Zepbound vs Wegovy: What’s the difference?

If you are considering using weight loss medications to help you lose weight, you may have heard about Zepbound® or Wegovy®. Up until recently, Wegovy was the latest FDA-approved medication for weight loss, showing the highest percentage of weight loss seen with any medication to date. Zepbound, while not as well known, has shown even greater weight loss benefit in clinical trials and was recently FDA-approved for weight loss treatment. Keep reading if you are curious about these two medications, how they work, their possible side effects, and which could be right for you.

Zepbound or Wegovy— Which one is right for you?

Zepbound and Wegovy are both FDA approved for weight loss treatment. Despite sharing some side effects, these medications operate differently in their interaction with hormones in the body.

What is Zepbound?

Tirzepatide, marketed under the brand name Zepbound, is a once-weekly injectable medication for the treatment of obesity or overweight in adults. Zepbound is in a class of its own when it comes to weight loss medications. It is the first single molecule weight loss medication that has the ability to mimic two naturally occurring hormones in the body: Glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1). These hormones help with blood sugar control but also assist in regulating appetite and cravings.

What is Wegovy?

Wegovy is a once-weekly injectable medication classified as a glucagon-like peptide-1 (GLP-1) receptor agonist. Its mode of action involves replicating the natural hormone GLP-1 produced by our bodies, which has dual effects. GLP-1 stimulates insulin release from the pancreas, thereby lowering blood sugar levels, while also influencing the brain to decrease appetite and cravings.

Zepbound vs Wegovy: What makes them different? 

If you are considering discussing a prescription for Zepbound or Wegovy for weight loss with your doctor, it's essential to delve deeper into these medications to determine which might be the best fit for you.

FDA-approval

Both Zepbound and Wegovy are FDA approved medications for weight loss treatment. Wegovy was announced in June of 2021. More recently in November 2023, Zepbound for weight loss was announced. These medications are intended to be used in conjunction with a balanced diet and regular physical activity. Wegovy shares the same active ingredient (semaglutide) as Ozempic®, an FDA-approved medication for type 2 diabetes. Similarly, Zepbound contains the same active ingredient (tirzepatide) as Mounjaro®, another medication used to treat type 2 diabetes.

Different forms of dosage

While both medications are weekly injections, they are administered via different doses and mechanisms. Wegovy comes in a pen with varying doses. There are 5 doses of Wegovy® ranging from 0.25 mg- 2.4 mg. Typically, Wegovy is started at 0.25 mg dosage weekly for 4 weeks. The dose is increased every 4 weeks until the maximum dose of 2.4 mg weekly (Month 2: 0.5 mg weekly, Month 3: 1 mg weekly, Month 4: 1.7 mg weekly, Month 5 and beyond: 2.4 mg weekly). Each increased dose requires a new prescription from a healthcare provider. 

Zepbound also offers several dosing options, but each pen is an autoinjector with a single dose. Patients begin treatment on 2.5 mg weekly. After 4 weeks, if the medication is tolerated, the dose is increased to 5 mg weekly. This continues every 4 weeks until a maximum dose of 15 mg weekly or a maximum tolerated dose is reached. (Month 2: 5 mg weekly, Month 3: 7.5 mg weekly, Month 4: 10 mg weekly, Month 5: 12.5 mg weekly, Month 6 and beyond: 15 mg weekly). Similar to Wegovy, a new prescription is needed for every dose adjustment, highlighting the need for affordable prescriptions.

Eligibility

Zepbound and Wegovy are approved for weight loss in adults with obesity (BMI ≥30) or overweight (BMI ≥27) who also have weight-related medical problems. It should be used together with a healthy diet and exercise to promote weight loss. In addition to its approval in adults, Wegovy has an additional FDA-indication for treating pediatric patients aged 12 years and older with a BMI at the 95th percentile or greater for age and sex (obesity).*

Please note that even if you have obesity or overweight, these medications may still not be appropriate for you. Your medical history, current medications, and insurance benefits will be taken into consideration during a discussion with your doctor prior to receiving a prescription. 

