GLP-1 program comparison

Most patients report meaningful appetite suppression by the 0.5 mg dose, with hunger dropping further as you titrate to the 1.7 mg and 2.4 mg maintenance doses.^[8][1]

Dual GIP/GLP-1 action suppresses hunger more aggressively than semaglutide for most patients. Many report needing to set reminders to eat by week 8.^[9][3]

Same active molecule as Wegovy, so appetite suppression is comparable when dosed identically. Some compounded formulations include B12, which does not change efficacy.^[1]

Dual-agonist appetite suppression matches branded Zepbound when titration is matched. Expect a sharp drop in cravings between weeks 4–8.^[3]

Oral bioavailability is lower than injected semaglutide, so appetite suppression is real but less dramatic at equivalent dosing.^[5][6]

Shorter half-life than semaglutide or tirzepatide, so appetite effects fluctuate during the day. Less hunger suppression overall.^[7][10]

First results

Week 4–8

Avg loss at 6 mo

8–12% of body weight

Avg loss at 12 mo

14–15% of body weight

STEP trial data showed an average 14.9% reduction at 68 weeks on the 2.4 mg dose. Weight loss tends to be linear through month 9, then flattens.^[1][2]

First results

Week 2–4

Avg loss at 6 mo

12–15% of body weight

Avg loss at 12 mo

18–22% of body weight

SURMOUNT-1 reported a 20.9% average loss at the 15 mg dose over 72 weeks — the highest of any approved GLP-1 to date.^[3][4]

First results

Week 4–8

Avg loss at 6 mo

8–12% of body weight

Avg loss at 12 mo

12–15% of body weight

Real-world telehealth data tracks closely with STEP trial outcomes when patients reach a 2.0–2.4 mg maintenance dose.^[1][2]

First results

Week 2–4

Avg loss at 6 mo

11–14% of body weight

Avg loss at 12 mo

16–20% of body weight

Compounded tirzepatide commonly delivers faster early loss than semaglutide thanks to stronger appetite effects.^[3][4]

First results

Week 6–10

Avg loss at 6 mo

5–8% of body weight

Avg loss at 12 mo

8–11% of body weight

Expect a slower, gentler curve. Many programs use oral as a stepping stone before injection.^[6][5]

First results

Week 4–6

Avg loss at 6 mo

5–7% of body weight

Avg loss at 12 mo

7–9% of body weight

Effective but outclassed by newer molecules. Often used when insurance prefers it or for patients sensitive to weekly dosing.^[7]

• Nausea
• Constipation
• Fatigue
• Sulfur burps

Side effects peak during dose escalation. Slow titration (staying 8+ weeks at each dose) reduces nausea significantly.^[8][1]

• Nausea
• Diarrhea
• Constipation
• Burping

Side effect profile is similar to semaglutide but with slightly more GI motility issues. Hydration and fiber matter more on tirzepatide.^[9][3]

• Nausea
• Constipation
• Fatigue
• Injection-site reaction

Side effects mirror Wegovy. Pay attention to your compounding pharmacy's source and sterility documentation.^[8][11]

• Nausea
• Diarrhea
• Reflux
• Fatigue

Similar to branded Zepbound. Some patients report stronger reflux on tirzepatide than semaglutide; smaller meals help.^[9][11]

• Mild nausea
• Bloating
• Decreased appetite

Must be taken on an empty stomach with ≤4 oz of water and 30 minutes before food — adherence is the real challenge.^[5]

• Nausea
• Vomiting
• Diarrhea
• Headache

Daily dosing means daily exposure to side effects rather than the once-weekly peak/trough pattern of newer GLP-1s.^[10][7]

Patients with commercial insurance who want the FDA-approved branded product and a predictable supply chain.^[12]

Heads up — Watch out: Insurance prior authorization can take 4–6 weeks; brand-name supply has improved but is not guaranteed.

Patients targeting >15% total body weight loss, especially those with insulin resistance.^[13]

Heads up — Watch out: Highest list price of any GLP-1; insurance coverage is the deciding factor for most.

Patients without GLP-1 insurance coverage who want semaglutide at a predictable monthly cost.^[11]

Heads up — Watch out: FDA enforcement discretion is evolving. Choose a provider that documents the pharmacy and offers a transition plan.

Patients chasing maximum weight loss without brand-name pricing.^[11]

Heads up — Watch out: Same regulatory uncertainty as compounded semaglutide. Confirm the pharmacy and the dose-escalation protocol.

Patients who can't or won't inject, or who want to test tolerance before committing to weekly shots.^[13]

Heads up — Watch out: Skipping the empty-stomach window destroys absorption. Daily discipline matters more than dose.

Patients whose insurance covers Saxenda but not Wegovy or Zepbound.^[12]

Heads up — Watch out: Daily injections become a long-term adherence burden for most patients.