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Wegovy vs. Mounjaro

Adipositas-Zulassung vs. T2D-Zulassung – Der Vergleich

Wegovy ist spezifisch für Adipositas zugelassen. Mounjaro ist für Typ-2-Diabetes zugelassen, wird aber aufgrund der starken SURMOUNT-Daten häufig zur Gewichtsreduktion in Betracht gezogen.

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Wirkungsweise

Wegovy

  • →GLP-1-Rezeptor-Agonist
  • →Zugelassen für Adipositas (BMI ≥30)
  • →Reduziert MACE-Risiko um 20% (SELECT-Studie)

Mounjaro

  • →Dualer GIP + GLP-1-Agonist
  • →Zugelassen für T2D (Zepbound für Adipositas)
  • →Stärkerer Gewichtsverlust in Studien (~21%)

Head-to-Head Comparison

FactorWegovyMounjaro
Active moleculeSemaglutideTirzepatide
Receptor targetsGLP-1 onlyGIP + GLP-1
FDA obesity approvalYes (June 2021)No — Zepbound brand for obesity
Max dose2.4 mg weekly15 mg weekly
Weight loss (STEP-1/SURMOUNT-1)14.9% at 68 wks20.9% at 72 wks
Nausea incidence~44% (STEP-1)~31% (SURMOUNT-1 15 mg)
Cardiovascular outcome trialSELECT 2023: 20% MACE reductionSURPASS-CVOT 2024: 15% MACE reduction
Off-label use for weight lossN/A — on labelCommon when Zepbound not covered
Monthly cost (uninsured)~$1,300–1,400~$1,000–1,200
T2D brandOzempicMounjaro

STEP-1 (Wilding et al., NEJM 2021); SURMOUNT-1 (Jastreboff et al., NEJM 2022); SURMOUNT-5 direct comparison (2025). [1, 2]

Weight Loss: The Numbers

Wegovy 2.4 mg (STEP-1)

14.9%

Mean body weight loss at 68 weeks in STEP-1 (N=1961, adults with obesity, no T2D).

Mounjaro/Zepbound 15 mg (SURMOUNT-1)

20.9%

Mean body weight loss at 72 weeks in SURMOUNT-1 (N=2539, adults with obesity, no T2D).

SURMOUNT-5 head-to-head (2025)

~47%

More relative weight loss with tirzepatide vs semaglutide in the 2025 direct comparison trial.

Choose Based on Your Goal

Maximum weight loss

Tirzepatide (Mounjaro/Zepbound) shows ~20.9% vs Wegovy's 14.9% in individual trials, and is directly superior in SURMOUNT-5 (2025).

On-label obesity treatment

Wegovy is specifically FDA-approved for obesity. If your primary diagnosis is obesity, Wegovy (or Zepbound for tirzepatide) is on-label.

Cardiovascular risk reduction

Wegovy's SELECT trial (2023) showed a 20% MACE reduction in obesity + CVD. Mounjaro's SURPASS-CVOT (2024) showed 15%. Both have positive CV data.

Lower nausea rates

Trial data suggests tirzepatide has lower nausea (~31% vs ~44% for semaglutide). GIP modulation may reduce GI side effects.

Insurance coverage

Mounjaro for T2D has better insurance coverage than Wegovy for obesity. If you have T2D, Mounjaro may be more accessible.

You want the obesity-approved obesity drug

For pure on-label obesity pharmacotherapy, compare Wegovy vs Zepbound (the obesity-approved tirzepatide brand).

Which Is Right for You?

For maximum weight loss, tirzepatide has consistently outperformed semaglutide in head-to-head data. SURMOUNT-5 (2025) directly compared them and found tirzepatide produced ~47% more relative weight loss. If maximum weight reduction is the priority and you have T2D or your plan covers Zepbound, tirzepatide is the evidence-based choice.

Wegovy has two key advantages: it is on-label for obesity (giving prescribers and patients confidence), and the SELECT trial showed a 20% MACE reduction in obesity with CVD — currently the strongest cardiovascular outcome data for an obesity drug. Mounjaro's SURPASS-CVOT (2024) showed 15% MACE reduction but in a T2D population.

For patients without T2D who are choosing between Wegovy and Mounjaro specifically, note that Mounjaro's obesity data comes from SURMOUNT trials under the Zepbound brand — the Mounjaro label is for T2D. Your prescriber can prescribe Mounjaro off-label for weight loss, but Zepbound is the indicated brand for that purpose.

Track Either in Shotlee

Shotlee supports both Wegovy and Mounjaro with dose tracking, weight charts, injection logs, and side effect notes. Your data is portable if you switch between them.

Wegovy vs Mounjaro: Häufig gestellte Fragen

Ja, laut Studiendaten erreicht Tirzepatid (Mounjaro) im Durchschnitt eine höhere Gewichtsreduktion.

Quellen

  1. [1]Clinical TrialWilding JPH, et al. "Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP-1)." NEJM. 2021;384(11):989-1002.
  2. [2]Clinical TrialJastreboff AM, et al. "Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1)." NEJM. 2022;387(3):205-216.
  3. [3]Clinical TrialLincoff AM, et al. "Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (SELECT)." NEJM. 2023;389(24):2221-2232.

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