Injectable division
Semaglutide 2.4 mg (Wegovy)
BCompetitive
Novo Nordisk · approved
vs
Injectable division
Tirzepatide (Zepbound)
Class-leadingA
Eli Lilly · approved
12%
Efficacy
leads · 18%
Mild (+3.9)
Tolerability
Mild (+3.6)
Subcutaneous injection
Route
Subcutaneous injection
None
Food / water rule
None
Refrigerated (room temperature up to 28 days)
Storage
Refrigerated (room temperature up to 21 days)
The call: The head-to-head that reset the field: tirzepatide is class-leading where semaglutide is competitive, and it is at least as easy to stay on. This is one of the few pairs backed by a real randomized comparison, so the edge is not cross-trial inference. Tirzepatide, clearly, on the evidence.
Standalone, this page carries its own key: Efficacy = % body weight lost vs placebo, on the conservative estimand that counts everyone. Tolerability = AE-discontinuation over placebo (Mild 1 to 5 · Notable 5 to 10 · Heavy over 10 points). Winners are called only across a tier or band boundary; within one, the drugs are effectively tied. The side marked leads or gentler wins that axis.
Semaglutide 2.4 mg verdict · Tirzepatide verdict · How this is scored