Wegovy vs. Zepbound: Comparing the Two Newest FDA-Approved Weight Loss Medications

The Adapt Lab January 28, 2026 Medical Weight Loss

If you’ve been hearing about Wegovy and Zepbound for weight loss and wondering how they work, you’re certainly not alone. These medications come up often in conversations about obesity, metabolism, and long-term health, and for good reason.

Both Wegovy and Zepbound work by mimicking natural gut hormones that influence appetite and metabolism. While they share that foundation, they differ in which hormonal signals they target and how broadly they affect metabolic function. Those differences can matter, depending on your goals and how your body responds.

This blog breaks down everything you need to know about how Wegovy and Zepbound compare, so you can better understand which option may best support your long-term health goals.

Understanding Wegovy and Zepbound

Wegovy and Zepbound are injectable medications used for chronic weight management. Before diving into their differences, it helps to understand what each medication is designed to do and who it’s intended for.

What Is Wegovy?

Wegovy is an FDA-approved prescription medication containing semaglutide, a GLP-1 peptide used for chronic weight management. GLP-1 is a hormone your body naturally releases after eating, helping regulate appetite, blood sugar, and insulin response.

Wegovy is intended for:

• Adults with obesity (BMI 30 or higher)
• Adults who are overweight (BMI 27 or higher) and have at least one weight-related health condition, such as:
  • High blood pressure
  • Type 2 diabetes
  • High cholesterol

Wegovy also has FDA approval for:

• Children ages 12 and older with obesity
• Cardiovascular risk reduction in adults with established heart disease and obesity
• Metabolic dysfunction-associated steatohepatitis (MASH), a form of fatty liver disease

At the metabolic level, Wegovy helps regulate appetite and blood sugar balance to feel more consistent, which often makes eating patterns easier to manage over time.

What Is Zepbound?

Zepbound, approved in late 2023, is an FDA-approved prescription medication for chronic weight management. It contains tirzepatide, which targets two hormone pathways: GLP-1 and GIP (glucose-dependent insulinotropic polypeptide).

Zepbound is intended for:

• Adults with obesity (BMI 30 or higher)
• Adults who are overweight (BMI 27 or higher) with weight-related health conditions

Zepbound also holds FDA approval for treating:

• Obstructive sleep apnea (OSA) in adults with obesity

Because it works on more than one metabolic pathway, Zepbound influences appetite, insulin response, and fat metabolism together. According to the SURMOUNT-5 clinical trial, published in the National Library of Medicine, this dual-pathway approach was associated with greater overall weight loss compared to single-hormone therapies.

ALSO READ: Semaglutide vs. Tirzepatide: Which Is Right for You?

What Makes These Medications Different?

If Wegovy and Zepbound both support weight loss, what actually sets them apart? The answer isn’t just in the dose or the brand name. It’s how many metabolic “levers” they pull and how those signals show up in daily life.

Hormone Targets and Mechanism of Action

1. Wegovy (Semaglutide)
   Wegovy works by reinforcing the signal that tells your brain, “You’ve had enough.” When that signal becomes clearer, cravings tend to fade into the background and meals feel complete sooner. Blood sugar stays steadier, which often shows up as more consistent energy and fewer mid-day crashes that lead to unplanned snacking.
2. Zepbound (Tirzepatide)
   Zepbound brings a second metabolic signal into the conversation. Along with appetite regulation, it influences how your body processes and uses energy after you eat. Many people notice that satisfaction lasts longer, portion sizes shrink without much effort, and energy feels more even from morning through evening. Instead of fighting hunger cues, those signals tend to feel more organized, almost like your metabolism finally got the memo.

Administration and Dosing Protocols

Both medications are administered as once-weekly subcutaneous injections using prefilled auto-injector pens, making it easier to stick to your treatment plan compared to daily medications.

