Tirzepatide Vs. Semaglutide: Which Is Better For Weight Loss?

There *is* a winner on the surface, but the real answer is a bit more complex.By Korin MillerPublished: Dec 30, 2023 7:00 AM EST

Medically reviewed by Steven Batash, MDGastroenterologist and weight loss specialistSave Article

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A lot has happened in the weight loss space over the last year, with a slew of medications suddenly becoming household names. With that, it’s more than fair to wonder what the deal is with tirzepatide vs. semaglutide.

On a basic level, tirzepatide is the generic name for Mounjaro, which is approved by the Food and Drug Administration (FDA) to treat type 2 diabetes, and Zepbound, which is FDA-approved for weight loss. Semaglutide is the generic name for Ozempic—FDA-approved for type 2 diabetes treatment—and Wegovy, a weight loss medication.

“Semaglutide and tirzepatide are very similar medications, but there are a few important differences,” says Dina Peralta-Reich, MD, director of New York Weight Wellness Medicine. If you’re interested in taking one of these medications, you’ll need to speak to a healthcare provider who should be able to guide you on next steps, including which one of these may be ideal for you.

Meet the experts: Kunal Shah, MD, is an assistant professor in the division of endocrinology at the Rutgers Robert Wood Johnson Medical Center. Dina Peralta-Reich, MD, is the director of New York Weight Wellness Medicine. Mir Ali, MD, is a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California. Steven Batash, MD, is a gastroenterologist and leading physician at the Batash Endoscopic Weight Loss Center.

It’s true that one medication has consistently shown better weight loss results in studies (more on that in a sec), but doctors stress that doesn’t mean it’s the best—or most feasible—solution for everyone.

So, is tirzepatide or semaglutide better for weight loss? Here’s what you need to know.

What is semaglutide?

Semaglutide is the active ingredient in Ozempic and Wegovy. It’s an injectable medication in a class of drugs known as glucagon-like peptide 1 (GLP-1) agonists. These drugs help improve blood sugar and can lead to weight loss, explains Kunal Shah, MD, an assistant professor in the division of endocrinology at the Rutgers Robert Wood Johnson Medical Center.

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Semaglutide mimics a protein in your body called GLP-1, and activates GLP-1 receptors in your body to increase the production of insulin, a hormone that helps escort glucose into your cells where it’s used for energy, Dr. Shah explains. Semaglutide also stimulates a pathway in your brain that controls your hunger cues and slows digestion. “That makes you feel fuller and less hungry,” Dr. Shah says.

What is tirzepatide?

Tirzepatide is the main active ingredient in both Mounjaro and Zepbound. It’s a type of injectable medication called a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist.

Tirzepatide works similarly to semaglutide but also targets an additional receptor—GIP —explains Mir Ali, MD, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California. “It works by helping you feel full and slowing the passage of food through the digestive tract which essentially reduces appetite,” says Steven Batash, MD, a gastroenterologist and leading physician at the Batash Endoscopic Weight Loss Center.