Wegovy vs Zepbound: Which Should You Choose?
Wegovy (semaglutide 2.4 mg) and Zepbound (tirzepatide) are the two FDA-approved once-weekly injections for chronic weight management. They differ in mechanism (Wegovy is a GLP-1 receptor agonist; Zepbound is a dual GIP/GLP-1 agonist), in average weight-loss magnitude in pivotal trials, and in real-world cost.
TrimRx
Full-spectrum GLP-1 program with both compounded and brand-name access plus unlimited provider check-ins.
Eden
Flat upfront pricing with the same dose-equal cost across both compounded and brand-name GLP-1s.
| Attribute | TrimRx | Eden |
|---|---|---|
| Program Fee | Included in monthly plan | No membership fee |
| Medication From | From $179/mo | From $129/mo |
| Editor Score | 4.5 / 5 | 4.5 / 5 |
| Primary Category | GLP-1 Weight Loss | GLP-1 Weight Loss |
| FDA Brand-Name Access | Ozempic, Mounjaro, Wegovy, Zepbound | Ozempic, Wegovy, Zepbound, Mounjaro |
| Compounded Options | 2 compounds | 2 compounds |
| Adjacent Categories | GLP-1 Weight Loss | GLP-1 Weight Loss, Women's Health & HRT, Hair Loss, Skincare, Peptide Therapy, Longevity & NAD+ |
What the Studies Actually Show
Percentages below are means from the pivotal Phase 3 trials of each medication. The two drugs were never compared head-to-head at full dose, so cross-trial comparisons should be read as directional, not definitive. Individual results vary; trial populations differed slightly in baseline BMI and comorbidities.
| Endpoint | TrimRx | Eden |
|---|---|---|
| Mean weight loss vs placebo (pivotal trial)1,2 | −14.9% at 68 weeks STEP 1 enrolled adults with BMI ≥30 (or ≥27 with a weight-related comorbidity). SURMOUNT-1 used the same eligibility criteria. Trial-design differences mean these figures cannot be directly compared. | −20.9% at 72 weeks (15 mg dose) |
| Placebo arm weight loss1,2 | −2.4% | −3.1% |
| Proportion losing ≥15% of body weight1,2 | 50.5% of participants | 78.0% (15 mg dose) |
| Most common GI side effects (≥10% incidence)3,4 | Nausea, diarrhea, vomiting, constipation | Nausea, diarrhea, vomiting, constipation |
| Cardiovascular outcomes evidence5 | SELECT trial: 20% MACE risk reduction in adults with established CV disease and overweight/obesity | SURMOUNT-MMO trial ongoing |
| Manufacturer | Novo Nordisk | Eli Lilly |
| FDA approval (chronic weight management)3,4 | June 2021 | November 2023 |
The Verdict
Tirzepatide (Zepbound) produced greater mean weight loss in its pivotal SURMOUNT-1 trial than semaglutide did in STEP 1 — though the trials are not directly comparable. Semaglutide (Wegovy) has been on the market longer and has a deeper real-world safety dataset, including the SELECT cardiovascular outcomes trial. Choose based on insurance coverage, GI tolerance, and clinician judgment.
- STEP 1 Trial — NEJM 2021 · Wilding JPH, Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med 2021;384:989–1002.
- SURMOUNT-1 Trial — NEJM 2022 · Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med 2022;387:205–216.
- FDA Prescribing Information — Wegovy (semaglutide) · WEGOVY (semaglutide) injection, for subcutaneous use. U.S. Food and Drug Administration prescribing information.
- FDA Prescribing Information — Zepbound (tirzepatide) · ZEPBOUND (tirzepatide) injection, for subcutaneous use. U.S. Food and Drug Administration prescribing information.
- SELECT Trial — NEJM 2023 · Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. N Engl J Med 2023;389:2221–2232.
RxNotebook is an editorial publication. Citations point to peer-reviewed journals, FDA labeling, and clinical society guidelines. We are not affiliated with the studies cited above. This page is for general information and is not medical advice.