Wegovy Dosing:

• Starting dose: 0.25 mg weekly
• Gradual escalation over 16-20 weeks
• Maximum dose: 2.4 mg weekly
• Daily oral pill option available for those who prefer not to inject

Zepbound Dosing:

• Starting dose: 2.5 mg weekly
• Gradual escalation based on response and tolerability
• Maximum dose: 15 mg weekly
• Vial option available (less expensive but requires more preparation)

MORE ON THIS TOPIC: How Does Tirzepatide Work for Weight Loss?

What to Expect During Treatment

Starting a weight loss medication involves more than just picking up a prescription. Knowing what happens before and during treatment can help you feel prepared and avoid surprises as your body adjusts.

Pre-Treatment Testing and Assessment

Before you start either medication, your naturopathic doctor will usually look at key metabolic markers to get a clearer picture of how your body is functioning beneath the surface. This often includes hormone levels, blood sugar markers, inflammation, cholesterol, and basic liver and kidney function. Think of this as creating a metabolic “starting point.” If two people eat the same way but get very different results, these labs often explain why. They also give you something concrete to measure progress against over time, especially if issues like insulin resistance are part of the picture.

Side Effects and Tolerability

Early on, it’s common to notice some digestive changes, especially as doses increase. You might feel a bit nauseated, notice changes in bowel habits, or realize food just doesn’t sound as appealing for a while. For most people, this adjustment phase is temporary. Simple habits, like eating smaller meals, skipping greasy foods, staying hydrated, and following a gradual dose schedule, often make the transition much easier. Over time, your body tends to settle into a new rhythm, though everyone’s experience is a little different.

Ongoing Monitoring and Adjustment

Weight loss medications aren’t a “set it and forget it” situation. Periodic check-ins give you a chance to see what’s working, what needs tweaking, and how your body is responding. These follow-ups may include reviewing labs, adjusting doses, or talking through changes you’re noticing in appetite, energy, or routine. Rather than working in isolation, medication becomes one part of a broader strategy that evolves with you, supporting consistency and long-term progress instead of short-term swings.

How to Choose Between Wegovy and Zepbound

So how do you decide which option makes sense for you? Instead of focusing on labels, it helps to step back and consider a few bigger-picture factors:

• Evaluate your primary goal: If your primary goal is maximum weight loss and there are no contraindications, top-line results from the SURMOUNT-5 phase 3b trial released by Eli Lilly suggest Zepbound may offer an advantage. However, if your goals are more moderate or you have health conditions that align with Wegovy’s FDA approvals, the difference in efficacy may be less important than other factors.
• Consider your lifestyle and preferences: Weekly injections work for most patients, but if you have a strong aversion to needles, Wegovy’s oral option eliminates that concern entirely. The best medication is the one you’ll actually take consistently.
• Assess your medication history: If you’ve tried GLP-1-only medications with limited success, Zepbound’s dual-agonist mechanism may offer better results. But if you responded well to semaglutide, you might prefer sticking with that medication.
• Factor in access and coverage: Insurance coverage, medication availability, and out-of-pocket costs can vary widely. A clinic experienced in navigating these challenges can help you understand your options and find the best choice for you.

The best decision usually comes from discussing these factors with a naturopathic doctor who can weigh clinical data alongside your individual health picture.

READ MORE: Top 5 Benefits of a Doctor-Supervised Weight Loss Program in San Diego

Schedule Your Metabolic Health Consultation Now

Choosing between Wegovy and Zepbound ultimately depends on your unique health profile, personal goals, and preferences. With all the information provided in this blog, the key is to work with a naturopathic doctor who understands your specific needs and can help you make the right choice. Your decision should align with both your immediate and long-term health objectives.

At The Adapt Lab, we take a data-driven approach to weight management, focusing on your metabolic health first. Through comprehensive lab testing, we ensure that your treatment plan is tailored to your unique needs, whether you’re considering Zepbound, Wegovy, or other weight management therapies. Our approach integrates the latest clinical data with personalized care, helping you achieve sustainable results.

Schedule a consultation today to discuss your metabolic health and explore the best treatment options to support your weight management goals. Let’s work together to create a plan that works for you.