Zepbound vs. Ozempic: What Are the Differences?

Both Zepbound and Ozempic are well-known medications if you are looking into options for managing weight or controlling blood sugar. While both are effective weekly injections, they contain different active ingredients and are approved for different uses.

Ozempic (semaglutide) is officially approved for type 2 diabetes and can reduce cardiovascular risk, whereas Zepbound (tirzepatide) is approved for weight management and is the first medication to treat obstructive sleep apnea in adults with obesity.

Studies show Zepbound may lead to greater weight loss of about 21% of body weight compared to approximately 15% with the weight-loss version of semaglutide, Wegovy. Your specific health goals, insurance coverage, and how your body responds will determine which is better for you.

Key Takeaways

• Zepbound mimics two gut hormones (GLP-1 and GIP) for potentially stronger effects, while Ozempic mimics one (GLP-1).
• For weight loss, Zepbound is more effective, leading to an average 21% reduction in body weight compared to approximately 15% with Wegovy, the weight-loss version of semaglutide.
• Ozempic is often the preferred choice for type 2 diabetes patients with heart disease, as it is proven to reduce the risk of heart attack and stroke.
• Both medications have very similar side effect profiles, primarily gastrointestinal issues like nausea, but they are often temporary and manageable.
• Insurance coverage is a major differentiator; Ozempic is typically covered for type 2 diabetes, while Zepbound is covered for weight loss if the plan includes that benefit.

How does Zepbound vs Ozempic differ in the way they work inside your body?

Both Zepbound and Ozempic work by mimicking hormones in your body that help regulate blood sugar and appetite. However, they target these hormones in different ways.

Ozempic (semaglutide) is a single-agonist medication. It mimics one hormone, called GLP-1 (glucagon-like peptide-1) . This hormone helps your body release insulin when blood sugar is high, slows down how quickly food leaves your stomach, and sends signals to your brain that you feel full .

Zepbound (tirzepatide) is a dual-agonist medication. It mimics two hormones: GLP-1 and a second one called GIP (glucose-dependent insulinotropic polypeptide) . By working through two pathways, it may provide a stronger effect on blood sugar control and appetite suppression . GIP is thought to further decrease appetite and may also improve how the body breaks down fat and sugar .

Think of it like this: Ozempic uses one key to unlock doors related to appetite and blood sugar, while Zepbound uses two keys, potentially opening those doors more effectively.

Which medication (Zepbound or Ozempic) leads to better weight loss results?

When it comes to weight loss, both medications are effective, but clinical trials consistently show that Zepbound leads to greater average weight loss.

In a 72-week study on adults with obesity or overweight, those taking Zepbound lost a significant amount of weight. At the highest dose (15 mg), participants lost an average of 21% of their body weight, or about 48 pounds . Lower doses also resulted in substantial weight loss, with the 5 mg dose leading to about a 15% reduction .

For Ozempic, which contains semaglutide, weight loss is a beneficial side effect when used for type 2 diabetes, resulting in about a 6% to 7% reduction in body weight . It is important to compare it to its sister drug, Wegovy, which contains a higher dose of semaglutide and is specifically FDA-approved for weight loss. In studies, Wegovy led to an average weight loss of about 15% over 68 weeks .

A direct head-to-head clinical trial (SURMOUNT-5) compared Zepbound to Wegovy. After 72 weeks, people taking Zepbound lost an average of 20.2% of their body weight (about 50 pounds), while those on Wegovy lost an average of 13.7% (about 33 pounds). This means Zepbound provided a 47% greater relative weight loss .

Your weight loss journey is personal, and your results will depend on many factors, including your diet, exercise, and starting point. However, the current evidence clearly points to Zepbound as the more potent option for weight loss.

What’s the difference between Zepbound and Ozempic when it comes to diabetes control?

Both medications are powerful tools for managing type 2 diabetes, though they are approved under different brand names for this purpose.

Mounjaro is the brand name for tirzepatide (the same drug in Zepbound) when it is prescribed for type 2 diabetes . In the Phase 3 SURPASS program, patients using Mounjaro saw impressive improvements in blood sugar, with average A1C reductions between 1.8% and 2.4%. Participants also lost between 12 and 25 pounds on average over 52 weeks.

