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Pick 2 or 3 medications to compare side by side.
Select 2 or 3 medications above to see them compared side by side.
The big picture
How the major categories compare before you look at individual options.
Broad ranges from clinical evidence. Individual results vary. Cost figures are approximate list prices.
Approved medications compared
Scroll horizontally to compare all 8 options. Figures from pivotal clinical trials.
| Zepboundtirzepatide | Wegovy inj.semaglutide | Wegovy pilloral semaglutide | Foundayoorforglipron | Saxendaliraglutide | Qsymiaphent. / top. | Contravenaltrex. / buprop. | Alli / Xenicalorlistat | |
|---|---|---|---|---|---|---|---|---|
| Known for | Highest average weight loss in trials | Proven heart benefits | Daily pill, proven heart benefits | Pill — take anytime, no food rules | 10+ years of safety data | Most affordable (~$30–80/mo) | Helps quiet food cravings | No prescription needed (OTC) |
| Weight loss (trial avg) | Up to 20.9% | Up to 14.9% | Up to 16.6% | Up to 12.4% | Up to 8% | Up to 9.8% | Up to 9.3% | Up to 8.5% |
| Real-world example | ~46 lbs (220 lb person) | ~33 lbs | ~37 lbs | ~27 lbs | ~18 lbs | ~22 lbs | ~20 lbs | ~19 lbs |
| How you take it | Weekly injection | Weekly injection | Daily pill | Daily pill | Daily injection | Daily capsule | Twice-daily tablet | 3× daily with meals |
| Approx. cost/month | $500–$1,100 | ~$1,350 | ~$149 | $149–$349 | $1,000–$1,400 | $30–$250 | $100–$400 | $40–$400 |
| Quit due to side effects | ~6% | ~7% | ~5% | ~8% | ~9% | ~13% | ~9% | ~12% |
| Prescription needed | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Rx / OTC |
| FDA approved | 2023 | 2021 | 2025 | 2026 | 2014 | 2012 | 2014 | 1999 / 2007 OTC |
| Detail page | Read more → | Read more → | Read more → | Read more → | Read more → | Read more → | Read more → | Read more → |
All figures from published clinical trials at highest approved dose. Individual results vary considerably.
What matters when choosing
People tend to weigh these factors differently — there is no single right answer.
Weight loss
Ranges from ~7% to ~21% depending on treatment
Heart benefits
Some drugs have proven heart benefit
Cost
From ~$30/mo (generic pill) to ~$1,350/mo (injection)
Convenience
Daily pill, weekly injection, or with-meal timing
Side effects
Nausea is common early on — severity and duration vary
Food & hunger
How much hunger and food noise affects your daily life
These factors matter differently to different people. This site helps you understand the differences — it does not recommend a specific option.
Head-to-head comparisons
Quick comparisons
Oral Semaglutide vs Orforglipron
Two GLP-1 pillsKey trade-off: Oral semaglutide produces higher weight loss and has proven heart benefit, but requires a strict 30-minute fast before eating. Orforglipron has zero food timing restrictions — take it anytime and eat immediately after. No head-to-head trial exists.
Tirzepatide vs Orforglipron
Injection vs pill (both Eli Lilly)Key trade-off: Tirzepatide is a dual agonist (GIP + GLP-1) with the highest weight loss of any approved drug, but requires weekly injections and costs 6–7x more. Orforglipron is a convenient daily pill with much lower cost, but produces lower weight loss with a single-pathway (GLP-1 only) mechanism.
Tirzepatide Injection vs Oral Semaglutide
Injection vs pillKey trade-off: Tirzepatide produces ~4 percentage points more weight loss through a dual-hormone mechanism but requires weekly injection and costs 7x more self-pay. Oral semaglutide has proven heart protection and is dramatically cheaper ($149/mo), but needs a 30-minute daily fast. Many people start with the pill and switch to the injection after 3–6 months.
All figures from separate clinical trials at maximum approved dose. No head-to-head trials exist between these pairs. Individual results vary.
Compare by what matters to you
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