Wegovy vs Zepbound
Side-by-side comparison based on STEP-1 and SURMOUNT-1 phase 3 trial data plus April 2026 pricing.
Wegovy
semaglutide (injection)
Peak weight loss14.9%
TrialSTEP-1
Administrationinjection
FDA statusweight-loss
List price$1,349/mo
Zepbound
Higher efficacytirzepatide (injection)
Peak weight loss22.5%
TrialSURMOUNT-1
Administrationinjection
FDA statusweight-loss
List price$1,059/mo
Weight loss comparison (220 lbs starting weight)
% of body weight lost over 18 months, modeled from phase 3 trial data
Monthly cost by payment channel
| Channel | Wegovy | Zepbound | Difference |
|---|---|---|---|
| Covered by insurance ($25–150 copay) | $63 | $88 | $25 (Wegovy cheaper) |
| Manufacturer self-pay (LillyDirect / NovoCare) | $499 | $349 | $150 (Zepbound cheaper) |
| Telehealth — brand name (Hims, Ro, Found) | $449 | $499 | $50 (Wegovy cheaper) |
| Cash retail (full list price) | $1,349 | $1,059 | $290 (Zepbound cheaper) |
Wegovy pros and cons
Pros
- ✓ FDA-approved specifically for weight loss
- ✓ Robust 14.9% average weight loss in STEP-1
- ✓ Wide telehealth and pharmacy availability
- ✓ Once-weekly injection (good adherence)
Cons
- ✗ High list price ($1,349/mo without coverage)
- ✗ Insurance often denies for weight loss without comorbidity
- ✗ Mild-to-moderate GI side effects common during titration
- ✗ Lower efficacy than tirzepatide-based alternatives
Zepbound pros and cons
Pros
- ✓ Highest efficacy of any FDA-approved GLP-1 (22.5% in SURMOUNT-1)
- ✓ Dual GLP-1/GIP mechanism
- ✓ LillyDirect self-pay vials starting around $349/mo for lower doses
- ✓ FDA-approved for chronic weight management
Cons
- ✗ List price still high ($1,059/mo)
- ✗ Insurance coverage varies more than for Wegovy
- ✗ GI side effects can be more pronounced at higher doses
- ✗ Periodic supply constraints during demand spikes
Common side effects
Wegovy
- • Nausea
- • Diarrhea
- • Constipation
- • Vomiting
- • Headache
Zepbound
- • Nausea
- • Diarrhea
- • Constipation
- • Vomiting
- • Decreased appetite
Which should you choose: Wegovy or Zepbound?
Choose Wegovy if: you prefer this medication after consulting your prescriber.
Choose Zepbound if: you want maximum weight loss (22.5% vs 14.9%); cash-pay cost matters most to you.
Final decisions should always be made with a licensed prescriber. This is educational content only.
Medical disclaimer: This calculator provides estimates only based on phase 3 clinical trial data and publicly listed prices. It is not medical advice. Real-world weight loss varies significantly. Consult a licensed healthcare provider before starting any medication.