Ozempic® vs. Zepbound® for weight loss: Which one works best in 2025?

What you’ll learn:     

• Ozempic^® contains semaglutide, which mimics GLP-1 to regulate appetite and blood sugar, while Zepbound^® contains tirzepatide, which mimics both GLP-1 and GIP hormones.
• Zepbound^® is FDA-approved for weight management, while Ozempic^® is approved for diabetes and can be prescribed off-label for weight loss.
• Choosing between Ozempic^® and Zepbound^® depends on individual weight loss goals, side effect tolerance, insurance coverage, and cost.

With more GLP-1 medications being prescribed for weight loss, figuring out which one is right for you can feel like a lot to sort through. Between the high costs, tricky insurance rules, and occasional shortages, the decision isn’t always straightforward. Plus, many of these medications work in similar ways, which only adds to the confusion.

Take Ozempic^® and Zepbound^®, for example—two of the most talked-about GLP-1 medications. While they have a lot in common, key differences could make one a better fit for you, especially if weight loss is your main goal. Understanding how they work, what they cost, and how easy they are to get can help you make the best choice. Let’s break it down.

Ozempic^® vs. Zepbound^®: How do they work?

Both Ozempic^® and Zepbound^® fall under the GLP-1 receptor agonist category, but they have different active ingredients that set them apart. Ozempic^® contains semaglutide, while Zepbound^® contains tirzepatide—and that difference matters when it comes to weight loss. Let’s look at them both:

• Semaglutide: This medication mimics the GLP-1 hormone, which helps curb appetite, slow digestion, and regulate blood sugar. Ozempic^® is one of the most well-known semaglutide medications. It’s approved to treat type 2 diabetes and can be prescribed off-label for weight loss. Its counterpart, Wegovy^®, is FDA-approved for weight management and to prevent cardiac events like heart attack and stroke.
• Tirzepatide: Tirzepatide, on the other hand, targets two hormones, GLP-1, like semaglutide, and another named GIP (glucose-dependent insulinotropic polypeptide). This dual-action approach may lead to greater weight loss for some people. Zepbound^® is FDA-approved for weight loss and also for managing obstructive sleep apnea (OSA). Its sister medication, Mounjaro^®, is FDA-approved for type 2 diabetes but is frequently prescribed off-label for weight loss, similar to Ozempic^®.

Ozempic^® vs. Zepbound^®: What are the similarities?

Even though Ozempic^® and Zepbound^® contain different active ingredients, they share several key similarities when it comes to how they work and who they’re for

• How they’re taken: Both medications are taken as a once-weekly injection that you administer yourself in the upper arm, thigh, or stomach. 
• Who can take them: Both Ozempic^® and Zepbound^® can be prescribed for weight loss to people who meet certain BMI thresholds. Zepbound^® can also be prescribed to treat OSA.
• Similar side effects: Nausea, vomiting, diarrhea, constipation, and fatigue are common for both drugs, especially in the early weeks of treatment. They also come with similar risks for more serious side effects, which we’ll dive into later.
• Highly effective: One of the biggest advantages of these medications is how effective they can be for weight loss, especially when combined with a balanced diet and regular exercise. Studies show that pairing either Ozempic^® or Zepbound^® with healthy lifestyle habits leads to even better results than medication or lifestyle changes alone.

Ozempic^® vs. Zepbound^®: What are the differences?

Ozempic^® and Zepbound^® are very similar, but they do have their differences, which may make one a better choice for you. Let’s take a closer look at what’s different:

• They are made by two different pharmaceutical companies: Ozempic^® is manufactured by Novo Nordisk, and Zepbound^® is produced by Eli Lilly. 
• Two different medications: Again, while the action is similar, they are two different drugs: semaglutide and tirzepatide. One or the other might work better for you.
• Pricing without insurance: Without insurance, Zebound^® may cost more. Ozempic^® costs about $998 per month, while Zepbound^® costs about $1,060 per month.
• Insurance coverage:  Ozempic^® is rarely covered for weight loss. It’s more likely to be covered for diabetes treatment. Since Zepbound^® is FDA-approved for weight loss, it is more likely to be covered for this use, though it’s still rare.
• Effectiveness: Zepbound^® has the potential to result in greater weight loss than Ozempic. Your body’s response, lifestyle, and overall health goals can impact how effective the medications are. We’ll talk more about the effectiveness of these medications below.
• Alternative forms: Ozempic^® comes in a pre-loaded injectable pen. Zepbound^® also comes as a pre-loaded pen, but it is also available in vial form, offering a potentially more affordable alternative to the standard prefilled injection pens. 

