How semaglutide and tirzepatide compare on results, dosing and side effects, and how our prescriber decides which one suits you.
Semaglutide works on GLP-1, a hormone your gut releases when you eat that tells your brain you have had enough. Tirzepatide works on GLP-1 and on a second hormone called GIP at the same time. That extra target is the whole difference, and it is why the two produce different average results.
In the only large trial to test them directly, published in the New England Journal of Medicine, 751 adults took one or the other for 72 weeks. Tirzepatide produced an average loss of 20.2 percent of body weight against 13.7 percent for semaglutide, roughly 22.8 kilograms against 15.0. Around 31 percent of the tirzepatide group lost at least a quarter of their starting weight, against 16 percent on semaglutide. Results vary considerably between individuals.
Two things that trial does not settle. It compared the branded products at their maximum tolerated doses, so it describes the molecules rather than any particular pharmacy's preparation. And a better average is not a better answer for one person: tolerance, history and cost all move the decision, which is why a prescriber makes it with you rather than a table making it for you.
Both are prescribed here. The conversation usually turns on these, not on which one has the bigger headline number.
Whichever molecule your provider prescribes, the program is the same shape: the consultation, your follow-ups, medication delivery and every dose adjustment are covered, with no contract.
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The single-hormone option, a lower dose ladder and the one most people have heard of. Read the semaglutide page.
The dual-hormone option, more dose steps and the stronger average result. Read the tirzepatide page.
Pricing, how the visits work and what is included, on the medical weight loss page.
Reviews are from real patients and describe their own experience. Weight loss results vary from person to person. In the large clinical trials of these medicines, adults lost about 15% of their body weight on average with semaglutide and about 15% to 21% with tirzepatide, depending on the dose, over roughly 16 months alongside changes to diet and activity. Your results will depend on your health, your dose and your habits. Prescription treatment requires an evaluation by a licensed provider.
Neither, at first. Bring your history and your goal to the consultation and let the prescriber recommend one. People who arrive certain about a molecule are often reacting to something they read rather than to how their own body handled a medication, and that is the information that actually decides it.
No. It produced more weight loss on average in the head-to-head trial, and averages hide a lot. Some people do well on semaglutide, tolerate it easily and reach their goal on it. Cost differs too. The right answer is the one you can stay on comfortably for as long as you need it.
Broadly the same family: nausea, feeling full quickly, constipation or loose stools, mostly early or after a dose rise. In the trials digestive effects grew more common at higher doses of either drug, and a small proportion of people stopped because of them. How gradually you climb matters more than which molecule you are on.
Yes, and people do, usually after a plateau or a rough run of side effects. Switching means starting low again on the new dose ladder rather than transferring across at an equivalent dose. Raise it at a follow-up and the provider will say whether it is worth doing.
Yes. Both are prepared for you by an FDA-registered compounding pharmacy, which is not the same as a manufacturer's branded product, and every prescription is written individually by a licensed provider after reviewing your health history.
A free fifteen minute call is usually enough to know which of the two fits your history and your goal.
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