Drug-vs-Drug Verdicts: GLP-1 & Weight Loss Comparisons
Head-to-head verdicts on the most-searched GLP-1 drug pairings. Every comparison cell cites an FDA label (DailyMed), a peer-reviewed trial, or a current manufacturer price page.
Last verified November 2026
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All drug-vs-drug verdicts
Wegovy vs Zepbound
semaglutide · tirzepatide
A real head-to-head exists here, which is rare. SURMOUNT-5 put Zepbound at 20.2% against Wegovy at 13.7% over 72 weeks, matching what their separate trials had suggested.
Ozempic vs Mounjaro
semaglutide · tirzepatide
Two diabetes drugs prescribed off-label for weight. SURPASS-2 compared them directly at 40 weeks (11.2 kg against 5.7 kg), and both now carry a cardiovascular risk-reduction indication.
Semaglutide vs Tirzepatide
semaglutide · tirzepatide
SURMOUNT-5 ran them head to head: 20.2% against 13.7% at 72 weeks. The larger loss belongs to tirzepatide, the finished cardiovascular outcomes trial to semaglutide.
Rybelsus vs Ozempic
semaglutide (oral) · semaglutide (subcutaneous)
The same molecule from the same maker, as a daily tablet and a weekly injection. Only about 1% of the tablet gets in, which explains almost every difference between them.
Mounjaro vs Zepbound
tirzepatide · tirzepatide
One molecule from one manufacturer under two names. The label is the whole difference: diabetes on one side, obesity and sleep apnea on the other, at identical doses but different cash prices.
Foundayo vs Rybelsus
orforglipron · semaglutide (oral)
Two GLP-1 pills, and they are not close. One is a small molecule with no food rules; the other is a peptide that needs an empty stomach to work at all, and in the US it is being replaced by Ozempic tablets.
Ozempic vs Zepbound
semaglutide · tirzepatide
Different molecules, different labels, and a head-to-head that favors one clearly: 20.2% against 13.7% at 72 weeks in SURMOUNT-5.
Wegovy vs Ozempic
semaglutide · semaglutide
The same molecule from the same maker under two names, with two labels, two dose ceilings and two entirely different coverage stories. This confusion costs people money every day.
Zepbound vs Foundayo
tirzepatide · orforglipron
Both are approved for weight, which makes this a rare like-for-like comparison. The injection takes off about twice as much; the pill needs no needle and no food rules.
Wegovy vs Foundayo
semaglutide · orforglipron
A weekly injection for weight against a daily pill that needs no fasting. About three points separate them, and only one has proven it prevents heart attacks.
Ozempic vs Foundayo
semaglutide · orforglipron
A weekly diabetes injection with proven cardiac benefit against a daily weight pill approved April 2026. Each holds exactly what the other lacks.
Wegovy vs Saxenda
semaglutide · liraglutide
The one comparison in this class that was tested directly: weekly semaglutide against daily liraglutide, -15.8% against -6.4% over 68 weeks. Same manufacturer, two and a half times the effect.
Ozempic vs Trulicity
semaglutide · dulaglutide
Two weekly diabetes injections, tested directly against each other. Ozempic wins on blood sugar and weight; Trulicity holds the broader cardiac indication and the pediatric one.
Trulicity vs Mounjaro
dulaglutide · tirzepatide
Two weekly Lilly injections for diabetes. Mounjaro lowers glucose and weight further, and in SURPASS-CVOT it matched Trulicity on heart outcomes head to head.
Trulicity vs Wegovy
dulaglutide · semaglutide
A weekly diabetes injection against a weekly weight injection. Different labels, different benefits, and which one your insurer pays for depends on which bucket your diagnosis lands in.
Saxenda vs Zepbound
liraglutide · tirzepatide
Saxenda is a daily injection approved from age 12. Zepbound is a weekly injection, adults only, at roughly three times the weight loss and a lower cash price.
Rybelsus vs Trulicity
semaglutide (oral) · dulaglutide
Rybelsus is a daily tablet with an empty-stomach rule. Trulicity is a weekly injection with no food rules at all. Similar blood-sugar effect, and both now have an outcomes trial showing fewer cardiac events.
Foundayo vs Mounjaro
orforglipron · tirzepatide
Foundayo is Lilly's daily pill, approved for weight in April 2026 on -11.1% in ATTAIN-1. Mounjaro is the same company's weekly injection, labeled for diabetes only. A pill against a shot.
Saxenda vs Foundayo
liraglutide · orforglipron
Saxenda is a daily injection approved down to age 12. Foundayo is a daily pill approved April 2026, adults only, and it takes off about three percentage points more weight.
Saxenda vs Ozempic
liraglutide · semaglutide
Saxenda is daily liraglutide, labeled for weight. Ozempic is weekly semaglutide, labeled for diabetes. Neither is the strongest option for weight, and only one of them is approved for it.
Mounjaro vs Saxenda
tirzepatide · liraglutide
Mounjaro is Lilly's weekly tirzepatide, labeled for diabetes. Saxenda is Novo's daily liraglutide, labeled for weight. Different molecules, different diseases, different schedules, and readers compare them anyway.