Can you switch between Ozempic^® and Zepbound^®?

Yes, you can switch between Ozempic^® and Zepbound^®, but it should be done under medical supervision. Since these medications stay in the body for different lengths of time, transitioning requires proper timing.

A healthcare provider will determine the best switching strategy based on your current dose, response to treatment, and side effect tolerance. Since the medications are not identical, your doctor will typically start you at an equivalent or slightly lower dose to minimize side effects.

Why you are switching could be a deciding factor, too. Here are a few reasons to switch:

• You need more weight loss support: Zepbound^® might offer more weight loss potential for someone who has plateaued on Ozempic^®.
• You may be having uncomfortable side effects: Some people tolerate one medication better than the other.
• Your insurance may cover one and not the other: Though both are rarely covered by insurance for weight loss, if yours covers one and not the other, you may want to switch.

Ozempic^® vs. Zepbound^®: Which is better for weight loss?

When it comes to weight loss, both Ozempic^® and Zepbound^® are very effective, but how much weight you lose will also depend on diet, activity level, and overall health.

How much weight can you lose on Ozempic^® vs. Zepbound^®?

Studies suggest that tirzepatide-based medication may lead to greater weight loss than semaglutide. 

• Semaglutide (Ozempic^®): In a 68-week study, people taking semaglutide lost an average of 15% of their body weight. For a 250-pound person, this would mean a weight loss of about 37.5 pounds.
• Tirzepatide (Zepbound^®): In a 72-week study, people taking tirzepatide lost an average of 21% of their body weight. For a 250-pound person, this would translate to about 52.5 pounds.

The important thing to keep in mind is that while these medications can help you lose weight, results vary based on individual factors, dosage, and lifestyle changes. People who adopt healthier eating habits and regular physical activity alongside medication may experience even better results. Those who don’t make lifestyle changes might see less weight loss than the averages reported in studies.

How long does it take to see results?

Many people notice weight loss within the first few weeks of starting these medications. Here’s a look at what studies on Ozempic^® and Zepbound^®  say you can expect in terms of average body weight lost: 

After 3 months:

• Tirzepatide: 6% 
• Semaglutide: 4% 

After 6 months:

• Tirzepatide: 10% 
• Semaglutide: 6% 

After 1 year:

• Tirzepatide: 15% 
• Semaglutide: 8% 

While everyone has a different experience, results depend a lot on your diet and exercise habits, as well as underlying health issues. Your doctor will adjust your dose to keep you losing steady weight as tolerated.

What if I’m not losing weight on Ozempic^® or Zepbound^®?

If you’re not seeing results, you should talk to your healthcare provider to discuss your options and next steps. They’ll likely increase your dose or suggest a different medication. You might have to adjust your diet or exercise routine in order to get the best results.

Who is eligible for Ozempic^® or Zepbound^® for weight loss?

Both Ozempic^® and Zepbound^® can be used for weight loss, but only Zepbound^® is FDA-approved for this purpose. Ozempic^® will be an off-label prescription. 

Here are the BMI requirements for each GLP-1 medication:

• Zepbound^® is FDA-approved for weight loss in people with:
  • BMI ≥ 30, or
  • BMI ≥ 27 with a weight-related health condition (such as high blood pressure or high cholesterol).
  • It can also be prescribed to treat OSA.
• Ozempic^® is not FDA-approved for weight loss, but many healthcare providers prescribe it off-label for people who meet the same BMI criteria as above.

Who can’t take Ozempic^® or Zepbound^®?

Ozempic^® or Zepbound^® are considered safe, but if you have certain conditions or family history, you shouldn’t take them, including:

• A personal or family history of medullary thyroid carcinoma (MTC) – MTC is a rare type of thyroid cancer.
• Multiple endocrine neoplasia syndrome type 2 (MEN 2) – MEN 2 is a genetic condition that increases the risk of thyroid tumors.
• A history of pancreatitis – These medications may increase the risk of pancreas inflammation.
• Severe kidney disease – Ozempic^® and Zepbound^® can cause dehydration, which may worsen kidney function.
• Severe gastrointestinal issues – If you have gastroparesis (delayed stomach emptying) or other severe digestive conditions, you shouldn’t take these medications, as they can worsen these issues.

You also can’t take Ozempic^® or Zepbound^® if you are pregnant, plan to become pregnant, or are breastfeeding. Read more about what you need to know about Ozempic^® and pregnancy.

If you take Zepbound^® or Ozempic^® to lose weight, will you need to keep taking them forever?

