Pick the molecule before you pick the program. Wegovy and Ozempic are the same drug, semaglutide. Zepbound and Mounjaro are the same drug, tirzepatide, which adds a second gut hormone (GIP) and produced more average weight loss than semaglutide in the SURMOUNT-5 head-to-head trial. Saxenda is the older daily option, largely priced out by the weekly drugs.
The brand split is mostly about the label, not the medicine. Wegovy and Zepbound carry the obesity approval; Ozempic and Mounjaro carry the type 2 diabetes approval, even though each pair shares an active ingredient at the same maintenance dose. If you have diabetes, the diabetes-labeled brand is usually the one insurance will cover.
So for most people starting today the real choice is semaglutide versus tirzepatide. Tirzepatide tends to drive more weight loss; semaglutide has the longer real-world track record and more compounded supply, which is why it carries the lowest cash prices.
Compare four things before you commit: the active ingredient, the trial weight-loss number at the maintenance dose (not the starter dose), the side-effect profile, and what you will actually pay once the introductory discount ends. The guides below break down each drug on exactly those.
