Quick verdict
Tirzepatide is a dual GIP/GLP-1 agonist and often produces slightly greater weight loss than semaglutide (GLP-1 only) in trials. Both are FDA-approved for type 2 diabetes and obesity. Choice depends on access, cost, and tolerability—many patients do very well on either.
| Attribute | Semaglutide | Tirzepatide |
|---|---|---|
| Class | GLP-1 Receptor Agonist | GIP/GLP-1 Receptor Agonist |
| FDA Status | FDA-Approved | FDA-Approved |
| Primary Uses | Weight Loss, Type 2 Diabetes | Weight Loss, Type 2 Diabetes |
| Administration | Subcutaneous Injection | Subcutaneous Injection |
| Typical Dosing | — | — |
| Evidence Level | — | — |
Semaglutide is a GLP-1 receptor agonist—it mimics one gut hormone to reduce appetite and improve blood sugar. Tirzepatide is a dual GIP/GLP-1 agonist, so it activates both GIP and GLP-1 receptors. The added GIP component is thought to enhance weight loss and glycemic control beyond GLP-1 alone, which explains the slightly higher average weight loss seen with tirzepatide in trials.
Both drugs produce substantial weight loss and HbA1c improvements. In the SURMOUNT-2 trial and similar studies, tirzepatide often leads to a few percentage points more body weight loss on average (e.g., 15–20% vs. around 15% with semaglutide over similar timeframes). For many people, either drug is highly effective; the difference may matter most for those seeking maximum possible weight loss or who have not reached goal on one agent.
Side effects are similar: nausea, diarrhea, vomiting, constipation, abdominal pain. Both are usually well tolerated with gradual dose escalation. Some patients find one agent easier than the other; there is no universal rule. Pancreatitis and thyroid C-cell precautions apply to both.
List prices are in a similar range ($900–$1,400+ per month without insurance). Coverage for diabetes and obesity has improved for both. Compounding is now restricted for both, so cost and access depend largely on insurance and manufacturer programs.
Find a clinic that offers Semaglutide or Tirzepatide near you.
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| Common Side Effects |
| — |
| — |
Both are widely prescribed. Supply has improved after earlier shortages. Compounding is no longer a routine option for either under current FDA guidance. Prescription and monitoring are through licensed providers.
Semaglutide may be preferred if you want once-weekly (or oral with Rybelsus) dosing and a long track record, or if tirzepatide is not covered or available. Tirzepatide may be preferred if you are aiming for maximum weight loss or have not reached goal on semaglutide. Shared decision-making with your provider—considering goals, comorbidities, cost, and tolerability—is the best approach.
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