It depends. These medications are approved for long-term use, but how long you should stay on them depends on individual health goals and doctor recommendations. Stopping can lead to weight regain, especially if you haven’t made lifestyle changes that you can stick with. GLP-1 medications like Zepbound^® and Ozempic help control appetite and blood sugar but don’t permanently change how your body regulates weight. Some people stay on a maintenance dose long-term to reduce appetite. 

The best way to maintain your results is to create a balanced diet and move your body regularly while taking them. A structured plan, like Noom, can help you build lasting behaviors.

If you stop taking Zepbound^® or Ozempic^®, here’s what you should know:

• Some regain weight after stopping, as hunger and appetite control return to pre-medication levels. 
• Gradually tapering off may reduce this risk. A study found that people who tapered off semaglutide maintained a stable weight for 26 weeks.
• Restarting the medication may be possible, but it’s best to do so under medical supervision.

A combination of medication, healthy eating, and behavior change can help you get the best long-term results. Zepbound and Ozempic^® can be tools for weight loss, but maintaining progress comes down to sustainable lifestyle changes.

Ozempic^® vs. Zepbound^®: Dosage and administration

Ozempic^® and Zepbound^® are both taken as once-weekly injections you give yourself. Though that sounds tricky at first, most people find the process easy and relatively painless. They are both injected under the skin in the abdomen, thigh, or upper arm on your chosen day each week. The needle is tiny, and most people report only minor discomfort when injecting. 

Both come as prefilled pens, though Zepbound^® also comes in a vial and syringe format. The difference is with prefilled pens, you push a button, and the correct dose is injected. With the vial and syringe, you will carefully measure the medication yourself by pulling back on the syringe and then injecting the medication. Both Ozempic^® and Zepbound^® should be refrigerated to maintain freshness.

Here’s how they are dosed:

• Ozempic^®: Starts at 0.25 mg once weekly and is increased as tolerated to continue losing steady weight up to 2 mg. Your doctor will adjust the dose slowly to prevent uncomfortable side effects.
  • If a higher dose is needed, you must switch to Wegovy^®, which contains up to 2.4 mg of semaglutide.
• Zepbound^® (tirzepatide): Zepbound^® begins at 2.5 mg once weekly and can be increased to a maximum of 15 mg as needed and tolerated.
  • Zepbound^®’s vial and syringe format is available in 2.5 mg, 5 mg, 7.5 mg, and 10 mg doses. (It tends to cost less than the pre-loaded pen for people without insurance coverage, which we’ll go into below.)

Ozempic^® vs. Zepbound^®: Costs

What you pay out-of-pocket for Zepbound^® or Ozempic^® will depend on your insurance coverage, the dose you need, pharmacy pricing, and manufacturer savings programs. Here’s what to expect:

• Ozempic^® (0.5 mg, 1 mg, or 2 mg.): As we noted above, the list price is about $998 per month and doesn’t increase as your dose increases. The only exception is f you need to go beyond the 2 mg dose. Then you will have to move to the 2.4 mg dose of Wegovy^®, which costs more than Ozempic^® ($1,350 per month without insurance). Actual costs will vary based on insurance coverage and pharmacy location. Learn more about what Ozempic^® might cost you in 2025. 
• Zepbound^®: Zepbound^® comes with a pricing structure different from that of Ozempic^® because it is available in two forms: a pre-loaded injection pen and a vial and syringe format.
  • Injector pen (2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg): The list price for the pen is around $1,086 per month and doesn’t increase as your dose increases. Insurance coverage and pharmacy location will determine your out-of-pocket cost. 
  • The vial and syringe format, available through the manufacturer’s Lilly Direct program, is less expensive if you don’t have insurance coverage. Lilly announced lower prices and additional doses in February 2025:
    • $349 for 2.5 mg
    • $499 for 5 mg, 7.5 mg, 10 mg 

Ozempic^® vs. Zepbound^®: Side effects

Ozempic^® and Zepbound^® share similar side effects that range from more frequent and mild to rare but serious health concerns. Some of the effects are caused by rapid weight loss in general. Let’s take a look at what you can expect. 

