Tirzepatide and semaglutide are type- 2 diabetes medications often used for weight loss management. Tirzepatide is less expensive and may be more effective. However, the drug is still new, and more research is needed.
Using medications for weight loss is becoming more common. Doctors sometimes prescribe newer type 2 diabetes drugs to help with weight management. This use is “off-label,” meaning that doctors prescribe the medicine for a use different from the one the Food and Drug Administration (FDA) approved.
Regardless of which medication is prescribed, both drugs can be highly effective in aiding patients lose weight by slowing down the process of digestion. This physiological phenomenon subsequently leads to a feeling of fullness and decreased food intake.
Tirzepatide vs. semaglutide
When you eat, your digestive tract releases the hormone glucagon-like peptide-1 (GLP-1), which prompts your body to secrete more insulin. This hormone can also send signals to your brain that you are full. Semaglutide is a GLP-1 receptor agonist that mimics this hormone, making you feel less hungry.
Semaglutide is FDA-approved to treat type- 2 diabetes under the brand names Ozempic and Rybelsus. Wegovy is the only semaglutide drug that Trusted Source approves for use in weight management. However, doctors may prescribe the other brand-name drugs off-label for weight loss.
Tirzepatide is sold under the brand name Mounjaro, which is also approved only to treat type 2 diabetes. However, tirzepatide may be prescribed for weight loss under the brand name Zepbound.
Note that semaglutide is available as either an oral tablet or an injection, whereas tirzepatide is available only as an injection.
Which is better for weight loss: semaglutide or tirzepatide?
Some recent studies have compared semaglutide and tirzepatide for weight loss. Research studies from 2024, 2023, and 2021 suggest that tirzepatide may result in more significant weight loss than semaglutide. However, there are some important caveats to these studies.
The doses of semaglutide and tirzepatide given to participants were not equal. Semaglutide and tirzepatide work slightly differently; Hence, researchers chose comparable dose levels. However, the dose of tirzepatide was higher, which may have affected the results of the study.
Tirzepatide is currently FDA-approved for use in people who are overweight or have a history of obesity, whether or not type 2 diabetes is present. However, studies suggest that semaglutide may be an effective weight loss treatment for individuals without a history of diabetes.
Conclusion: Which should I use - tirzepatide or semaglutide?
In the class of incretin mimetics, there are many predisposing factors: risk of severe heart disease or kidney disease, history heart disease (previous heart attack or stroke), A1C and weight loss needs, presence of obstructive sleep apnea, costs and insurance coverage, and patient and doctor preference. These are all important considerations to take when determining which drug to use.
You and your healthcare provider should discuss your individual needs when selecting a treatment for type- 2 diabetes or weight loss. Every health history is unique in and of itself. What may be in the best interest of one individual, may require a different protocol for others. You might think about:
Cardiovascular risk factors: Semaglutide (Ozempic and Wegovy) has been shown to reduce cardiovascular risks like heart attack, stroke and heart-related death in patients with established heart disease. Cardiovascular outcomes studies for tirzepatide are still ongoing.
Risk for worsening kidney disease: At this time, Ozempic (semaglutide) is the only GLP-1 type drug approved to reduce the risk of worsening kidney disease and cardiovascular death in patients with type- 2 diabetes and chronic kidney disease.
Use for obstructive sleep apnea (OSA) in obesity: In December 2024, the FDA approved Zepbound (tirzepatide) as a treatment for moderate to severe obstructive sleep apnea (OSA) in adults with obesity.
Side effects: Studies have shown tirzepatide may have a more significant impact on weight loss and A1C levels, but higher doses of tirzepatide are also linked to more severe stomach side effects such as nausea, vomiting, and diarrhea.
Dosage form: Most of these products are available as injections. If you prefer not to use an infusion for the treatment of type- 2 diabetes, Rybelsus is an oral form of semaglutide that is taken by mouth once daily.
Use in children: All semaglutide and tirzepatide products are approved for use in adults. Currently, only Wegovy is approved for weight loss in children 12 years and older.