Insurance coverage

Both Zepbound and Wegovy are expensive medications without insurance coverage, and insurance coverage will vary depending on a patient’s plan benefits. In some cases, insurance plans require a prior authorization. Although the medication might be included in the insurance coverage, there could still be copayments or a deductible requirement before attaining full coverage. Importantly, while a medication may be considered a covered benefit by the insurance plan, there may be specific eligibility criteria that a person must meet for it to be covered. 

To best determine what medications are covered by your plan, you can review your plan’s drug formulary which is a list of generic and brand name prescription drugs that are covered by your prescription drug plan (including Zepbound and Wegovy). You may also contact your insurance provider to understand your coverage options.

Side effects

Like all medications, both options carry potential risks of side effects that must be carefully considered.

Common Zepbound and Wegovy side effects include nausea, fatigue, vomiting, diarrhea, constipation, stomach upset, and heartburn. Patients typically start on the lowest dose of the medication to allow the body to adjust, then gradually increase the dose with close monitoring for difficulty tolerating the medication. Rare but more serious potential side effects of Zepbound and Wegovy include gallbladder disease and pancreatitis. It is always important to monitor for side effects and discuss with your healthcare provider should they arise. These medications should not be used if you are pregnant or have a personal or family history of medullary thyroid cancer or MEN 2A/2B syndrome. It has also been shown to increase the risk of stomach paralysis and potential for mood disorders.

Weight loss results

The amount of weight one can lose while taking Zepbound (or the time it takes to see results) or Wegovy will vary from person to person as weight loss is also influenced by nutrition and a variety of other factors including physical activity, medical history, and other medications you may be taking. Zepbound (tirzepatide) has shown the greatest weight loss achieved with any medication to date. In clinical trials, patients lost at least 5% of their body weight after 3 months with a combination of tirzepatide and intensive lifestyle changes. When these individuals took 15 mg tirzepatide, the highest dose, for up to a year and a half, they lost an average of 26.6% of their body weight. In terms of what to expect from Wegovy weight loss – while on the highest dose of Wegovy (2.4 mg) patients lost on average 15.8% of their total body weight after 1 year.

Selecting between Zepbound and Wegovy: Which option is right for you?

Both Zepbound and Wegovy can be highly effective medications in helping patients achieve weight loss success.

Selecting a weight loss medication is a personalized choice that involves collaboration between the patient and their healthcare provider. The decision is influenced by factors like the patient's medical background, existing medications, financial considerations, and insurance coverage. There are several reasons why a healthcare professional might recommend one medication over another: 

• Availability: weight loss medication availability is dependent on where you live in the US, and some medications may be available in your area while others are not
• Insurance Coverage: both Zepbound and Wegovy have a high out of pocket cost, and insurance coverage will vary depending on the provider
• If you have already tried Wegovy to lose weight with no success, Zepbound may still help as it targets both the GLP-1 and the GIP receptors

Navigating your weight loss journey with Zepbound or Wegovy

If you are interested in achieving sustainable weight loss, but you aren't sure how to get started, Form Health can help. When you join Form Health, you will be paired with a Board Certified Doctor specialized in weight loss and a Registered Dietitian with whom you will meet on a regular basis. After getting to know your health history and goals, they will create a personalized plan which could include medications like Zepbound or Wegovy when appropriate.

If you are interested in learning more about Form Health, send a message today for more information. You can also take our quiz to see if you are eligible to join Form Health.

*The Form Health program is only available to patients 18 and over. 

Zepbound® and its delivery device base are registered trademarks owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates.

Wegovy® is a registered trademark of Novo Nordisk A/S.

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Disclaimer: The content made available on The Form Health Medical Weight Loss Blog represents the views and opinions of the authors and not those of other entities, such as the manufacturers of products mentioned therein.