Drug comparison hub: weight loss medications

The FDA has approved more weight loss medications in the past five years than in the previous two decades combined. That’s good news for patients but makes choosing the right one harder. This page compares every current option with real trial data, actual pricing, and honest assessments of what each drug does well and where it falls short.

If you’re exploring peptide-based weight loss options, this hub connects to every detailed comparison on the site.

Master comparison table

Medication	Generic name	Drug class	Dosing	Avg weight loss	FDA approved for weight loss	Monthly cost (retail)	Compounded option
Wegovy	Semaglutide 2.4 mg	GLP-1 RA	Weekly injection	~15%	Yes	~$1,300	Yes (~$299–399)
Ozempic	Semaglutide 1.0/2.0 mg	GLP-1 RA	Weekly injection	~10–12%	No (T2D only)	~$900–1,000	Yes (~$299–399)
Zepbound	Tirzepatide 5–15 mg	GLP-1/GIP dual agonist	Weekly injection	~20–22%	Yes	~$1,060	Yes (~$349–699)
Mounjaro	Tirzepatide 5–15 mg	GLP-1/GIP dual agonist	Weekly injection	~20–22%	No (T2D only)	~$1,060–1,200	Yes (~$349–699)
Saxenda	Liraglutide 3.0 mg	GLP-1 RA	Daily injection	~8%	Yes	~$1,300	No
Contrave	Naltrexone/bupropion	Opioid antagonist + antidepressant	Twice daily oral	~5–6%	Yes	~$300–400	No
Qsymia	Phentermine/topiramate	Sympathomimetic + anticonvulsant	Daily oral	~8–10%	Yes	~$200–250	No
Xenical/Alli	Orlistat	Lipase inhibitor	Three times daily oral	~3–5%	Yes (Alli OTC)	~$50–200	No
Phentermine	Phentermine	Sympathomimetic amine	Daily oral	~5%	Yes (short-term)	~$20–50	No

Weight loss percentages are averages from clinical trials in adults with obesity. Individual results vary. Prices reflect approximate US retail costs as of early 2026.

GLP-1 receptor agonists

The GLP-1 drugs dominate the weight loss market for good reason. They produce the most weight loss of any non-surgical option, and the newer ones (semaglutide, tirzepatide) significantly outperform the older generation.

Semaglutide (Wegovy/Ozempic)

Semaglutide targets the GLP-1 receptor, slowing gastric emptying and reducing appetite at the brain level. The STEP 1 trial showed 14.9% average body weight loss over 68 weeks with the 2.4 mg dose [1]. That trial enrolled 1,961 adults without diabetes.

Wegovy is the FDA-approved weight loss formulation. Ozempic is the diabetes version, often prescribed off-label. The main difference: Wegovy goes up to 2.4 mg, while Ozempic maxes out at 2.0 mg.

Compounded semaglutide from licensed pharmacies runs $299–$399 per month, making it the most cost-effective GLP-1 option for uninsured patients. Read our full semaglutide vs tirzepatide breakdown for a head-to-head comparison.

Tirzepatide (Zepbound/Mounjaro)

Tirzepatide is a dual GLP-1/GIP receptor agonist, meaning it activates two incretin pathways instead of one. The SURMOUNT-1 trial demonstrated average weight loss of 20.9% at the highest dose (15 mg) over 72 weeks [2]. About 57% of participants on the 15 mg dose lost 20% or more of their body weight.

Zepbound is approved for weight management. Mounjaro is the diabetes formulation. Both contain tirzepatide at identical doses.

Eli Lilly introduced single-dose vials with a self-pay price of $399/month for the 2.5 mg starting dose and $549/month for 5 mg, bypassing insurance entirely. For details on all pricing options, see our Mounjaro cost without insurance guide.

Liraglutide (Saxenda)

The first-generation GLP-1 for weight loss. The SCALE trial showed 8.0% weight loss over 56 weeks [3]. Saxenda requires daily injections, costs about $1,300/month at retail, and has largely been superseded by semaglutide in clinical practice.

Still worth considering if your insurance covers it but not the newer options. Our Saxenda vs Ozempic comparison covers this decision in depth.

Dual agonists and next-generation drugs

Retatrutide

Retatrutide is a triple agonist targeting GLP-1, GIP, and glucagon receptors. Phase 2 data showed up to 24.2% weight loss at the highest dose over 48 weeks [4]. Phase 3 trials (TRIUMPH program) are underway. Not yet FDA-approved.

If approved, retatrutide could become the most effective injectable weight loss medication available. Our retatrutide guide tracks the latest trial data and approval timeline.

CagriSema

CagriSema combines cagrilintide (an amylin analogue) with semaglutide. The REDEFINE-1 trial reported 22.7% weight loss at 68 weeks, outperforming semaglutide alone (16.1%) [5]. Novo Nordisk has filed for FDA approval.

Learn more about the CagriSema combination and how amylin fits into the weight loss picture.

Survodutide and orforglipron

Boehringer Ingelheim’s survodutide (a GLP-1/glucagon dual agonist) showed 18.7% weight loss in phase 2 data. Eli Lilly’s orforglipron is an oral GLP-1 that produced 14.7% weight loss in phase 2 trials, potentially offering semaglutide-level results without any injections. Both are in phase 3 trials as of early 2026.

The weight loss medication market is changing fast. Within two to three years, patients may have effective oral options that match today’s injectable results.

Older weight loss medications

Phentermine/topiramate (Qsymia)

An oral combination pill that suppresses appetite through two different mechanisms. The EQUIP trial showed roughly 10% weight loss at the top dose over 56 weeks. It’s one of the more effective oral options but carries risks including increased heart rate, cognitive issues (“topiramate brain fog”), and birth defects [6].

