In this guide
Two medications dominate the GLP-1 weight loss market in 2026: semaglutide (sold as Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound). Both are injectable, once-weekly medications that dramatically reduce appetite and produce meaningful weight loss — but they work differently, cost differently, and produce different results.
This guide compares them head-to-head on every dimension that matters: efficacy, monthly cost for brand and compounded versions, side effects, and which patient profile fits each medication best.
Quick Verdict (TL;DR)
Bottom line
- More weight loss? Tirzepatide wins — 20–22% vs 15% average body weight lost.
- Lower monthly cost? Semaglutide wins — compounded from $129/mo vs $249/mo for tirzepatide.
- Better value per pound lost? Tirzepatide — ~$985 per 1% weight reduction vs ~$1,845 for semaglutide.
- Most accessible starting point? Compounded semaglutide at Eden Health from $129/mo.
What Each Medication Is
Ozempic / Wegovy
GLP-1 receptor agonist
Mimics the GLP-1 hormone to suppress appetite, slow gastric emptying, and improve insulin response. Once-weekly subcutaneous injection. Approved for type 2 diabetes (Ozempic) and obesity (Wegovy).
Mounjaro / Zepbound
Dual GIP + GLP-1 receptor agonist
Activates both the GLP-1 and GIP receptors simultaneously. The dual mechanism produces stronger appetite suppression and greater weight loss than single-receptor GLP-1 drugs. Once-weekly injection. FDA-approved for both diabetes and obesity.
The key difference: tirzepatide's dual-action mechanism is why it outperforms semaglutide in clinical trials. GIP receptor activation appears to enhance the weight-loss effect of GLP-1 stimulation, producing results that approach bariatric surgery outcomes in some patients.
Efficacy: Weight Loss Comparison
For a 200-pound person, that translates to roughly 40–44 lbs lost with tirzepatide versus 30 lbs with semaglutide — a meaningful difference. Importantly, these are averages from well-designed randomized controlled trials. Individual results vary based on adherence, diet, exercise, and metabolic factors.
Cost Comparison: Brand vs Compounded
Brand-name GLP-1 drugs remain unaffordable for most people without insurance coverage. Compounded versions — prepared by licensed pharmacies under physician supervision — offer the same active ingredient at a fraction of the price.
| Semaglutide | Tirzepatide | |
|---|---|---|
| Brand name(s) | Ozempic / Wegovy | Mounjaro / Zepbound |
| Brand cost / month | $900 – $1,300 | $1,060 – $1,350 |
| Compounded cost / month | $129 – $299 | $249 – $399 |
| Cheapest provider | Eden Health ($129/mo, 3-mo plan) | Multiple providers (~$249/mo) |
| Cost per 1% weight loss | ~$1,845 | ~$985 |
| Insurance coverage | Limited (Wegovy often covered) | Limited (Zepbound improving) |
The "cost per 1% weight loss" metric using brand prices shows tirzepatide is significantly more cost-efficient despite higher sticker price — because it produces substantially more weight loss. With compounded versions, the difference narrows.
For patients on a budget, compounded semaglutide from Eden Health at $129/month is the most affordable GLP-1 option available. See our Eden Health full review or complete guide to cheapest GLP-1 options in 2026 for more details.
Side Effects Comparison
Both medications share a nearly identical side-effect profile, since both activate the GLP-1 receptor. GI symptoms are the most common and are typically dose-dependent — they tend to peak during dose escalation and improve over time.
| Side Effect | Semaglutide | Tirzepatide |
|---|---|---|
| Nausea | Common (44% in trials) | Common (31–33% in trials) |
| Diarrhea | Common (30%) | Common (22–30%) |
| Constipation | Common (24%) | Common (17–25%) |
| Vomiting | Occasional (24%) | Less frequent (16%) |
| Fatigue | Occasional | Occasional |
| Injection site reaction | Mild, uncommon | Mild, uncommon |
| Pancreatitis (rare) | Black box warning | Black box warning |
| Thyroid C-cell tumors (animal data) | Contraindicated if family history | Contraindicated if family history |
Tirzepatide may cause slightly less nausea than semaglutide. One hypothesis is that GIP receptor activation buffers some of the GI effects of pure GLP-1 stimulation — but head-to-head trial data (the SURMOUNT-5 trial) suggests the overall GI tolerability is similar. Individual variation is high.
Which Should You Choose?
Decision Guide
Use our GLP-1 cost calculator to compare your projected monthly costs and estimated weight loss outcomes based on your starting weight and budget.
Ready to start? Eden Health offers semaglutide from $129/mo
Eden Health is a licensed telehealth provider offering compounded semaglutide with physician-guided dose escalation, included supplies, and ongoing support. One of the most affordable entry points for GLP-1 treatment.
View Eden Health Plans → Read our Eden Review