Full side-by-side comparison of Ozempic, Wegovy, Mounjaro, Zepbound, Saxenda, and Rybelsus — built from FDA prescribing information and peer-reviewed clinical trials.
Data from FDA prescribing information and STEP, SURMOUNT, and SCALE clinical trials.
| Attribute | Ozempic | Wegovy | Mounjaro | Zepbound | Saxenda | Rybelsus |
|---|---|---|---|---|---|---|
| Active Ingredient | Semaglutide | Semaglutide | Tirzepatide | Tirzepatide | Liraglutide | Semaglutide |
| Mechanism | GLP-1 RA | GLP-1 RA | GLP-1 + GIP dual agonist | GLP-1 + GIP dual agonist | GLP-1 RA | GLP-1 RA |
| FDA Indication | Type 2 Diabetes | Obesity / Weight Mgmt | Type 2 Diabetes | Obesity / Weight Mgmt / OSA | Obesity / Weight Mgmt | Type 2 Diabetes |
| FDA Approved Year | 2017 | 2021 | 2022 | 2023 | 2014 | 2019 |
| Form | Injection | Injection | Injection | Injection | Injection | Oral tablet |
| Dosing Frequency | Weekly | Weekly | Weekly | Weekly | Daily | Daily |
| Starting Dose | 0.25mg/wk | 0.25mg/wk | 2.5mg/wk | 2.5mg/wk | 0.6mg/day | 3mg/day |
| Maximum Dose | 2mg/wk | 2.4mg/wk | 15mg/wk | 15mg/wk | 3mg/day | 14mg/day |
| Avg Weight Loss (%) | ~8% | ~15% | ~20% | ~21% | ~8% | ~5% |
| Weight Loss (250 lb person) | ~20 lbs | ~37 lbs | ~50 lbs | ~52 lbs | ~20 lbs | ~12 lbs |
| Titration Length | 12 weeks | 16 weeks | 20 weeks | 20 weeks | 5 weeks | 8 weeks |
| Clinical Trial | SUSTAIN | STEP-1 | SURMOUNT-1 | SURMOUNT-1 | SCALE | PIONEER |
| Est. List Price/mo | ~$935 | ~$1,349 | ~$1,069 | ~$1,059 | ~$1,400 | ~$935 |
| With Savings Card | $25/mo | $0–$200/mo | $25/mo | $25/mo | $99/mo | $10/mo |
| Compounding Available | Sometimes* | Sometimes* | Sometimes* | Sometimes* | No | No |
| Telehealth Access | Yes | Yes | Yes | Yes | Yes | Limited |
| Medicare Coverage (T2D) | Yes | No (wt only) | Yes | OSA only | No | Yes |
| Cardiovascular Benefit | SELECT trial | SELECT trial | SURPASS-CVOT | SURPASS-CVOT | LEADER trial | Limited data |
| Manufacturer | Novo Nordisk | Novo Nordisk | Eli Lilly | Eli Lilly | Novo Nordisk | Novo Nordisk |
* Compounding availability subject to FDA shortage status. Cost estimates are ranges from various sources as of May 2026.
Ozempic and Wegovy are often confused — and for good reason. Both contain semaglutide, the same active ingredient, made by the same company (Novo Nordisk). The critical difference is dose: Ozempic's maximum dose is 2mg weekly (FDA-approved for type 2 diabetes), while Wegovy's maximum dose is 2.4mg weekly (FDA-approved specifically for chronic weight management).
Because Wegovy delivers a higher dose, it produces significantly more weight loss. The STEP-1 trial demonstrated ~14.9% average weight loss with Wegovy vs ~8% with Ozempic. Many patients who cannot get Wegovy covered by insurance turn to Ozempic as an off-label alternative — it costs similarly and uses the same pen device.
Bottom line: If your goal is weight loss, Wegovy is the appropriate on-label choice and produces better results. If cost or insurance barriers exist, Ozempic off-label is a common clinical alternative. Your provider can prescribe either for weight management.
Mounjaro and Zepbound both contain tirzepatide — the exact same molecule — made by Eli Lilly. They share identical dosing, titration schedules, and clinical efficacy. The difference is purely regulatory: Mounjaro (2022) is FDA-approved for type 2 diabetes, while Zepbound (2023) is FDA-approved for chronic weight management and obstructive sleep apnea.
From a clinical standpoint, the drugs are interchangeable. However, insurance coverage differs based on indication — Mounjaro is typically covered by plans covering T2D medications, while Zepbound coverage depends on weight management benefits. Both use Eli Lilly's savings card for $25/month for commercially insured patients.
Zepbound also received a notable first in 2024: FDA approval for obstructive sleep apnea (OSA), making it the first GLP-1 eligible for Medicare coverage for a weight-related condition beyond T2D.
Bottom line: If you have type 2 diabetes, Mounjaro may have better insurance coverage. If you're seeking treatment for obesity or weight management specifically, Zepbound is the appropriate on-label choice.
The head-to-head question the GLP-1 world had been waiting for was answered in 2024 with the SURMOUNT-5 trial: tirzepatide (Zepbound/Mounjaro) produced significantly more weight loss than semaglutide (Wegovy/Ozempic). Patients on tirzepatide 15mg lost a mean of 20.2% body weight vs 13.7% on semaglutide 2.4mg — a 47% relative difference in favor of tirzepatide.
Why does tirzepatide work better? Tirzepatide is a dual agonist, activating both GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) receptors. This dual action may produce more potent appetite suppression and metabolic effects compared to GLP-1 receptor activation alone.
However, both drugs are highly effective. A 15% weight loss with semaglutide is far superior to any prior weight loss medication, and individual responses vary. Some patients lose more with semaglutide than average; others lose more with tirzepatide. Additionally, semaglutide may have longer-term cardiovascular outcome data (SELECT trial, NEJM 2023) at this time.
Bottom line: Tirzepatide (Mounjaro/Zepbound) produces statistically superior weight loss on average. Semaglutide (Ozempic/Wegovy) is still highly effective with strong long-term cardiovascular safety data. Cost, insurance coverage, and individual response all factor into the best choice for you.