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Weight Loss Drugs Compared: Ozempic, Wegovy, Mounjaro & Zepbound

February 27, 2026 · 10 min read

The weight loss drug market exploded in 2023-2024 with GLP-1 medications like Ozempic and Mounjaro. But here's what confuses people: Ozempic and Wegovy are the same drug. So are Mounjaro and Zepbound. The difference? FDA approval for weight loss vs diabetes.

This guide breaks down every major GLP-1 weight loss medication, compares effectiveness and cost, and explains which one your doctor is most likely to prescribe.

Quick Comparison Table

Drug Name Active Ingredient FDA Approved For Avg Weight Loss Monthly Cost
Wegovy Semaglutide Weight loss 15% $1,300-1,500
Ozempic Semaglutide Type 2 diabetes 10-15% $900-1,000
Zepbound Tirzepatide Weight loss 20-22% $1,000-1,200
Mounjaro Tirzepatide Type 2 diabetes 15-20% $900-1,100
Saxenda Liraglutide Weight loss 5-8% $1,300-1,500
Key Insight: Ozempic = Wegovy (same drug, different dose/approval). Mounjaro = Zepbound (same drug, different dose/approval). Doctors often prescribe the diabetes version off-label for weight loss because it's easier to get insurance coverage.

Understanding the GLP-1 Drug Family

All of these medications are GLP-1 receptor agonists (or dual GIP/GLP-1 agonists for tirzepatide). They work by:

The result: significant weight loss without traditional "diet and exercise only" struggles. Clinical trials show these drugs work better than any previous weight loss medication.

Wegovy (Semaglutide for Weight Loss)

FDA Approval: Chronic weight management in adults with obesity (BMI ≥30) or overweight (BMI ≥27) with at least one weight-related condition.

How it works: Once-weekly injection. Semaglutide mimics the GLP-1 hormone your body produces after eating, which suppresses appetite and slows digestion.

Average weight loss: 15% of body weight over 68 weeks (about 33 lbs for a 220 lb person)

Dosing: Start at 0.25 mg weekly, escalate monthly up to 2.4 mg maintenance dose

Cost without insurance: $1,300-$1,500/month

Pros:

Cons:

Ozempic (Semaglutide for Diabetes)

FDA Approval: Type 2 diabetes management

How it works: Identical to Wegovy—same active ingredient (semaglutide), same mechanism. The only difference is FDA indication and maximum dose.

Average weight loss: 10-15% (similar to Wegovy, but often prescribed at lower doses)

Dosing: 0.25 mg → 0.5 mg → 1 mg → 2 mg weekly (max dose is 2 mg, vs Wegovy's 2.4 mg)

Cost without insurance: $900-$1,000/month

Pros:

Cons:

Ozempic vs Wegovy: They're the same drug. Doctors prescribe Ozempic off-label for weight loss because insurance companies are more likely to cover a "diabetes drug" than a "weight loss drug"—even though semaglutide does both.

Zepbound (Tirzepatide for Weight Loss)

FDA Approval: Chronic weight management (November 2023)

How it works: Dual GIP/GLP-1 receptor agonist. Tirzepatide activates both GLP-1 receptors (like semaglutide) AND GIP receptors, which may enhance weight loss.

Average weight loss: 20-22% of body weight (the highest of any approved medication)

Dosing: Start at 2.5 mg weekly, escalate to 5 mg → 10 mg → 15 mg max

Cost without insurance: $1,000-$1,200/month

Pros:

Cons:

Mounjaro (Tirzepatide for Diabetes)

FDA Approval: Type 2 diabetes (May 2022)

How it works: Identical to Zepbound—same active ingredient (tirzepatide), same dual GIP/GLP-1 mechanism.

Average weight loss: 15-20% (depends on dose)

Dosing: Same as Zepbound (2.5 mg → 15 mg max)

Cost without insurance: $900-$1,100/month

Pros:

Cons:

Saxenda (Liraglutide for Weight Loss)

FDA Approval: Weight management (2014)

How it works: Older GLP-1 agonist. Same class as semaglutide but shorter-acting (requires daily injection instead of weekly).

