Clinician answer
Head-to-head SURMOUNT-5 (NEJM 2024) put max-dose tirzepatide (Zepbound) at 20.2% mean weight loss over 72 weeks vs 13.7% for max-dose semaglutide (Wegovy) — a 6.5-point gap. Zepbound patients also hit ≥15% loss at nearly twice the rate. Trade-off: tirzepatide GI side effects are slightly higher at max dose, and supply/pricing has been less stable. For most patients starting fresh, Zepbound is the higher-efficacy pick; Wegovy remains the choice if your insurance covers it and Zepbound is not on formulary.
Answered by Dr. Jane Novak, MD, MPH