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Semaglutide vs Tirzepatide: How Do They Compare?

Semaglutide acts on one gut hormone receptor and tirzepatide acts on two. Here is how they compare on how they work, trial results, side effects and price.

By The Good Life Collective editorial teamReviewed against the sources below on October 30, 20263 minute read

Semaglutide and tirzepatide are both once-weekly injections that reduce appetite and support weight loss. The main difference is that semaglutide acts on one gut hormone receptor, GLP-1, while tirzepatide acts on two, GIP and GLP-1; in separate clinical trials of the brand-name products, tirzepatide produced greater average weight loss.

Neither one is right for everyone. The better choice depends on your health history, how you tolerate side effects, your goals and your budget, which is why a licensed provider makes the decision with you.

Key takeaways

  • Both are weekly injections taken with nutrition and activity changes, not instead of them.
  • Average weight loss was greater with tirzepatide than with semaglutide in their separate trials, but individual results vary widely.
  • Side effects are similar and mostly affect the stomach, especially when starting or raising the dose.

How does each medicine work?

GLP-1 is a hormone your gut releases after eating. It signals fullness to the brain, slows how fast the stomach empties and helps regulate blood sugar. Semaglutide mimics GLP-1. Tirzepatide mimics GLP-1 and also GIP, a second gut hormone involved in how the body handles food. NIDDK describes both as prescription options for adults with obesity, or overweight with a weight-related condition.

What did the trials show?

The STEP 1 trial studied brand-name semaglutide in adults with overweight or obesity for 68 weeks. The SURMOUNT-1 trial studied brand-name tirzepatide in a similar group for 72 weeks. Both groups also received lifestyle support. Average weight loss was higher in SURMOUNT-1, but the trials were run separately, with different people, so they are not a head-to-head comparison. Compounded versions were not studied in these trials.

How do they compare side by side?

Semaglutide Tirzepatide
Acts on GLP-1 GIP and GLP-1
How often Once a week Once a week
Common side effects Nausea, diarrhea, constipation, vomiting Nausea, diarrhea, constipation, vomiting
Affects birth control pills Not specifically listed Yes, for about 4 weeks after starting and after each increase
Price at The Good Life Collective $195 a month, every dose $259 a month, every dose

Are the side effects different?

The most common side effects are similar: nausea, diarrhea, constipation, vomiting and stomach pain. They are most likely in the first weeks and after each dose increase. Both carry the same warning about medullary thyroid cancer in animal studies, and both require caution with pancreatitis, gallbladder disease and kidney problems. Tirzepatide can reduce how well birth control pills work for a period after starting and after each increase, so a backup method may be needed.

Which one should I choose?

Your provider weighs several things: your health history, any past experience with either medicine, how sensitive your stomach is, your goals and your budget. Some people start with semaglutide and switch later; others start with tirzepatide. Doses are not interchangeable, so a switch is always planned by your provider.

Frequently asked questions

Is tirzepatide stronger than semaglutide?

In separate trials of the brand-name products, average weight loss was higher with tirzepatide. That does not mean it is the better choice for every person.

Can I switch from semaglutide to tirzepatide?

Possibly. Your provider decides whether to switch and chooses a new starting dose, since the doses do not convert directly.

Why does the price stay the same as my dose increases?

At The Good Life Collective, each medicine has one monthly price at every dose, so your cost does not change as your provider adjusts your plan.

Do I still need to change my diet?

Yes. Both medicines were studied together with nutrition and activity changes, and those habits help you keep your progress.

Talk to a licensed provider

Adults in Florida and Georgia can start a secure online visit. A licensed provider reviews your history and helps you choose between semaglutide and tirzepatide, if either is appropriate. Results vary.

Sources

  1. Wilding et al., Once-Weekly Semaglutide in Adults with Overweight or Obesity, N Engl J Med (2021)
  2. Jastreboff et al., Tirzepatide Once Weekly for the Treatment of Obesity, N Engl J Med (2022)
  3. MedlinePlus, Semaglutide Injection
  4. MedlinePlus, Tirzepatide Injection
  5. NIDDK, Prescription Medications to Treat Overweight and Obesity

This article is educational and is not medical advice. Rx programs require an online visit with a licensed provider. Results vary.

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