Common side effects

Most people experience these mild to moderate side effects when first starting treatment or when their dose is increased. They tend to subside as the body adjusts to the medication:

• Nausea
• Vomiting
• Diarrhea or constipation
• Stomach pain or bloating
• Fatigue

Rare but serious side effects

Ozempic^® and Zepbound^® are considered safe, but they do have some potentially serious side effects associated with them. If you experience, or think you are experiencing, any of the below symptoms, you should seek immediate medical attention. These include:

• Pancreatitis: Symptoms include severe abdominal pain that radiates to your back, with or without vomiting. 
• Vision changes: If you notice any sudden changes in your vision while taking Ozempic^®  or Zepbound^®, get immediate medical attention.
• Low blood sugar (hypoglycemia): Low blood sugar is most likely in people who are also taking medications for diabetes. Symptoms include dizziness, shakiness, blurred vision, and a fast heartbeat. 
• Kidney problems: Diarrhea, nausea, and vomiting can cause dehydration and worsen kidney issues. Go to the ER if you experience decreased urination, swelling in the ankles or legs, fatigue, or shortness of breath.
• Gallbladder problems: Symptoms include upper abdominal pain, fever, jaundice, or clay-colored stools. 
• Allergic reaction: Symptoms include swelling of the face, lips, tongue, or throat, difficulty breathing or swallowing, or a rapid heartbeat. Get immediate medical attention if you’re having an allergic reaction. 
• Thyroid tumors or cancer: Be alert for a lump or swelling in the neck, difficulty swallowing, or shortness of breath. (This connection has only been established in animal studies.) 
• Mood changes: Watch for any new or worsening mental health symptoms, such as depression. If you have suicidal thoughts, get help immediately. Note that this side effect is specific to Zepbound^®.

Other side effects

Some side effects have been widely reported but are not officially listed by manufacturers. These are generally attributed to rapid weight loss and include these symptoms:

• Muscle loss – Losing weight too quickly can result in loss of muscle mass. This can also cause what’s known as “Ozempic face,” the name given to a gaunt or aged appearance due to rapid weight loss. The best thing you can do to prevent muscle loss is to lose weight gradually (1 to 2 pounds per week), incorporate strength training into your workout routine, and eat enough protein. 
• Hair thinning or shedding – Some people report increased hair loss or thinning, likely due to nutritional changes from rapid weight loss. Again, maintaining nutrition while losing weight is important,
• Feeling cold – A drop in body temperature regulation is common with significant weight loss. Besides quick fixes like adding a layer or turning up your heat, make sure you’re eating enough nutrient-rich foods to help your body keep itself warm.

Ozempic^® vs. Zepbound^®: Which one is safer?

Again, both Ozempic^® and Zepbound^® are safe when you take them as directed, though side effects vary, and both have serious issues associated with them in rare cases. Studies show that the benefits of taking these medications to reduce BMI and treat other health conditions outweigh their risks in many cases. 

Managing side effects and building sustainable habits is key. If you get your medication through Noom Med, your clinician will help you work through side effects. You’ll also get a diet and exercise plan to help improve your health while taking the medication. If you get your medication through your personal doctor, use Noom’s GLP-1 Companion to help you make lifestyle changes and maintain long-term success.

Learn more about the safety of Ozempic^® and Zepbound^®.

Zepbound^® or Ozempic^®: Which is right for me?

Choosing between Zepbound^® or Ozempic^® isn’t just about weight loss—it’s also about your budget, insurance coverage, weight loss goals, and availability. These factors can make a big difference in which medication is the better choice for you. Let’s go through them.

	Ozempic®	Zepbound®
Pricing (without insurance per month)	List price: $997.58 (all doses cost the same)	List price: $1,060 (prefilled pen, all doses)Vial and syringe option through Lilly Direct:2.5 mg: $3495 mg, 7.5 mg,10 mg: $499
Weight loss goals	People lost an average of 15% of their body weight in a 68-week study.	People lost an average of 21% of their body weight in a 72-week study.
Insurance coverage	More likely to be covered for diabetes, rarely for weight loss.	Zepbound® is more likely to be covered for weight loss than Ozempic®, but this is still rare.
Availability	The FDA has declared the shortage of semaglutide medications to be resolved. It might still be difficult to find Ozempic® in stock due to its popularity.	All tirzepatide medications are off the FDA shortage list. The availability of Zepbound® can still be spotty due to its popularity.

Alternatives to Ozempic^® and Zepbound^®

If Ozempic^® and Zepbound^® aren’t the right fit due to cost, insurance coverage, or side effects, there are several other options you can consider for weight loss. These include other GLP-1 medications and other weight loss medications. Let’s take a look at some of the options.

Semaglutide-based alternatives

There are other medications that contain semaglutide and work similarly to Ozempic^®. 

• Wegovy^®: As we’ve mentioned, Wegovy is the same medication as Ozempic^® under a different name but can be prescribed in a higher dose. It’s approved for weight management in people who meet the same BMI criteria as Zepbound^® and to prevent cardiac events. The list price for Wegovy^® is $1,349 per month without insurance, so it’s unlikely to be a cheaper option unless you have coverage.
• Rybelsus^®: This medication is the only FDA-approved GLP-1 in pill form. It’s FDA-approved to treat type 2 diabetes. If BMI requirements are met, it can be prescribed off-label for weight loss. The list price for Rybelsus^® is $997 per month.

