GLP-1 Medication Comparison
Side-by-side comparison of semaglutide, tirzepatide, liraglutide, and dulaglutide. All data drawn from published clinical trials—no marketing spin, just results.
Note: These medications have different FDA-approved indications. Some are approved specifically for weight management, others for diabetes with cardiovascular benefits. Your eligibility depends on your specific health profile.
Weight Loss Efficacy Comparison
| Medication | Avg Weight Loss | Trial Name | Trial Duration | Participants |
|---|---|---|---|---|
Tirzepatide 15mg Mounjaro, Zepbound | 20.9% | SURMOUNT-1 | 72 weeks | 2,539 |
Tirzepatide 10mg Mounjaro, Zepbound | 15.0% | SURMOUNT-1 | 72 weeks | 2,539 |
Semaglutide 2.4mg Wegovy | 14.9% | STEP 1 | 68 weeks | 1,961 |
Liraglutide 3mg Saxenda | 8.0% | SCALE | 56 weeks | 3,731 |
Dulaglutide 3mg Trulicity (off-label) | 3.1% | AWARD-11 | 52 weeks | 1,842 |
Reading This Data
These numbers represent average weight loss in clinical trials compared to placebo. Individual results vary widely—some people lose significantly more, some less. Tirzepatide shows the highest average efficacy, but semaglutide has more real-world data available since it was approved earlier. Liraglutide requires daily injections (vs weekly for others), which affects adherence. Dulaglutide isn't FDA-approved for weight management but shows modest weight loss in diabetes trials.
Dosing & Administration
| Medication | Frequency | Starting Dose | Maintenance Dose | Titration Time |
|---|---|---|---|---|
| Tirzepatide | Weekly | 2.5mg | 5-15mg | ~20 weeks to 15mg |
| Semaglutide | Weekly | 0.25mg | 1.7-2.4mg | ~16 weeks to 2.4mg |
| Liraglutide | Daily | 0.6mg | 3mg | ~5 weeks to 3mg |
| Dulaglutide | Weekly | 0.75mg | 1.5-4.5mg | Varies by indication |
Common Side Effects
| Side Effect | Tirzepatide | Semaglutide | Liraglutide |
|---|---|---|---|
| Nausea | 31% | 44% | 39% |
| Diarrhea | 23% | 30% | 21% |
| Vomiting | 12% | 24% | 16% |
| Constipation | 17% | 24% | 20% |
| Discontinued due to side effects | ~6% | ~7% | ~9% |
What This Means
All GLP-1 medications cause gastrointestinal side effects in a significant portion of users, especially during dose escalation. Tirzepatide appears to have slightly lower nausea rates than semaglutide, possibly due to the dual GIP/GLP-1 mechanism or different titration protocols. Most side effects improve over time as your body adapts. Serious side effects (pancreatitis, gallbladder issues) are rare but require immediate medical attention.
Cost Comparison
Brand-Name List Prices
Without insurance. Actual cost depends on insurance coverage, which varies widely by plan and indication.
Compounded Versions
Available through telehealth providers when brand-name supplies are limited. Same active ingredients, prepared by compounding pharmacies. Cash-pay only (no insurance).
Which Medication to Choose?
TConsider Tirzepatide if...
- •You want the highest proven average weight loss
- •Insurance covers it or you can afford out-of-pocket cost
- •You have type 2 diabetes (Mounjaro may be covered)
- •You're okay with longer titration period (~20 weeks)
SConsider Semaglutide if...
- •You want proven efficacy with more real-world data
- •Lower compounded versions are more affordable ($99-300/mo)
- •Your insurance covers Wegovy for weight management
- •You prefer a medication that's been available longer (2017)
LConsider Liraglutide if...
- •Daily injections don't bother you (more frequent dosing)
- •Your insurance covers Saxenda but not newer medications
- •You have cardiovascular risk factors (has cardiovascular data)
- •Shorter titration period appeals to you (~5 weeks)
DConsider Dulaglutide if...
- •You have type 2 diabetes (approved indication)
- •Your insurance covers Trulicity but not other GLP-1s
- •Weight loss is a secondary goal (primary is diabetes control)
- •Note: Not FDA-approved for weight management specifically
The Real Answer
The "best" medication depends on your specific situation: insurance coverage, out-of-pocket budget, medical history, tolerance for side effects, and whether you have diabetes or other conditions. Tirzepatide shows the highest average weight loss in trials, but semaglutide works excellently too and may be more accessible. Talk to your doctor about which makes sense for your individual circumstances.
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Compare ProvidersMedical Disclaimer
This comparison is for educational purposes only and does not constitute medical advice. All medications discussed require prescriptions and medical supervision. We are not healthcare providers. Consult your doctor to determine which medication, if any, is appropriate for your individual health situation.