What is the weight loss difference between tirzepatide and semaglutide?

In a direct head-to-head trial, tirzepatide produced 20.2% average weight loss vs 13.7% for semaglutide. This translates to roughly 14–17 lbs more for a 240 lb person. Individual results vary substantially.

Does tirzepatide have proven heart benefits?

Semaglutide has proven heart benefit — a large trial showed a 20% reduction in major heart events. Tirzepatide has been shown to be at least as safe for the heart but does not yet have proven heart benefit like semaglutide.

Which drug is cheaper?

Tirzepatide injection costs ~$1,086/month via LillyDirect. Semaglutide injection costs ~$1,350/month. Oral semaglutide (Wegovy pill) is dramatically cheaper at ~$149/month.

Can tirzepatide be taken as a pill?

No, tirzepatide is injection only (once-weekly under the skin with no food timing restrictions). Semaglutide is available as both an injection and a daily oral pill.

Mounjaro vs Ozempic (Tirzepatide vs Semaglutide) — Side-by-Side Comparison

Head-to-head weight loss

From the only large trial that directly compared these two drugs. 751 adults with obesity, 72 weeks at maximum dose.

Zepbound / Mounjaro(tirzepatide)20.2%(~48 lbs)

Wegovy / Ozempic(semaglutide)13.7%(~33 lbs)

Tirzepatide showed higher average weight loss in this direct comparison. Individual results vary substantially.

That is the headline number. But neither drug is universally "better" — they differ on heart evidence, cost, and form. Here is the fuller picture.

Weight loss at maximum approved dose

Including the oral semaglutide pill, which was not part of the head-to-head trial.

Zepbound(tirzepatide injection)20.9%(~50 lbs)

Oral Wegovy(semaglutide pill)16.6%(~40 lbs)

Wegovy(semaglutide injection)14.9%(~36 lbs)

For a 240 lb person. Averages from published studies.

Monthly cost

The oral pill option is dramatically cheaper than either injection.

Oral Wegovy(semaglutide pill)$149/mo

Zepbound(via LillyDirect)~$1,086/mo

Wegovy(semaglutide injection, list price)~$1,350/mo

List prices and manufacturer self-pay programs. Insurance coverage varies.

Side effects comparison

From each drug's main weight loss trial. All stomach side effects are most common in the first 4–8 weeks and usually fade.

Nausea

Tirzepatide31%

Semaglutide44%

Diarrhea

Tirzepatide23%

Semaglutide30%

Vomiting

Tirzepatide18%

Semaglutide25%

Constipation

Tirzepatide12%

Semaglutide24%

Quit due to side effects

Tirzepatide6%

Semaglutide7%

Tirzepatide had lower rates across all stomach side effects in trials. Both drugs use slow dose escalation to minimize symptoms.

Beyond weight loss

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Heart protection

Semaglutide

20% reduction in major heart events — proven in a large 17,604-person trial

Tirzepatide

Heart safety confirmed — heart benefit trial in progress

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Form & convenience

Tirzepatide

Weekly injection only — no food timing restrictions

Semaglutide

Weekly injection OR daily pill — pill needs 30-min fasting window

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Side effects

Nausea (semaglutide)44%

Nausea (tirzepatide)31%

Quit due to side effects~7%

Usually peaks weeks 2–4, fades by week 8–12

Prefer a pill over injections?

Two oral GLP-1 pills are now FDA-approved: Oral Wegovy (~16.6% weight loss, $149/month) and Foundayo (~12.4% weight loss, no food restrictions).

See the Oral Wegovy vs Foundayo comparison →

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Compare All Options

See how medications, diet, exercise, and supplements compare at a glance

Oral Wegovy vs Foundayo

The two approved GLP-1 pills compared

Tirzepatide (Mounjaro/Zepbound)

Full breakdown: weight loss, side effects, cost, and how it works

Semaglutide (Ozempic/Wegovy)

Full breakdown: injection vs pill, weight loss, cardiovascular data

Built with agentic AI tools and not a substitute for medical advice

Last reviewed: June 2026

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.