When deciding between Zepbound and Ozempic, it can be helpful to understand the differences between the two, as well as their similarities, before making a decision.
While both Ozempic and Zepbound can cause weight loss, there are notable differences between them. For instance, Zepbound is the only one that is approved for weight loss. Plus, you will lose more weight with Zepound. Here are some other differences between the two medications to consider.
Difference
Zepbound
Ozempic
Weight loss
21% of body weight after 72 weeks
15% of body weight after 68 weeks
FDA approvals
Weight loss and sleep apnea
Type 2 diabetes, heart disease, kidney disease
Differences in pens
Single use injection pen
Multi-dose injection pen
Conditions treated
Obesity, overweight, sleep apnea
Type 2 diabetes, kidney function, heart disease
Mechanisms of action
Dual-agonist drug
Single-agonist drug
Serious adverse events
5% to 7% of people
3% of people
While only Zepbound is approved for weight loss, both drugs can impact the number on the scale, especially when combined with a nutritious diet and regular exercise. Here are some other similarities between the two:
- Approved for adults 18 and older
- Intended for long-term use
- Reduces appetite
- Causes weight loss
- Lowers blood sugar
- Impacts digestion
- Injected once a week
- Increases risk for thyroid cancer in certain people
Choosing between Ozempic and Zepbound depends on which option your healthcare provider believes is safest and most effective for you. They’ll consider your medical conditions, side-effect tolerance, insurance coverage, and weight-loss goals before recommending one. Things to consider include:
- Heart-related conditions: If you have conditions like heart disease, your provider may recommend Ozempic because it has been shown to reduce the risk of certain heart-related complications.
- Weight loss or sleep apnea: If your primary needs are weight loss or treatment for obstructive sleep apnea—and you meet the criteria—your provider may recommend Zepbound.
- Insurance considerations: Because Ozempic is not FDA-approved for weight loss, insurance may not cover it, making Zepbound the more cost-effective option.
- Safety guidance: Always consult with your healthcare provider before making this decision. Avoid counterfeit or online-purchased medications, as they pose significant safety risks.
- FDA approval: Initially approved in 2017 to treat type 2 diabetes, its approval was later expanded to include the reduction of the risk of major cardiovascular events. And, in 2025, it was approved to prevent the worsening of kidney disease. Ozempic is not approved for weight loss, but it may be prescribed for off-label use.
- Effectiveness: Although Ozempic is not approved for weight loss, it can still impact weight management and may lead to weight loss. One study followed people for 68 weeks and found that those taking semaglutide lost an average of 15% of their body weight.
- Common side effects: Like Zepbound, Ozempic can cause nausea, diarrhea, constipation, vomiting, stomach pain, injection site reactions, burping, and reflux. It can also cause rarer, but more serious, side effects like allergic reactions, pancreatitis, thyroid cancer, and diabetic retinopathy. Ozempic also has a boxed warning from the FDA that it causes thyroid tumors in animals, but researchers do not know if it will do the same in humans.
- Safety: Just as with Zepbound, if you or someone in your family has ever had medullary thyroid cancer, you should not take this medication. You also should not take Ozempic if you have multiple endocrine neoplasia type 2. Additionally, this drug is not meant to treat type 1 diabetes.
- FDA approval: Zepbound was approved in 2023 for weight loss in adults with a body mass index (BMI) of 30 or more. People with a BMI of 27 and at least one weight-related health condition can also be prescribed Zepbound. The drug was also approved for the treatment of obstructive sleep apnea in December 2024.
- Effectiveness: Zepound is a highly effective weight loss drug. One 72-week study found that people taking the medication lost an average of 21% of their body weight. This means someone who weighs 250 pounds when they start the drug could potentially lose 52 pounds or more. For those with sleep apnea, up to 50% had no symptoms after one year.
- Common side effects: Like other similar medications, Zepbound can cause nausea, diarrhea, constipation, hair loss, vomiting, stomach pain, injection site reactions, fatigue, burping, and reflux. It can also cause rarer, but more serious, side effects like allergic reactions, gallbladder problems, pancreatitis, and thyroid cancer. In fact, Zepbound has a boxed warning from the FDA that it causes thyroid tumors in animals, though it is unknown if it will do the same in humans.
- Safety: If you or someone in your family has ever had thyroid cancer such as medullary thyroid cancer, you should not take this medication. Likewise, if you have multiple endocrine neoplasia type 2, you also should not take Zepbound.
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