Best GLP-1 Medications for Weight Loss: Complete Comparison

Among the options listed in the reference file, tirzepatide currently has the highest average weight-loss result in named obesity trials. Zepbound is the tirzepatide brand approved for chronic weight management, per FDA prescribing information. Tirzepatide is a dual GIP/GLP-1 receptor agonist, which makes it mechanistically different from semaglutide and liraglutide.

The main number to cite is from the SURMOUNT-1 trial published in NEJM in 2022: average weight loss reached 20.9% at the highest 15 mg dose over 72 weeks. The reference file also notes SURMOUNT-2 at 14.7% in adults with type 2 diabetes and SURMOUNT-3 at 26.6% when combined with intensive lifestyle intervention. Those are average trial outcomes and should never be presented as guaranteed individual results.

Per FDA prescribing information, tirzepatide is a weekly injection and has common side effects including nausea, diarrhea, decreased appetite, vomiting, constipation, and dyspepsia. The boxed warning about thyroid C-cell tumors observed in rodents and other safety warnings still apply, so higher average trial efficacy does not automatically mean it is the right fit for every patient.

Wegovy is the semaglutide product approved for chronic weight management, per FDA prescribing information. Semaglutide is a GLP-1 receptor agonist and is also the active ingredient in Ozempic, though Ozempic itself is approved for type 2 diabetes rather than weight loss. That brand distinction matters when comparing options or checking insurance coverage.

The best-known semaglutide result is the STEP 1 trial published in NEJM in 2021. It reported average 14.9% body weight loss over 68 weeks versus 2.4% with placebo. Additional results in the reference file include STEP 2 at 9.6% in adults with type 2 diabetes and STEP 3 at 16% with intensive behavioral therapy. The SELECT trial later supported an added cardiovascular indication for Wegovy.

Semaglutide is also a weekly injection, which may appeal to patients comparing it with daily liraglutide. Common side effects include nausea, diarrhea, vomiting, constipation, and abdominal pain per FDA prescribing information. Like other GLP-1 medications, it requires a conversation with a healthcare provider about boxed warnings, contraindications, and how the trial population compares with your own health profile.

Liraglutide is the older GLP-1 option in this group. Saxenda is approved for chronic weight management, while Victoza is approved for type 2 diabetes. The reference file highlights one major practical difference immediately: liraglutide is a daily injection instead of a weekly injection.

The main clinical-trial figure cited in the reference file is the SCALE trial, which reported average 8% body weight loss over 56 weeks versus 2.6% with placebo. That places liraglutide behind the newer weekly options in the trial ranking summarized here, but it remains part of the FDA-approved landscape and may still be relevant depending on availability, insurance, tolerability, or clinician preference.

The reference file lists common liraglutide side effects as nausea, diarrhea, constipation, and vomiting. Patients comparing liraglutide with semaglutide or tirzepatide should talk with their healthcare provider about the tradeoff between daily dosing, older trial averages, and coverage options.

Compounded GLP-1 medications are not FDA-approved, according to the reference file. They may use semaglutide or tirzepatide active ingredients, but compounded does not mean generic. The legal status of compounding has been tied to FDA drug shortage designations and has changed over time.

As of early 2025, the reference file notes semaglutide was removed from the shortage list in February 2025, making compounding legality more uncertain, while tirzepatide had been removed in December 2024 and later re-added. That means clinics and patients should not assume the legal environment is stable. They should verify current status and discuss options with a healthcare provider.

The main reason compounded options come up in comparisons is cost. The reference file says compounded semaglutide is typically about 50-80% cheaper than brand-name versions, with approximate monthly ranges of $200-500 for semaglutide and $300-600 for tirzepatide. Lower price does not remove the need to check pharmacy licensing, accreditation, and medical oversight.

Zepbound: about $1,000-1,100/month without insurance as of early 2025.

Wegovy: about $1,300-1,400/month without insurance as of early 2025.

Saxenda: about $1,300-1,500/month without insurance as of early 2025.

Compounded semaglutide: about $200-500/month; compounded tirzepatide: about $300-600/month as of early 2025.

Prices vary by pharmacy and location, and compounded options have legal-status and quality caveats.

Pricing is approximate and based on the reference file as of early 2025. Prices vary by pharmacy and location. Consult your healthcare provider and pharmacy for current pricing.