Compounded semaglutide 

If you qualify for Noom Med, you can ask your clinician about compounded semaglutide* through Noom GLP-1^Rx. It contains the same active ingredient as Ozempic^® and Wegovy^® but can be more affordable for some people. Your clinician can determine if it is the right medication for you and then prescribe it if needed. It starts at $149 for the first month and then costs $279 per month, billed in three-month increments. This price includes medication delivered to your door, unlimited access to a clinician, and a weight loss plan designed specifically for you. You’ll also get access to all of Noom’s trackers, tools, and community support. Here’s how you can find out if a prescription for compounded semaglutide is right for you.

Tirzepatide-based alternatives

Tirzepatide is also available under another brand name, Mounjaro^®. The only difference between Mounjaro^® and Zepbound^® medications is their FDA approval. Like Ozempic®, Mounjaro® is FDA-approved for type 2 diabetes but can be prescribed off-label for weight loss. Without insurance, it costs about $1,080 per month. Zepbound^® and Mounjaro^® are prescribed at the same doses.

Liraglutide-based alternatives

Liraglutide is another medication that mimics GLP-1, but it requires daily injections rather than weekly. Here are the medications that contain it and what they are approved for:

• Saxenda^®: Saxenda^® is FDA-approved for weight loss and has a list price of $1,349 per month without insurance.
• Victoza^®: Victoza^® is FDA-approved to treat type 2 diabetes and can be prescribed off-label for weight loss. The list price for Victoza^® is $815 for a 3-pen package.
• Generic liraglutide has recently been FDA-approved for managing type 2 diabetes. The current cost for generic liraglutide is $469 for two pens and $704 for three pens.

Dulaglutide-based alternative

Dulaglutide is a weekly injectable GLP-1, available under the brand name Trulicity^®. It works similarly to Ozempic^®  but targets GLP-1 receptors differently and might be less effective. Trulicity^® is FDA-approved for diabetes management and occasionally prescribed off-label for weight loss. The list price is $987 per month without insurance.

Other weight-loss medications to consider

While GLP-1 medications are a very popular choice, other weight loss medications can also be effective or more affordable for some people. Here are some of the alternatives. (Always double-check the prices at your pharmacy for the most accurate numbers.)

• Metformin – Metformin is FDA-approved for diabetes, but it can be prescribed off-label for weight loss. It can help people lose modest amounts of weight. If you qualify for Noom Med, your clinician can decide if a prescription for metformin is right for you. It will cost $59 for the first month and $89 for recurring 3-month supplies if prescribed. You’ll also get access to medical counseling, a coach, and Noom’s trackers and tools.
• Orlistat – This medication helps block fat absorption and is taken three times daily with meals. The cost can vary widely, ranging from $50 to $800 per month without insurance.
• Phentermine – Phentermine is an appetite suppressant designed for short-term use. It’s taken once daily to help reduce hunger. Prices typically range from $27 to $100 per month without insurance.
• Diethylpropion – Diethylpropion is taken one to three times daily and is used for short-term appetite suppression. Its price ranges from $40 to $85 per month without insurance.
• Naltrexone and bupropion (Contrave) – This combination drug is FDA-approved for weight management and helps reduce appetite and cravings. For people using the CurAccess™ Patient Support Program, Contrave is $99 per month with free shipping. If your insurance covers Contrave, it may cost less. Without these benefits, prices can range from $600 to $800 per month.

Ozempic^® or Zepbound^®: Choosing a weight loss medication

The bottom line is that both Ozempic® and Zepbound® are very effective for weight loss. The right choice depends on your weight loss goals, budget, and how your body reacts to the medication.

Whichever you and your doctor choose, your best chance of achieving long-term success comes from making sustainable lifestyle changes. Focusing on balanced nutrition, regular movement, reducing stress, and improving sleep will help you maintain your hard-earned results! If you’re looking for a comprehensive plan, Noom provides structured guidance, coaching, and resources to help you stay on track and build habits that last.

If you think Ozempic^® or Zepbound^® might be right for you, talk to your doctor or explore Noom Med to determine which medication will be best for you and your goals. 

*Compounded semaglutide available on the Noom platform is produced in an FDA-registered facility but not reviewed by the FDA for safety, efficacy, or quality.

Note: Ozempic^® and Mounjaro^® are not FDA-approved to treat obesity or for weight loss.