Zepbound vs Wegovy: Tirzepatide vs Semaglutide for Weight
Zepbound vs Wegovy: tirzepatide vs semaglutide for weight management — approved uses, trial themes, side effects and user reports. Not medical advice.
Anonymous user report. Not medical advice. Peptides discussed are not FDA-approved for the uses described. Editorial process →
Head-to-head result (SURMOUNT-5)
In SURMOUNT-5, published in the New England Journal of Medicine in 2025, 751 adults with obesity but without type 2 diabetes were randomised to the maximum tolerated weekly dose of tirzepatide (Zepbound) or semaglutide (Wegovy) for 72 weeks. Average weight loss was 20.2% with tirzepatide vs 13.7% with semaglutide, and waist circumference fell 18.4 cm vs 13.0 cm. Gastrointestinal side effects were the most common in both groups. The trial was open-label and funded by Eli Lilly, Zepbound's maker. Peptide Confessions does not publish dosing, timing, injection or sourcing guidance.
Short answer
Zepbound is a tirzepatide brand approved for chronic weight management (and related labels in some regions). Wegovy is a semaglutide brand approved for chronic weight management (and, in the US, certain cardiovascular-risk indications). They are different active ingredients. Diabetes-facing sister brands are Mounjaro (tirzepatide) and Ozempic (semaglutide). Peptide Confessions does not publish dosing, timing, injection or sourcing guidance.
Side by side
| Wegovy | Zepbound | |
|---|---|---|
| Active ingredient | Semaglutide | Tirzepatide |
| Receptor targets | GLP-1 | GLP-1 and GIP |
| Weight-management brand | Yes | Yes |
| Diabetes sister brand | Ozempic | Mounjaro |
| Molecule comparison on this site | Semaglutide vs tirzepatide | Semaglutide vs tirzepatide |
How this relates to other pages
If you searched Mounjaro vs Ozempic, you are usually asking the same molecule question with diabetes brand names — see Mounjaro vs Ozempic. Same-drug brand pairs: Wegovy vs Ozempic. Side-effect story counts: semaglutide and tirzepatide reports.
Trial results side by side
Last reviewed October 15, 2026. Averages from published trials; individual results vary widely.
| Wegovy (semaglutide) | Zepbound (tirzepatide) | |
|---|---|---|
| Pivotal weight trial | STEP 1: about 15% at 68 weeks (placebo about 2%) | SURMOUNT-1: up to about 21% at 72 weeks (placebo about 3%) |
| Head-to-head (SURMOUNT-5) | 13.7% | 20.2% |
| Heart outcome data | SELECT: 20% fewer major cardiovascular events | Outcome trials reported; check the current label |
| Other US labels | Cardiovascular risk reduction; MASH liver disease | Obstructive sleep apnoea |
| Pill version | Wegovy pill (US) | None; Lilly's pill is a different drug, orforglipron |
| Generic | None in the US; generics in Canada | None |
Side effects compared
Both cause nausea, diarrhoea, vomiting and constipation, mostly while doses are increased. In SURMOUNT-5 the rates were broadly similar. Both carry the same class warnings: pancreatitis, gallbladder disease, dehydration-related kidney injury and thyroid C-cell tumours in rodents. Tirzepatide can reduce the effect of oral contraceptives after starting or increasing a dose. Details: Wegovy side effects and Zepbound side effects.
What users report
Switchers are the most useful voices. #384 says semaglutide "just made eating too much feel miserable" while tirzepatide brought "0 interest", and most of their 57-lb loss came after switching. #194 switched from semaglutide to tirzepatide and now forgets lunch. #43 switched to tirzepatide after heavy hair shedding on semaglutide.
Both groups describe GI trouble early (#298, #190) and regain after stopping (#57, #200). Anecdotes, not a ranking.
Related topics
related peptides:
community guides:
More confessions from the archive
Community Q&A
- Can you switch from Wegovy to Zepbound?
- People do switch under prescriber supervision; how to transition is a clinical decision. Users here describe stronger appetite suppression after switching, but that is anecdote.
- Do Zepbound and Wegovy have the same side effects?
- Largely yes: gastrointestinal effects dominate both, with the same class warnings.
- Is Zepbound more effective than Wegovy?
- In the SURMOUNT-5 head-to-head trial, average weight loss was 20.2% with Zepbound (tirzepatide) vs 13.7% with Wegovy (semaglutide) at 72 weeks. Individual results vary.
- Is Zepbound the same as Wegovy?
- No. Zepbound is tirzepatide. Wegovy is semaglutide. Both are used for weight management under their labels, but they are different drugs.
- Is Zepbound the same as Mounjaro?
- Same active ingredient (tirzepatide), different brand and labelled uses. Mounjaro is the diabetes-facing brand in many markets; Zepbound is the weight-management brand.
- Is Wegovy the same as Ozempic?
- Same active ingredient (semaglutide), different brand and labelled uses. See Wegovy vs Ozempic.
- Which is better for weight loss?
- This page does not rank them. Trial results and individual medical factors differ. Decisions belong with a licensed clinician.
- Does this page give dosing advice?
- Peptide Confessions does not publish dosing, timing, injection or sourcing guidance.
Sources
- STEP 1 — Wilding et al., Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med 2021
- SURMOUNT-1 — Jastreboff et al., Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med 2022
- SURMOUNT-5 — Aronne et al., Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. N Engl J Med 2025
- Zepbound (tirzepatide) prescribing information — DailyMed (NLM)
- Mounjaro (tirzepatide) prescribing information — DailyMed (NLM)
- Wegovy (semaglutide) prescribing information — DailyMed (NLM)
- Ozempic (semaglutide) prescribing information — DailyMed (NLM)
Anonymous first-hand reports plus sourced context — educational only, not medical advice. Editorial policy & corrections.