Reviewed by Ed Kauffman, Board-Certified Nurse Practitioner
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Semaglutide Comparison Guide

GLP-1 medications like Semaglutide, Ozempic, Mounjaro, and Tirzepatide are helping people lose significant weight—but while they are similar, they’re not interchangeable. This guide breaks down the key differences so you can make an informed, confident decision based on your goals, insurance, and biology.

• How each medication works
• FDA approval and intended use
• Effectiveness in clinical trials
• Side effects, tolerability, and real-world outcomes
• Cost, coverage, and access in Vancouver, WA

GLP-1 medications are changing the way we approach weight loss—but with so many names in the mix, it’s easy to feel overwhelmed. Semaglutide, Ozempic, Wegovy, Mounjaro, and tirzepatide all sound similar, yet they work in slightly different ways, or have different approval paths, and come with unique considerations.

Semaglutide is one of the most studied GLP-1 medications available. It has been evaluated extensively in the STEP clinical trial program, which showed an average weight loss of 15% or more over 68 weeks

Source: New England Journal of Medicine

In this guide, we’ll break down what makes each option distinct—so you can understand not just what these medications do, but why it matters for your goals, health, and budget. Whether you’re just beginning your journey or looking to switch, this comparison can help you feel more informed, confident, and supported in the decision ahead.

Semaglutide vs Ozempic

Ozempic is often the first GLP-1 medication people hear about when considering weight loss options. Though it’s primarily approved for diabetes, it’s widely used off-label due to its effectiveness and name recognition.

• Active ingredient: Semaglutide
• Approval: Type 2 diabetes
• Dose: Up to 2.0 mg/week
• Weight loss: ~5–10% (off-label)

Because Ozempic is prescribed at lower doses than Wegovy, it may result in less total weight loss—but it still delivers meaningful outcomes for many. For patients whose insurance doesn’t cover Wegovy, Ozempic offers a practical path forward.

Ozempic is typically more accessible and can be an excellent option for individuals who want to begin GLP-1 therapy, particularly those with coexisting type 2 diabetes or insulin resistance. It’s also been studied longer than most GLP-1s in the weight-loss space, making it a trusted entry point for many providers and patients alike.

What’s better, semaglutide or Ozempic?

Semaglutide is the active ingredient in Ozempic—so the answer depends on dose and context. For weight loss, Wegovy (higher-dose semaglutide) is often more effective than Ozempic. But if insurance or tolerance is an issue, Ozempic is a strong alternative.

Pros and cons of Ozempic

• Pros: Widely available, often covered by insurance, proven effectiveness, weekly dosing
• Cons: Off-label for weight loss, may cause nausea, lower total weight loss vs. Wegovy

Semaglutide vs Wegovy

Wegovy, the brand name for weight-loss–approved semaglutide, was granted FDA approval in 2021 for use in individuals with obesity or overweight and at least one weight-related condition.

Source: FDA Wegovy Approval

Wegovy is semaglutide too—but in a higher dose and FDA-approved specifically for chronic weight management.

• Ingredient: Semaglutide
• Approval: Weight loss (BMI ≥30 or ≥27 with comorbidities)
• Dose: Up to 2.4 mg/week
• Weight loss: ~10–15%

Wegovy’s primary advantage is that it’s designed—and approved—for weight loss. The dosing protocol is optimized for fat reduction rather than glucose control, making it the preferred option for people who don’t have diabetes.

That said, Wegovy is often more expensive and harder to get approved by insurance. Still, for patients with qualifying BMI or conditions, it represents the most direct and clinically supported way to use semaglutide for weight loss.

What’s better, semaglutide or Wegovy?

Wegovy is the most effective branded semaglutide option for weight loss. If available and affordable, it’s typically preferred over off-label Ozempic.

Pros and cons of Wegovy

• Pros: Highest-dose semaglutide for weight loss, FDA-approved, strong clinical data
• Cons: Cost, insurance barriers, same GI side effects as other GLP-1s

Semaglutide vs Mounjaro

Mounjaro (tirzepatide) works through two hormone pathways: GLP-1 and GIP. It may offer slightly better results for some patients, but also more side effects.

• Ingredient: Tirzepatide
• Mechanism: GLP-1 + GIP dual agonist
• Approval: Type 2 diabetes (Mounjaro), weight loss (Zepbound)
• Weight loss: Up to 22%

Tirzepatide has generated buzz for its ability to reduce body weight more dramatically than semaglutide in head-to-head trials. However, the tradeoff may be stronger GI reactions and a steeper titration curve.

