In a recent head-to-head trial, Eli Lilly’s obesity drug Zepbound significantly outperformed Novo Nordisk’s Wegovy in terms of weight loss. Participants on Zepbound, which contains the active ingredient tirzepatide, lost an average of 50 pounds over 72 weeks, whereas those on Wegovy, which contains semaglutide, lost about 33 pounds. This study, led by Dr. Louis Aronne and published in the New England Journal of Medicine, involves 751 overweight participants, all with at least one weight-related health issue but not diabetes.
Both drugs function by mimicking hormones that regulate appetite and fullness, but tirzepatide is unique because it targets two hormones—GLP-1 and GIP—compared to semaglutide, which targets GLP-1 alone. The trial revealed that around 32% of Zepbound users lost at least 25% of their body weight, compared to 16% for those on Wegovy. Weight loss also correlated with improvements in various health markers, such as blood pressure and blood sugar levels.
However, both drugs have side effects, mostly mild to moderate gastrointestinal issues, with a similar dropout rate due to adverse events—6% for Zepbound and 8% for Wegovy. Each drug’s accessibility can be challenging; while both have recently had their shortages alleviated, affordability still poses a barrier. The average cost per month has been reduced to about $500, but recent formulary adjustments by CVS may affect insurance coverage for Zepbound. Both experts assert that a variety of treatment options is essential given the scale of obesity in the U.S., which affects about 40% of adults.
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