Zepbound vs Saxenda
Side-by-side comparison based on SURMOUNT-1 and SCALE phase 3 trial data plus April 2026 pricing.
Zepbound
Higher efficacytirzepatide (injection)
Peak weight loss22.5%
TrialSURMOUNT-1
Administrationinjection
FDA statusweight-loss
List price$1,059/mo
Saxenda
liraglutide (injection)
Peak weight loss8.4%
TrialSCALE
Administrationinjection
FDA statusweight-loss
List price$1,349/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 | Zepbound | Saxenda | Difference |
|---|---|---|---|
| Covered by insurance ($25–150 copay) | $88 | $63 | $25 (Saxenda cheaper) |
| Manufacturer self-pay (LillyDirect / NovoCare) | $349 | — | — |
| Telehealth — brand name (Hims, Ro, Found) | $499 | $399 | $100 (Saxenda cheaper) |
| Cash retail (full list price) | $1,059 | $1,349 | $290 (Zepbound cheaper) |
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
Saxenda pros and cons
Pros
- ✓ Most prescribing experience of any GLP-1
- ✓ Fully covered by Medicare for some indications
Cons
- ✗ Daily injection (vs weekly for newer drugs)
- ✗ Substantially lower weight loss (8.4% vs 14.9–22.5%)
- ✗ Outdated by newer molecules
Common side effects
Zepbound
- • Nausea
- • Diarrhea
- • Constipation
- • Vomiting
- • Decreased appetite
Saxenda
- • Nausea
- • Diarrhea
- • Constipation
- • Vomiting
- • Headache
Which should you choose: Zepbound or Saxenda?
Choose Zepbound if: you want maximum weight loss (22.5% vs 8.4%); cash-pay cost matters most to you.
Choose Saxenda if: you prefer this medication after consulting your prescriber.
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.