Ozempic
Best for: Type 2 diabetes with weight benefit
Wegovy
Best for: Weight loss (higher dose semaglutide)
Mounjaro
Best for: Maximum weight loss (dual mechanism)
The Full Comparison
| Feature | Ozempic | Wegovy | Mounjaro/Zepbound |
|---|---|---|---|
| Generic Name | semaglutide | semaglutide | tirzepatide |
| Mechanism | GLP-1 only | GLP-1 only | GLP-1 + GIP (dual) |
| FDA Indication | Type 2 diabetes | Weight management | Both (Mounjaro for diabetes, Zepbound for weight) |
| Max Dose | 2.0 mg/week | 2.4 mg/week | 15 mg/week |
| Avg Weight Loss | ~10-14% | ~15-17% | ~20-22% |
| Frequency | Weekly injection | Weekly injection | Weekly injection |
| Manufacturer | Novo Nordisk | Novo Nordisk | Eli Lilly |
| List Price | ~$900-1,000/mo | ~$1,300-1,400/mo | ~$1,000-1,100/mo |
Key Differences Explained
Ozempic vs Wegovy
Same drug (semaglutide), different doses and indications. Wegovy goes up to 2.4mg while Ozempic maxes at 2.0mg. If you have diabetes, Ozempic may be easier to get covered. If weight is the primary goal and you don't have diabetes, Wegovy is the indicated product.
Semaglutide vs Tirzepatide
The real comparison. Tirzepatide (Mounjaro/Zepbound) targets two receptors—GLP-1 and GIP—producing about 5% more weight loss on average. Head-to-head trials show tirzepatide outperforms semaglutide for both weight loss and blood sugar control. But both are highly effective.
Which Should You Choose?
If you have type 2 diabetes: Both work. Mounjaro may provide slightly better glucose control. Insurance coverage often determines the choice.
If weight loss is the primary goal: Tirzepatide (Zepbound) produces the most weight loss in trials. Wegovy is also highly effective and has longer track record.
If cost is the main concern: Whichever your insurance covers best. Or compounded versions of either active ingredient.
If you've tried one and it didn't work: Switching to the other mechanism (semaglutide → tirzepatide or vice versa) may produce better results.
The Bottom Line
Ozempic and Wegovy are the same drug (semaglutide) at different doses—Wegovy is specifically approved for weight loss at a higher dose. Mounjaro/Zepbound (tirzepatide) is a different drug with a dual mechanism that produces slightly more weight loss on average (~20% vs ~15-17%). All three are highly effective. The "best" choice depends on your specific situation: diabetes status, insurance coverage, and individual response. Many people do well on any of them.
Sources
- FDA prescribing information for Ozempic, Wegovy, Mounjaro, Zepbound.
- STEP trials (semaglutide) and SURMOUNT trials (tirzepatide).
- SURPASS head-to-head trials comparing tirzepatide to semaglutide.