From the Guidelines
For weight loss, Mounjaro (tirzepatide) is generally considered the most effective, followed by Wegovy (semaglutide 2.4mg), with Ozempic (semaglutide 1mg) ranking third. This ranking is based on the medications' mechanisms of action and clinical trial results, with Mounjaro's dual GLP-1 and GIP receptor activation potentially leading to greater weight loss of approximately 20-25% of body weight 1. Key factors to consider when choosing between these medications include:
- Efficacy: Mounjaro and Wegovy have demonstrated higher efficacy in terms of weight loss compared to Ozempic 1
- Dosage: Wegovy uses a higher dose of semaglutide than Ozempic, which may contribute to its greater weight loss effects 1
- Side effects: All three medications have similar side effect profiles, including nausea, vomiting, and diarrhea, which can be mitigated with slow dose titration 1
- Individual factors: Insurance coverage, cost considerations, and specific health conditions should be taken into account when selecting a medication, and consultation with a healthcare provider is essential before starting any of these medications 1. It's also important to note that these medications work by slowing gastric emptying, increasing feelings of fullness, and reducing appetite through their effects on brain receptors, which can lead to significant weight loss and improvements in cardiovascular risk factors 1.
From the Research
Weight Loss Comparison
- The available studies compare the efficacy of tirzepatide and semaglutide for weight loss, with tirzepatide demonstrating superior results in some trials 2, 3, 4.
- Tirzepatide has been shown to result in greater mean percent weight reductions compared to semaglutide, with mean differences of 2.57% and 4.79% for tirzepatide 10mg and 15mg, respectively 4.
- The odds of achieving ≥5% weight reduction were also higher for tirzepatide 15mg compared to semaglutide, with an odds ratio of 1.76 (95% CI 1.04-2.97, p = 0.035) 4.
Ranking of Weight Loss Efficacy
- Based on the available evidence, the ranking of weight loss efficacy from highest to lowest is:
- Tirzepatide (Mounjaro)
- Semaglutide (Wegovy)
- Ozempic (no direct comparison available in the provided studies)
Safety and Efficacy
- Both tirzepatide and semaglutide have been associated with gastrointestinal adverse events, including nausea, diarrhea, and vomiting 2, 3.
- The safety profile of both medications is deemed acceptable, despite a high incidence of gastrointestinal adverse events 2.
- There is no direct comparison of Ozempic to the other two medications in the provided studies, so its ranking is based on the lack of available data.