side-by-side at a glance
| Drug | Active | Mean weight loss | Target dose | US list cost |
|---|---|---|---|---|
| Zepbound | Tirzepatide | ~20.9% (72wk) | 15 mg/wk | ~$1,060/mo |
| Wegovy | Semaglutide | ~14.9% (68wk) | 2.4 mg/wk | ~$1,350/mo |
| Mounjaro | Tirzepatide | ~15-20% off-label | 15 mg/wk | ~$1,000/mo |
| Ozempic | Semaglutide | ~10-12% off-label | 2.0 mg/wk | ~$900/mo |
| Compound Semaglutide | Semaglutide | Tracks Wegovy | 2.4 mg/wk | ~$200-400/mo |
| Compound Tirzepatide | Tirzepatide | Tracks Zepbound | 15 mg/wk | ~$250-500/mo |
Open the dose calculators
Research informational use only. Not medical advice. Compounded GLP-1 products are not FDA-approved finished drugs and have regulatory restrictions following FDA shortage resolution in 2025. Consult a qualified healthcare provider for any clinical decision.
Frequently asked
Which GLP-1 produces the most weight loss?
Tirzepatide (Zepbound) produces the largest mean weight loss in published trials at approximately 20.9% at 72 weeks (SURMOUNT-1). Semaglutide (Wegovy) is the most studied GLP-1 mono-agonist at approximately 14.9% mean at 68 weeks (STEP-1). Retatrutide is in late-stage trials with even larger reductions reported.
How long does it take to reach the target dose?
Wegovy and Ozempic reach maintenance in approximately 16 to 17 weeks. Zepbound and Mounjaro take approximately 21 to 24 weeks due to six titration steps rather than four or five.
Is compounded semaglutide still available?
The FDA declared the semaglutide shortage resolved in early 2025, narrowing legal 503A compounding. Some 503A pharmacies still produce it for individual patient prescriptions when a clinical reason justifies a non-approved formulation, but the broad shortage-driven supply has retreated.
How much does Zepbound cost without insurance?
Zepbound has a US list price of approximately $1,060 per month. Eli Lilly offers a self-pay vial program at approximately $549 to $699 per month for select dose strengths. Insurance coverage for the obesity indication is patchy in 2026.
Wegovy vs Ozempic, are they the same thing?
Both contain semaglutide. Wegovy is FDA-approved for chronic weight management with a 2.4 mg maintenance dose. Ozempic is FDA-approved for Type 2 diabetes with maintenance up to 2.0 mg per week. The active drug is identical; the labeling, dose, and pen strengths differ.
Can I switch from Wegovy to Zepbound?
Switching is common when patients plateau on semaglutide. Most protocols restart titration at the new product's starting dose (2.5 mg tirzepatide weekly for Zepbound) and step up over the standard 21-week ladder. Discuss the switch with your prescriber.
For research informational use only. Brand names are trademarks of their respective owners. Cost figures reflect US list price as of 2026.