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Zepbound vs Saxenda

Quick read · 5 min

Last reviewed: September 2026Based on 2 clinical trialsEvery claim linked to source

Zepbound (tirzepatide, weekly injection) and Saxenda (liraglutide, daily injection) are both approved for weight loss in the United States. No head-to-head trial has compared these two drugs. The figures below come from separate trials, each with its own participants, length and comparison group.

At a glance

Zepbound and Saxenda compared on form, trial results, cost and reported side effects
 ZepboundSaxenda
FormWeekly injectionDaily injection
How oftenOnce-weekly injectionDaily injection
Weight loss in trialsUp to 20.9% — SURMOUNT-1 (72 weeks)Up to 8% — SCALE Obesity and Prediabetes (56 weeks)
FDA approved20232014
Made byEli LillyNovo Nordisk
How it worksA single molecule that activates two hunger-regulating signals in the brain — GIP and GLP-1 (both natural hormones released after eating).A GLP-1 analogue with a half-life of approximately 13 hours (requiring daily injection).
Monthly cost, self-pay$299–$1,086/mowith the manufacturer savings programme; list ~$1,086$1,000–$1,349/mo
Most reported reactionNausea 31% (SURMOUNT-1)Nausea 40% (SCALE Obesity and Prediabetes)

Every figure in this table is read from the same trial and label records used everywhere else on this site.

Weight loss in each drug's main trial

No head-to-head trial has compared these two drugs.

Zepbound(tirzepatide)20.9%

SURMOUNT-1 (72 weeks)

Saxenda(liraglutide)8%

SCALE Obesity and Prediabetes (56 weeks)

In clinical trials, participants taking tirzepatide lost on average up to 20.9% of their starting body weight, and participants taking liraglutide lost on average up to 8%. Those numbers come from two different studies: SURMOUNT-1 enrolled 2,539 adults with obesity or overweight with comorbidities, no type 2 diabetes over 72 weeks against placebo, while SCALE Obesity and Prediabetes enrolled 3,731 adults with obesity or overweight with comorbidities over 56 weeks against placebo. Who took part, how long each trial ran and what each drug was measured against all move the percentage, so the two figures are not a measured difference between the drugs.

Monthly cost, self-pay

The bar spans the range in each drug's price record — lowest listed price to highest.

Zepbound$299–$1,086/mo

with the manufacturer savings programme; list ~$1,086

Self-pay vials via LillyDirect from $299/month (2.5 mg) to $699/month (10–15 mg), per zepbound.lilly.com on 4 September 2026; list price ~$1,086/month; $25/month copay card for eligible commercial insurance.

Saxenda$1,000–$1,349/mo

Brand (Saxenda) ~$1,000–$1,349/month. Generic liraglutide is typically $135–$200 less than brand.

Self-pay prices are what the manufacturer or the pharmacy lists, not what most people end up paying. Zepbound: $299–$1,086/month. Saxenda: $1,000–$1,349/month. Insurance, dose and pharmacy all change both figures.

Side effects reported in the trials

Both trials reported 4 reactions in common. Each rate is the percentage of participants who reported it in the trial named beside it, so the two columns are not from the same study.

Nausea
Zepbound · SURMOUNT-131%
Saxenda · SCALE Obesity and Prediabetes40%
Diarrhoea
Zepbound · SURMOUNT-123%
Saxenda · SCALE Obesity and Prediabetes21%
Constipation
Zepbound · SURMOUNT-112%
Saxenda · SCALE Obesity and Prediabetes19%
Vomiting
Zepbound · SURMOUNT-118%
Saxenda · SCALE Obesity and Prediabetes16%

A rate is the share of trial participants who reported that reaction, not a prediction for any one person.

How they differ in practice

How you take it

  • ZepboundOnce-weekly subcutaneous injection (2.5, 5, 7.5, 10, 12.5, 15 mg)
  • SaxendaOnce-daily subcutaneous injection

Dose build-up

  • Saxenda0.6 mg → 3.0 mg, escalated over 4 weeks

Where a drug is not listed here, its prescribing information sets out its own dose steps.

How soon it acts

  • ZepboundNoticeable appetite reduction typically within 4–8 weeks; significant weight loss by 12–16 weeks
  • SaxendaEffects visible within 4–8 weeks; maximum benefit typically by 56 weeks

Heart and metabolic findings

  • ZepboundImprovements in systolic/diastolic blood pressure, triglycerides, LDL, and HbA1c across SURMOUNT trials.
  • SaxendaThe LEADER trial (type 2 diabetes) showed cardiovascular benefit.

As stated in each drug’s trial record — not a claim about which drug protects the heart more.

Other findings recorded

  • ZepboundReduced progression to type 2 diabetes; improved sleep apnoea (SURMOUNT-OSA trial)
  • SaxendaApproved for adolescents aged 12 and over (SCALE teens programme); generic liraglutide now available (Teva, August 2025) — reducing out-of-pocket cost

If you stop taking it

  • ZepboundIn SURMOUNT-4, participants who switched to placebo regained an average of 14.0% body weight over 52 weeks.
  • SaxendaWeight regain after stopping is expected, as with other GLP-1 drugs.

Common questions

Written and maintained by one person · Built with agentic AI tools · Every number checked against the cited trial · Not medical advice

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Medical disclaimer: This website is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any treatment.