Zepbound vs. Wegovy: Which Obesity Treatment Might Be Right for You?

While both can be effective, they’re not the same. Here’s how Zepbound and Wegovy compare and how to decide which one might be right for you.

Both medications are lab-made versions of certain hormones your body naturally produces that help control appetite and fullness. They contain different ingredients and work in similar but slightly different ways.

There are differences in who can use these medications, says Thomas So, PharmD, a clinical pharmacist and senior manager of Consumer Drug Information Group at First Databank. Wegovy is approved for a broader age range, including some teens, while Zepbound is currently approved only for adults.

• Adults and children age 12 and older with obesity (a body mass index, or BMI, of 30 or higher)
• Adults and children age 12 and older who are overweight (a BMI of 27 or higher) and have at least one weight-related condition, such as high blood pressure, high cholesterol or triglycerides, or type 2 diabetes

• Adults with obesity
• Adults who are overweight and have at least one weight-related condition

Beyond weight loss, both medications offer additional health benefits, says Dr. Kumar. They’re tools that can improve your overall health, not just help you see a lower number on the scale, she says.

Both Wegovy and Zepbound can improve blood sugar control by helping the body make more insulin and less sugar, says So. They can also support better blood pressure and cholesterol levels, often as a result of weight loss, he says. Plus, both medications may help with health issues related to being overweight or having obesity, such as joint pain, sleep apnea, and fatigue, says Connor.

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Bloating
• Indigestion
• Stomach pain
• Burping

These side effects usually occur when you first start the medication or increase the dose, but tend to improve as your body adjusts, says Connor. Eating smaller meals, avoiding greasy foods, and staying hydrated can help manage them, she says. “In some cases, we slow down the dose increase to help patients tolerate the medication better,” says Kumar.

• Inflammation of the pancreas (pancreatitis)
• Gallbladder problems
• Kidney issues
• Mood changes

• A personal or family history of medullary thyroid cancer
• Multiple endocrine neoplasia syndrome type 2
• A known allergy to either medication or any of its ingredients

“Many plans still do not cover anti-obesity medications, such as Zepbound and Wegovy, even though strong evidence shows these treatments can improve long-term health outcomes and reduce future costs related to diabetes and heart disease,” says Kumar.

Even with insurance, coverage varies widely from plan to plan, says So. Differences can include which medication is covered, prior authorization requirements, copays, and deductibles. Some insurance plans have started covering Wegovy more widely, particularly after it gained FDA approval to reduce cardiovascular risk in 2024, says Connor.

Choosing between Wegovy and Zepbound comes down to finding the option that fits your health goals, lifestyle, and what feels right for you. Here are a few things to consider as you discuss these with your doctor.

Your Weight Loss Goals

If the goal is significant weight loss, say around 20 percent or more of body weight, Zepbound might be the stronger choice, says So. “For moderate weight loss of about 10 percent to 15 percent, Wegovy may be enough,” he says.

Your Overall Health

Additional health conditions you’re managing can help guide your choice. For example, if you have heart disease, Wegovy’s cardiovascular benefits may make it a better fit. If you live with obstructive sleep apnea, Zepbound could offer an added advantage, says So.

Tolerance

Kumar suggests thinking through how well you tolerate medications. Some people find Wegovy’s slower dose increase easier on their stomach, while others do fine with Zepbound’s faster ramp-up.

Coverage and Cost

Check what your insurance covers and whether you’d need prior authorization for either medication. If you’re paying out of pocket, compare the savings programs and direct-to-consumer prices from both manufacturers.

Long-Term Success

The best and most sustainable long-term outcomes occur when these medications are combined with lifestyle changes, such as healthy eating, physical activity, adequate sleep, stress management, and ongoing follow-up, says So.

It also helps to talk openly with your healthcare provider about your goals, challenges, and concerns. Consider connecting with others who’ve used these medications or read discussions in trusted forums or support groups. Getting different perspectives can help you feel more informed and confident about which option might fit you best.

• Wegovy and Zepbound are both FDA-approved injectable weight loss medications that work in similar but slightly different ways, though clinical trials show Zepbound may lead to more weight loss than Wegovy.
• Choosing between Wegovy and Zepbound depends on several factors. Wegovy offers heart health benefits for people with cardiovascular disease, while Zepbound is approved to treat obstructive sleep apnea in people with obesity.
• Side effects for both medications are mostly stomach-related and usually improve over time. If you experience severe abdominal pain, vomiting, or mood changes, contact your healthcare provider right away.
• These medications work best when paired with sustainable lifestyle habits like balanced eating, regular activity, good sleep, and stress management, along with ongoing support from a healthcare provider.