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 cardiovascular benefits?

Semaglutide has proven cardiovascular benefit — a large trial showed a 20% reduction in major heart events. Tirzepatide has non-inferiority for cardiovascular safety but does not yet establish cardiovascular 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.

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

Semaglutide(Ozempic / Wegovy)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 cardiovascular 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.

Tirzepatide(Injection)20.9%(~50 lbs)

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

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

For a 240 lb person. Averages from clinical trials.

Monthly cost

The oral pill option is dramatically cheaper than either injection.

Semaglutide pill(Oral Wegovy)$149/mo

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

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

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

Beyond weight loss

🫀

Heart protection

Semaglutide

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

Tirzepatide

Cardiovascular 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)33%

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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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

Backed by evidence · Every claim linked to its source

Last reviewed: April 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.