From the Guidelines
Wegovy (semaglutide) and Zepbound (tirzepatide) are both effective medications for chronic weight management in adults with obesity or overweight, but Zepbound has shown greater weight loss effects in clinical trials, with average losses of 20% of body weight compared to about 15% with Wegovy 1.
Key Points
- Wegovy is a GLP-1 receptor agonist that mimics the effects of the GLP-1 hormone, targeting areas of the brain that regulate appetite and food intake, helping patients feel fuller longer and eat less 1.
- Zepbound is a dual-action medication that works on both GLP-1 and GIP receptors, potentially offering greater weight loss effects than Wegovy 1.
- Both medications require a prescription and ongoing medical supervision, and common side effects include nausea, diarrhea, vomiting, and constipation.
- Clinical trials have shown that Zepbound may produce more significant weight reduction than Wegovy, with average losses of 20% of body weight compared to about 15% with Wegovy 1.
- Insurance coverage varies for both medications, and they are typically used as part of a comprehensive weight management program that includes diet and exercise.
Eligibility
- Adults with obesity (BMI ≥30) or overweight (BMI ≥27) who have at least one weight-related condition such as high blood pressure, type 2 diabetes, or high cholesterol are eligible for Wegovy or Zepbound treatment 1.
- The choice of medication should be based on individual patient needs and medical history, as well as the potential benefits and risks of each medication 1.
Comparison
- A recent meta-analysis of RCTs that included 12,371 adults with overweight or obesity without diabetes reported that 15 mg weekly of tirzepatide was associated with greater weight loss compared with 2.4 mg weekly of subcutaneous semaglutide (mean difference, 5.1%; 95% CI, 0.6%-9.8%) and 3 mg daily of subcutaneous liraglutide (mean difference, 13.0%; 95% CI, 8.8%-17.4%) 1.
- The SELECT study showed that in 17,604 participants with CVD, with a BMI of 27 or greater, and without diabetes, those randomized to semaglutide, 2.4 mg, vs placebo had a lower composite incidence of death due to cardiovascular events, nonfatal myocardial infarction, or nonfatal stroke at 39.8 months (hazard ratio, 0.80; 95% CI, 0.72-0.90) 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
What is Wegovy
- Wegovy is a brand name for the medication semaglutide, which is used for chronic weight management in adults with obesity or overweight with at least one weight-related condition such as high blood pressure, type 2 diabetes mellitus, or high cholesterol 2, 3.
- It is administered via subcutaneous injection at a dose of 2.4 mg once weekly 2.
Indications for Wegovy
- Wegovy is indicated for weight management in patients with a BMI of 27 kg/m2 or greater who have at least one weight-related ailment or in patients with a BMI of 30 kg/m2 or greater 2.
- It is used in conjunction with a weight management program consisting of a reduced calorie diet and increased physical activity 2.
Comparison to Zepbound (Tirzepatide)
- Both semaglutide (Wegovy) and tirzepatide (Zepbound) are glucagon-like peptide-1 (GLP-1) receptor agonists used for weight loss and glycemic control 3, 4.
- Studies have shown that tirzepatide may be more effective in terms of weight loss, with a study showing a 21.4% body weight loss compared to 9.1% with semaglutide 4.
- However, more research is needed to directly compare the two medications in terms of efficacy and safety 4.
Eligibility for Wegovy
- Adults with obesity or overweight with at least one weight-related condition such as high blood pressure, type 2 diabetes mellitus, or high cholesterol are eligible for Wegovy 2.
- Patients with a BMI of 27 kg/m2 or greater who have at least one weight-related ailment or patients with a BMI of 30 kg/m2 or greater are also eligible 2.