Rybelsus vs Zepbound
semaglutide (oral) · tirzepatide
Rybelsus is daily oral semaglutide, labeled for diabetes only, with a strict 30-minute fast. Zepbound is weekly tirzepatide, labeled for weight and sleep apnea. About 4% against about 21%.
Rybelsus vs Mounjaro
semaglutide (oral) · tirzepatide
A daily tablet with a strict empty-stomach rule against a weekly injection with none. Both are labeled for diabetes only, and the injection produces roughly twice the blood-sugar drop.
Wegovy vs Mounjaro
semaglutide · tirzepatide
A weight-labeled drug against a diabetes-labeled one. The like-for-like comparison to Mounjaro is Zepbound: same molecule, same doses, different label and a very different price.
Foundayo vs Trulicity
orforglipron · dulaglutide
Foundayo is Lilly's daily pill for weight, approved April 2026 on -11.1% in ATTAIN-1. Trulicity is the older weekly injection for diabetes, with completed heart and kidney evidence the pill does not have.
Saxenda vs Trulicity
liraglutide · dulaglutide
Novo's daily liraglutide at 3.0 mg, labeled for weight, against Lilly's weekly dulaglutide, labeled for diabetes. Different molecules, different labels, different injection schedules.
Wegovy vs Contrave
semaglutide · naltrexone-bupropion
An injection that took off about 14.9% of body weight in STEP-1 against a pill that managed about 6.1% in COR-I. The pill costs roughly $250 a month less.
Zepbound vs Contrave
tirzepatide · naltrexone-bupropion
Over three times the weight loss for three to four and a half times the price. Contrave is a pill at about $99 a month; Zepbound is a weekly injection that reached about 20.9%.
Wegovy vs Qsymia
semaglutide · phentermine-topiramate
Wegovy reached -14.9% in STEP-1; Qsymia's top dose reached -10.9% in EQUIP. A weekly shot against a daily capsule, and Qsymia requires contraception and monthly pregnancy tests.
Zepbound vs Qsymia
tirzepatide · phentermine-topiramate
About 20.9% against about 10.9%: roughly double. Qsymia answers on price and on being a pill, and carries a pregnancy-risk program that Zepbound does not.
Contrave vs Qsymia
naltrexone-bupropion · phentermine-topiramate
The two older oral weight drugs, both far cheaper than a GLP-1 and both far weaker. Qsymia takes off more; Contrave avoids the mandatory contraception program.
Ozempic vs Contrave
semaglutide · naltrexone-bupropion
One is a diabetes injection prescribed off-label for weight; the other is an oral drug the FDA actually approved for weight. That difference decides what a plan will pay.
Ozempic vs Qsymia
semaglutide · phentermine-topiramate
A weekly injection used off-label against a daily pill approved for weight since 2012. The pill is far cheaper and carries a mandatory pregnancy-prevention program.
Wegovy vs Rybelsus
semaglutide · oral semaglutide
The same molecule as a weekly injection for weight and a daily tablet for diabetes. Two to three times the effect on one side; no needle and a strict fasting rule on the other.
Zepbound vs Trulicity
tirzepatide · dulaglutide
Only one of these is approved for weight. Zepbound reached about 20.9% at 72 weeks; Trulicity treats diabetes and cardiovascular risk, and its weight effect is modest and off-label.
Saxenda vs Rybelsus
liraglutide · oral semaglutide
Two daily Novo Nordisk drugs that are not interchangeable. Saxenda is approved for weight and reached about 8.0% in SCALE; the tablet is diabetes-only, and any weight use is off-label.
CagriSema vs Retatrutide
cagrilintide 2.4 mg + semaglutide 2.4 mg · retatrutide (LY3437943)
Both are investigational, both have cleared 20% in trials, and neither can be bought. No trial has ever compared them, so any ranking of the two is inference.
Retatrutide vs Zepbound
retatrutide (LY3437943) · tirzepatide
One is approved and on pharmacy shelves; the other showed about 24% in phase 2 and cannot be bought. Anyone selling retatrutide today is not selling an approved product.
CagriSema vs Wegovy
cagrilintide + semaglutide · semaglutide
An approved semaglutide against an investigational amylin combination still in phase 3. One has cardiovascular outcomes data and a pharmacy shelf; the other has neither yet.
CagriSema vs Zepbound
cagrilintide + semaglutide · tirzepatide
Approved Zepbound against investigational CagriSema. In the one head-to-head obesity trial, tirzepatide 15 mg took off more weight (23.6% vs 20.2% at 84 weeks); at lower doses in type 2 diabetes, CagriSema came out ahead.
Survodutide vs Retatrutide
survodutide (BI 456906) · retatrutide (LY3437943)
Two pipeline drugs with no trial between them. What separates them on paper is their liver-disease evidence and how far each has got through development.
Mazdutide vs Retatrutide
mazdutide (IBI362 / LY3305677) · retatrutide (LY3437943)
Two investigational drugs whose trials ran in different countries and never against each other. Every comparison here is cross-trial, and that is a real limit on it.