Average weight loss: 5-8% (significantly less than Wegovy or Zepbound)

Dosing: Daily injection, escalate from 0.6 mg to 3 mg over 5 weeks

Cost without insurance: $1,300-$1,500/month

Pros:

Cons:

Which One Is Best?

Most Effective: Zepbound/Mounjaro (Tirzepatide)

Clinical trials show 20-22% average weight loss—the best results of any medication. If maximum weight loss is your priority and you can tolerate the side effects, tirzepatide wins.

Best Studied: Wegovy/Ozempic (Semaglutide)

Semaglutide has been used since 2017 (Ozempic) and has extensive safety data, including proven cardiovascular benefits. If you prioritize long-term safety data, semaglutide is the safer bet.

Best Insurance Coverage: Ozempic or Mounjaro

Insurance companies resist covering "weight loss drugs" but will cover "diabetes drugs." If you have pre-diabetes or type 2 diabetes, your doctor can prescribe Ozempic or Mounjaro, and insurance is more likely to approve it.

Best for Budget: None (They're All Expensive)

Without insurance, expect $900-$1,500/month. None of these drugs are "affordable" unless insurance covers them. Compounding pharmacies offer cheaper versions (semaglutide/tirzepatide compounded for $200-400/month), but quality and legality vary by state.

Side Effects: What to Expect

Common side effects (affecting 20-40% of users):

Less common but serious:

Important: These drugs slow digestion. If you need surgery or have severe vomiting, stop the medication and inform your doctor—there's a risk of aspiration (food in stomach during anesthesia).

Insurance Coverage: The Real Challenge

Here's the harsh reality: most insurance plans don't cover GLP-1 drugs for weight loss alone. Even though Wegovy and Zepbound are FDA-approved for obesity, many insurers consider weight loss "cosmetic" or "lifestyle."

Strategies to get insurance coverage:

  1. Have a qualifying diagnosis: Type 2 diabetes, pre-diabetes, PCOS, fatty liver disease, or cardiovascular disease make approval more likely.
  2. Try the diabetes version first: Ozempic or Mounjaro are easier to get approved than Wegovy or Zepbound.
  3. Document medical necessity: Your doctor may need to submit a "prior authorization" letter explaining why you need the medication (failed other weight loss attempts, weight-related health issues, etc.).
  4. Appeal denials: If denied, appeal. Many insurance companies approve on second request, especially with a strong doctor's letter.

Do You Have to Take It Forever?

Yes, for most people. Clinical trials show that when patients stop GLP-1 medications, they regain most of the weight within 12 months.

These drugs don't "cure" obesity—they treat it, similar to how blood pressure medications treat hypertension. Stopping the medication means losing the appetite suppression and metabolic benefits.

Exception: Some people use GLP-1 drugs as a "jumpstart" to lose significant weight, then maintain with diet and exercise. Success rates are low (most regain weight), but it's possible with strict lifestyle changes.

Which Drug Will Your Doctor Prescribe?

Most likely: Ozempic or Mounjaro

Here's why: Insurance companies approve diabetes drugs more easily than weight loss drugs. Even if your primary goal is weight loss, your doctor will probably prescribe the "diabetes version" (Ozempic or Mounjaro) to maximize your chance of insurance approval.

If you don't have diabetes: Your doctor might document "pre-diabetes" or "metabolic syndrome" to justify the prescription.

If insurance denies Ozempic/Mounjaro: Your doctor may then try Wegovy or Zepbound (the weight-loss-approved versions) and appeal with a medical necessity letter.

The Bottom Line

Talk to your doctor. The "best" drug depends on your medical history, insurance coverage, tolerance for side effects, and weight loss goals. All of these medications require a prescription and medical supervision.
Medical Disclaimer: This article is for informational purposes only and is based on FDA drug label information and published clinical trial data. Never stop, start, or change medications without consulting your healthcare provider. Weight loss drugs carry risks and are not appropriate for everyone. If you think you may have a medical emergency, call your doctor or 911 immediately. Drug-price.info does not provide medical advice, diagnosis, or treatment.