Short answer
For weight loss, yes in the one head-to-head trial: over 72 weeks, people on Zepbound lost about 20.2% of body weight versus 13.7% on Wegovy (SURMOUNT-5, 751 adults). Wegovy has something Zepbound doesn’t yet: proof it cuts heart attacks and strokes, from the 17,604-person SELECT trial. Which is better depends on what you need, and your prescriber decides.
The head-to-head
SURMOUNT-5, published in the New England Journal of Medicine in 2025, randomized 751 adults with obesity but no diabetes to tirzepatide (Zepbound) or semaglutide (Wegovy) for 72 weeks. Average weight loss was 20.2% with tirzepatide and 13.7% with semaglutide. That is the only direct comparison, and it favors Zepbound clearly.
What Wegovy has that Zepbound doesn’t
In the SELECT trial, 17,604 adults with existing heart disease and overweight or obesity took Wegovy or placebo for about three years. Major heart events fell from 8.0% to 6.5%, a 20% relative reduction, and the FDA added heart-risk reduction to Wegovy’s label in 2024. Tirzepatide’s heart-outcome trial in diabetes, SURPASS-CVOT, showed it was non-inferior to another GLP-1 but did not show superiority, and Zepbound has no heart-risk indication yet.
Price and access
Self-pay through the makers on 30 September 2026: Zepbound $299 to $449 a month at LillyDirect; Wegovy $199 for the first two intro months, then $349 at NovoCare, with the higher-dose Wegovy HD at $399. Both are covered by Medicare’s GLP-1 Bridge at a $50 copay for eligible members. Side-effect profiles are similar and led by nausea and other stomach symptoms; both carry the same thyroid boxed warning.
Related questions
Does more weight loss mean better?
Not for everyone. If you have heart disease, Wegovy’s outcome evidence may matter more than a few extra percentage points. That is a prescriber’s call.
Is there a Zepbound pill?
No. Lilly’s pill is Foundayo, a different molecule. Novo’s Wegovy pill is oral semaglutide.
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Sources
Published 2026-09-30 · Last checked 2026-09-30
Educational content, not medical advice. Made for the United States.