Ozempic is the brand name for semaglutide approved for type 2 diabetes. It works by stimulating insulin secretion and lowering glucagon secretion in a glucose-dependent manner, which means it mainly works when your blood sugar is high, reducing the risk of dangerous lows . Ozempic has been shown to be very effective at lowering A1C.

A key difference in their official approvals is that Ozempic is also approved to reduce the risk of major cardiovascular events like heart attack and stroke in adults with type 2 diabetes and known heart disease. This cardiovascular benefit is a significant reason a doctor might prescribe Ozempic for a patient with diabetes and heart concerns.

Are the side effects of Zepbound vs Ozempic similar or different for most patients?

Because Zepbound and Ozempic work in similar ways, their side effect profiles are also very similar. The most common side effects are gastrointestinal and often occur as your body adjusts to the medication.

Common side effects for both medications include :

• Nausea
• Diarrhea
• Vomiting
• Constipation
• Abdominal pain
• Indigestion

These side effects are usually temporary and can be managed by starting at a low dose and gradually increasing it as directed by your doctor . Staying hydrated and eating smaller meals can also help.

Serious side effects and risks are also similar for both drugs. You should be aware of the following and contact your doctor immediately if you experience any symptoms:

• Thyroid C-cell tumors: These medications have caused thyroid tumors in rodents. It is unknown if they cause this in humans, but Zepbound and Ozempic are not recommended for people with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) .
• Pancreatitis: Severe stomach pain that doesn't go away and may spread to your back could be a sign of inflamed pancreas .
• Gallbladder problems: Such as gallstones or inflammation .
• Kidney injury: This can be related to dehydration from severe nausea, vomiting, or diarrhea .
• Severe allergic reactions .

While the types of side effects are nearly identical, some studies suggest that the intensity might be slightly higher with Zepbound, possibly due to its stronger efficacy . However, every person's experience is unique.

How do cost and insurance coverage compare between Zepbound and Ozempic?

Cost and insurance coverage are major practical factors in your decision, and the landscape can be complex.

The list price for both medications is high. Without insurance, Ozempic costs about $936 to $998 per month, while Zepbound costs about $1,060 per month .

Insurance coverage is where a key difference lies:

• Ozempic is FDA-approved for type 2 diabetes and cardiovascular risk reduction. Therefore, it is more likely to be covered by insurance if you have a diagnosis of type 2 diabetes . Using it for weight loss alone is considered "off-label" and is less likely to be covered.
• Zepbound is FDA-approved for weight loss and sleep apnea. This makes it more likely to be covered for weight management if your plan includes benefits for weight loss medications . However, many insurance plans still exclude weight loss drugs.

What can you do to manage the cost? Both manufacturers offer savings card programs for eligible patients. For example, with a savings card, people with commercial insurance that covers Zepbound may pay as little as $25 per month. Those whose insurance does not cover it might get the price down to around $550 per month . It is worth checking the official manufacturer websites for the latest offers.

Historically, government insurance like Medicare did not cover weight loss drugs, but policies are changing. You must check with your specific insurance provider to understand your coverage .

Which is better for you (Zepbound or Ozempic) based on your health goals and lifestyle?

Choosing between Zepbound and Ozempic is not about which drug is "better" in absolute terms, but which is the better fit for your individual health profile and goals.

Consider Zepbound (tirzepatide) if:

• Your primary goal is maximum weight loss. Clinical evidence strongly supports Zepbound for greater weight reduction .
• You have obesity or are overweight with weight-related conditions like high blood pressure or sleep apnea, and your insurance covers weight loss medications .
• You have been diagnosed with moderate-to-severe obstructive sleep apnea, for which Zepbound is an approved treatment .

Consider Ozempic (semaglutide) if:

• You have type 2 diabetes and established heart disease. Ozempic has a specific FDA approval to reduce the risk of heart attack and stroke in this population, which may make it the preferred choice .
• You need to manage blood sugar and achieve moderate weight loss.
• You are between 12 and 17 years old. Ozempic is not approved for this age group, but its sister drug, Wegovy, is approved for adolescents 12 and older. Zepbound is currently only approved for adults .

The best way to decide is to have an open conversation with your doctor. They can help you weigh the benefits, risks, and costs based on your complete medical history.