Monthly cost is $200–$250, making it one of the cheaper prescription options. No injection required.

Naltrexone/bupropion (Contrave)

Combines an opioid antagonist with an antidepressant to reduce food cravings. Average weight loss of about 5-6% in the COR trial program. Side effects include nausea, constipation, headache, and insomnia. It carries a black-box warning for suicidal thoughts from the bupropion component [6]. That sounds alarming, but the risk is inherited from bupropion’s antidepressant class labeling and wasn’t specifically elevated in the obesity trials.

Our Contrave vs Ozempic comparison covers when this oral option might make sense over an injectable GLP-1.

Orlistat (Xenical/Alli)

Blocks fat absorption in the gut. Produces modest weight loss (3-5%) and causes unpleasant gastrointestinal side effects, including oily stools and fecal urgency. Alli is available over the counter at half the prescription dose. It’s the least effective option on this list but the most accessible.

Phentermine (Adipex-P, Lomaira)

FDA-approved only for short-term use (up to 12 weeks). It’s a stimulant that suppresses appetite. Cheap ($20–$50/month) and widely prescribed, but the short-term limitation and stimulant side effects (insomnia, increased heart rate, dry mouth) make it a temporary solution. Our phentermine vs Ozempic comparison explains when each makes sense.

Many doctors prescribe phentermine alongside GLP-1 medications to boost results during the initial months of treatment. This off-label combination hasn’t been studied in large trials, but the different mechanisms of action (stimulant-based appetite suppression plus incretin-based satiety) make it pharmacologically reasonable.

How to choose the right medication

The decision tree is simpler than the number of options suggests:

Start with your insurance. If your plan covers a GLP-1 for weight loss, that’s almost always the best first choice. Semaglutide or tirzepatide will produce the most weight loss with weekly dosing.

If you’re paying out of pocket, compounded semaglutide ($299–$399/month) or Eli Lilly’s self-pay tirzepatide vials ($399–$549/month) are the most effective options at accessible price points.

If you can’t do injections, Qsymia produces the best results among oral medications. Contrave is a reasonable second choice, especially if food cravings are a major issue.

If you want something OTC, orlistat (Alli) is the only FDA-approved option. Results will be modest.

Your BMI, medical history, and other medications all factor in. A provider can help match you to the right option. If you’re interested in how peptide therapy pricing works beyond weight loss medications, that guide covers the broader cost picture.

For patients with specific conditions, our guides on PCOS weight loss medication and weight loss for women over 40 address medication selection for those populations.

Find out which weight loss medication is right for you →

FAQ

What is the most effective weight loss drug available right now?▼

Based on clinical trial data, tirzepatide (Zepbound/Mounjaro) produces the most weight loss among FDA-approved medications, averaging 20-22% body weight reduction at the highest dose [2]. Semaglutide (Wegovy) is second at roughly 15% [1]. Retatrutide may surpass both if approved, with phase 2 data showing up to 24.2% [4].

Can I take two weight loss medications together?▼

Some combinations are used in clinical practice, though most haven’t been tested in large trials. Adding phentermine to a GLP-1 is one combination some doctors use. Combining two GLP-1 drugs (like Saxenda and Ozempic) makes no sense since they target the same receptor. Always consult your prescriber before combining medications.

Do I need to take weight loss medication forever?▼

Most patients regain weight after stopping GLP-1 medications. The STEP 1 extension study showed about two-thirds of lost weight returned within a year of discontinuation [1]. Current guidance treats obesity as a chronic condition requiring ongoing treatment, similar to blood pressure medication. Some patients do maintain weight loss after stopping, particularly if they’ve established new eating and exercise habits during treatment.

Why are GLP-1 medications so expensive?▼

Brand-name GLP-1s are priced at $1,000+ per month in the US, reflecting patent protections, manufacturing complexity (these are biologics, not simple pills), and high demand. Other countries pay significantly less for the same drugs. Compounded versions offer a lower-cost alternative while patents and FDA-approved generics remain unavailable.

Are compounded GLP-1 medications safe?▼

When sourced from a licensed 503A or 503B compounding pharmacy, compounded semaglutide and tirzepatide contain the same active molecule as brand-name drugs. Quality varies by pharmacy, which is why choosing a provider that verifies pharmacy credentials matters. Our guide on compounded semaglutide safety covers this in detail.

What about Ozempic alternatives that aren’t injections?▼

Oral semaglutide (Rybelsus) exists but is approved only for diabetes, and the weight loss dose hasn’t been fully studied yet. Novo Nordisk is developing a higher-dose oral semaglutide pill for weight loss. Eli Lilly’s oral tirzepatide (orforglipron) is in late-stage trials. For now, effective oral options are limited to Qsymia and Contrave. Read our Ozempic alternatives page for a full breakdown.

How do I know if I qualify for weight loss medication?▼

Most GLP-1 medications require a BMI of 30 or higher, or a BMI of 27+ with at least one weight-related condition (high blood pressure, type 2 diabetes, high cholesterol). A licensed provider can evaluate your medical history and determine which options fit.

Check your eligibility now →

References

1. Wilding JPH, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989-1002. PubMed

2. Jastreboff AM, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387(3):205-216. PubMed

3. Pi-Sunyer X, et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 2015;373(1):11-22. PubMed

4. Jastreboff AM, et al. Triple-hormone-receptor agonist retatrutide for obesity — a phase 2 trial. N Engl J Med. 2023;389(6):514-526. PubMed

5. Novo Nordisk. CagriSema REDEFINE-1 trial results. Presented at ADA 2024 Scientific Sessions.

6. Comparison table: Some drugs for weight management. Med Lett Drugs Ther. 2025;67(1734). PubMed