Semaglutide vs tirzepatide — which is better?
Tirzepatide produces greater average weight loss in head-to-head trials (~15-22% vs ~12-15%). Semaglutide has longer real-world track record. Choice depends on candidacy, tolerability, access, and cost.
Full answer
Semaglutide and tirzepatide are both injectable GLP-1-class therapies, but tirzepatide is a dual GLP-1/GIP agonist while semaglutide is GLP-1 only. In the SURMOUNT-5 head-to-head trial, tirzepatide produced greater weight loss (~20.2% vs ~13.7% at 72 weeks). Semaglutide has a longer real-world track record and broader cardiovascular outcome evidence. Choice depends on individual response, tolerability profile, candidacy, formulary access, and cost. oMeds provider review individualizes the choice and monitors response on a recalibration cadence rather than relying on average trial numbers.
Educational. Not a substitute for individualized provider review.
- Metabolic optimization — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-05-29