Patients often notice faster initial weight loss on Mounjaro, but some don’t tolerate the medication well long term. It’s a promising new tool, but not necessarily a better fit for everyone.

What’s better, semaglutide or Mounjaro?

For some, Mounjaro results in more weight loss. For others, semaglutide is better tolerated and more accessible. It comes down to patient response and provider guidance.

Pros and cons of Mounjaro

• Pros: Highest weight loss potential, dual hormone mechanism, newer FDA approval
• Cons: More GI symptoms, fewer long-term safety studies, insurance hurdles

Semaglutide vs Tirzepatide

These are the two dominant molecules in GLP-1 weight loss treatment. In its 2023 guidelines, the American Diabetes Association highlighted both semaglutide and tirzepatide as pharmacologic options for managing weight in patients with type 2 diabetes.

Source: ADA Pharmacologic Guidance

Which works best depends on individual response, goals, and tolerability.

• Semaglutide: GLP-1 receptor agonist
• Tirzepatide: GLP-1 + GIP receptor agonist
• Weight loss: Comparable; tirzepatide may show a slight edge
• GI side effects: Both cause nausea; tirzepatide may be stronger

While tirzepatide is emerging as the front-runner in trial results, semaglutide remains more widely available and may be easier to start with. It’s also more established, which may be a deciding factor for conservative treatment plans.

Ultimately, your body will determine which medication delivers better outcomes. This is why follow-up and provider feedback are so essential to long-term success.

What’s better, semaglutide or tirzepatide?

In clinical data, tirzepatide may outperform semaglutide—but tolerability and access can make semaglutide the more practical choice.

Pros and cons of tirzepatide

• Pros: Stronger appetite suppression, rapid weight loss, dual action
• Cons: More nausea and vomiting, newer on the market, expensive

Semaglutide vs Compounded GLP-1 Medications

Compounded semaglutide or tirzepatide is not FDA-approved but may be offered through specialized pharmacies. It can be a lower-cost option when access is limited.

• Pros: Lower price, greater availability
• Cons: Variable quality and regulatory oversight
• Note: Use only under licensed provider supervision

Compounded medications may appeal to those priced out of brand-name prescriptions. However, not all formulations are created equal. Always vet the source, and never begin a compounded medication without guidance.

Compounded semaglutide is best considered a fallback—an option to be used responsibly if traditional access is blocked.

What’s better, semaglutide or compounded GLP-1s?

FDA-approved semaglutide (Wegovy, Ozempic) is preferred for consistency and safety. Compounded versions are alternatives—not first-line treatments.

Pros and cons of compounded medications

• Pros: Affordability, workaround when brand meds are unavailable
• Cons: Requires careful monitoring

Considerations When Choosing Weight Loss Medications

Finding the right medication is about more than weight loss numbers. You should also consider your medical history, coexisting conditions, how your body tolerates medications, your financial situation, and your comfort level with injections.

Other considerations include whether you’re looking for short-term results or sustainable long-term change. The right medication should align with a broader health plan that includes nutrition, movement, and provider-guided support.

At Vancouver Direct Primary Care, we consider:

• Your weight loss goals and timeline
• Insurance coverage and pharmacy access
• Health history and other medications

Semaglutides and Tirzepatide in Review

GLP-1 medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) represent a major breakthrough in metabolic care. While their results are impressive, choosing the right one depends on your unique situation—including goals, side effects, and access.

Semaglutide remains the most studied and widely used. Tirzepatide may offer superior weight loss for some but comes with stronger side effects. Compounded versions may lower costs but introduce new risks. It’s not about the “best” drug—it’s about the best match for you.

By comparing ingredients, mechanisms of action, approval status, and typical weight loss outcomes, this guide helps readers make informed decisions with clinical support. Whether you’re considering your first prescription or reevaluating your options, understanding the science—and the context—behind each choice matters.

Which Medication Is Right for Me?

We strongly recommend speaking to a qualified provider to review your goals, health history, and insurance options before starting any medication. Ed Kauffman and the team at Vancouver Direct Primary Care are here to walk you through each step of your weight loss journey with trusted, compassionate care.

Do your research, ask questions, and find the support you deserve. It’s your body—and your future.

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Schedule your consultation today or Join VDPC for personalized, expert support.