Wegovy vs. Zepbound
Der wichtigste Vergleich bei Adipositas – Daten aus SURMOUNT-5
Wegovy und Zepbound sind die beiden führenden FDA-zugelassenen Medikamente gegen Adipositas. SURMOUNT-5 (2025) zeigte: Tirzepatid (Zepbound) liefert ca. 47% mehr relativen Gewichtsverlust.
Die Zahlen
- →GLP-1 receptor agonist — single incretin mechanism
- →Mimics endogenous GLP-1 released after meals
- →Suppresses appetite via hypothalamic GLP-1 receptors
- →Slows gastric emptying, prolonging satiety
- →Glucose-dependent insulin secretion enhancement
- →Half-life ~7 days; once-weekly autoinjector pen
- →SELECT trial: 20% MACE reduction in obesity + CVD (2023)
- →Dual GIP + GLP-1 receptor agonist
- →GIP receptor activation enhances adipose insulin sensitivity
- →GIP co-signalling may reduce GLP-1-driven nausea
- →Additive appetite suppression from two incretin pathways
- →Deeper weight loss vs GLP-1 monotherapy in all trials
- →Half-life ~5 days; once-weekly autoinjector pen
- →SURMOUNT-MMO cardiovascular outcomes trial ongoing
Head-to-Head Comparison
| Factor | Wegovy | Zepbound |
|---|---|---|
| Active molecule | Semaglutide | TirzepatideBest |
| Receptor targets | GLP-1 only | GIP + GLP-1 |
| FDA approval (obesity) | June 2021 | November 2023 |
| Max dose | 2.4 mg weekly | 15 mg weekly |
| Weight loss — STEP-1/SURMOUNT-1 | 14.9% (sema 2.4 mg, 68 wks) | 20.9% (tirz 15 mg, 72 wks) |
| Direct head-to-head (SURMOUNT-5) | Reference arm | ~47% more weight loss vs Wegovy |
| Nausea incidence | ~44% (STEP-1) | ~31% (SURMOUNT-1 15 mg) |
| Cardiovascular outcome trial | SELECT 2023: 20% MACE reduction | MMO trial ongoing |
| Monthly cost (uninsured) | ~$1,300–1,400 | ~$1,000–1,200 |
| T2D brand | Ozempic | Mounjaro |
Weight Loss: The Numbers
Choose Based on Your Goal
Maximum weight loss
Zepbound 15 mg achieved ~20.9% mean weight loss in SURMOUNT-1 and was directly superior to Wegovy in SURMOUNT-5.
Strongest cardiovascular evidence
Wegovy's SELECT trial (2023) showed a 20% MACE reduction in obesity + CVD. Zepbound's cardiovascular trial (MMO) is still ongoing as of 2026.
Lower nausea rates
Zepbound reported ~31% nausea in SURMOUNT-1 vs ~44% for Wegovy in STEP-1. GIP modulation may reduce GI side effects.
Cost and insurance access
Zepbound is often slightly less expensive uninsured. Both have limited insurance coverage for obesity. Check your plan's formulary.
Earlier FDA approval history
Wegovy was approved June 2021 — over two years earlier than Zepbound (November 2023). More real-world safety data is available for semaglutide.
T2D + obesity combination
Both have T2D equivalents (Ozempic/Mounjaro). Your prescriber may choose based on which indication — T2D or obesity — is primary.
Which Is Right for You?
For pure weight loss efficacy, the evidence favours Zepbound. SURMOUNT-5 (2025) is the definitive direct comparison: tirzepatide produced approximately 47% more relative weight loss than semaglutide. This is consistent with the individual trial data — SURMOUNT-1 showing 20.9% vs STEP-1's 14.9%.
Wegovy's key advantage is cardiovascular outcome data. The SELECT trial (2023) was the first obesity drug to show a statistically significant reduction in MACE (20%) in adults with obesity and established CVD — a landmark result. Zepbound's SURMOUNT-MMO cardiovascular trial is ongoing.
Tolerability: SURMOUNT-1 reported ~31% nausea rate vs ~44% for STEP-1. However, both trials used different populations and titration schedules, so direct nausea comparison should be interpreted with caution. Both drugs share the same class of GI side effects and are managed with slow dose escalation.
Wegovy vs Zepbound: Häufig gestellte Fragen
Zepbound zeigt eine höhere Wirksamkeit beim Gewicht, während Wegovy aktuell die umfangreicheren Herz-Kreislauf-Daten hat.
Wegovy oder Zepbound mit Shotlee tracken
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