Weight loss medication comparison chart
Every FDA-approved weight loss medication at PEAK, compared side by side.
The complete comparison
Six FDA-approved weight loss medications. Different mechanisms, different price points, different strengths. Here's how they stack up across every factor that matters.
| Wegovy semaglutide | Zepbound tirzepatide | Foundayo orforglipron | Phentermine phentermine HCl | Saxenda liraglutide | Contrave naltrexone/bupropion | |
|---|---|---|---|---|---|---|
| Drug class | GLP-1 agonist | GLP-1/GIP dual agonist | GLP-1 agonist (small molecule) | Sympathomimetic amine | GLP-1 agonist | Opioid antagonist + antidepressant |
| Administration | Weekly injection | Weekly injection | Daily tablet | Daily tablet | Daily injection | Twice-daily tablet |
| Avg. weight loss | ~15% | 18–22.5% | ~11% | 5–10% | ~8% | ~5–6% |
| FDA-approved | 2021 | 2023 | 2026 | 1959 | 2014 | 2014 |
| Cost without insurance | Request pharmacy quote | Request pharmacy quote | $149–$349/mo ($299 on 14.5/17.2 mg with refill purchases within 45 days of delivery/receipt) (LillyDirect) | Request pharmacy quote | Request pharmacy quote | Request pharmacy quote |
| Cost with insurance | Copay varies by coverage and offer eligibility | Copay varies by coverage and offer eligibility | Savings card as low as $25/mo with eligible commercial drug coverage; caps apply | Check plan-specific copay | Check plan-specific copay | Check plan-specific copay |
| Insurance coverage | Most major plans | Growing rapidly | Growing; new to market | Most plans | Many plans | Many plans |
| Duration of use | Ongoing | Ongoing | Ongoing | Up to 12 weeks | Ongoing | Ongoing |
| Titration period | 16–20 weeks | 16–20 weeks | ~12 weeks | None | 4–5 weeks | 4 weeks |
| Main side effects | Nausea, constipation, vomiting | Nausea, diarrhea, vomiting | Nausea, diarrhea, vomiting | Dry mouth, insomnia, jitteriness | Nausea, diarrhea, constipation | Nausea, headache, constipation |
| How it works | Mimics GLP-1 hormone to slow digestion and reduce appetite | Mimics GLP-1 and GIP hormones for enhanced appetite and metabolic control | Small-molecule GLP-1 agonist taken orally; no food or water restrictions | Stimulates norepinephrine release to suppress appetite | Mimics GLP-1 hormone to reduce appetite (shorter-acting, daily) | Blocks food reward pathways (naltrexone) + reduces appetite (bupropion) |
| Best for | Patients seeking strong, sustained weight loss with broad insurance coverage | Patients seeking maximum weight loss; growing insurance coverage | Patients who want oral GLP-1 therapy without food or water timing restrictions | Affordable first step, step therapy, or short-term jump-start | Insurance-favored formulary; patients who prefer daily GLP-1 dosing | Emotional or reward-driven eaters; patients who prefer oral medication |
| Can combine with | Phentermine (under supervision) | Phentermine (under supervision) | Phentermine (under supervision) | Wegovy or Zepbound (under supervision) | Phentermine (under supervision) | Not typically combined |
| Learn more | Wegovy at PEAK → | Zepbound at PEAK → | Foundayo at PEAK → | Phentermine at PEAK → | Saxenda at PEAK → | Contrave at PEAK → |
Costs reflect typical ranges. Your actual cost depends on your insurance plan. PEAK verifies coverage before prescribing.
Medication summaries
Each medication works through a different mechanism and is suited to different patient profiles. Here's a brief overview of each option.
Wegovy
Wegovy was the first GLP-1 medication FDA-approved specifically for weight loss. It mimics a natural hormone that signals fullness after eating, slows stomach emptying, and reduces appetite at the brain level. The STEP 1 trial demonstrated approximately 15% average body weight loss over 68 weeks.
Full Wegovy guideZepbound
Zepbound is the newest and most potent weight loss medication available. It activates both GLP-1 and GIP receptors, providing a dual mechanism that produces the highest average weight loss in clinical trials (18–22.5% of body weight). SURMOUNT trials showed approximately one in three patients lost 25% or more of their body weight.
Full Zepbound guideFoundayo
Foundayo is the first oral small-molecule GLP-1 medication approved for weight loss that has no food or water timing restrictions. Unlike peptide-based GLP-1s, orforglipron is a small-molecule non-peptide agonist taken as a daily tablet at any time of day, with or without food. Clinical trials demonstrated approximately 11% average body weight loss at the approved 17.2 mg dose. FDA-approved in April 2026.
Full Foundayo guidePhentermine
Phentermine suppresses appetite and is approved for short-term use. It may be part of a step-therapy requirement. Ask the pharmacy for the exact generic price and your plan for coverage requirements.
Full phentermine guideSaxenda
Saxenda is the first-generation GLP-1 approved for weight loss, with the longest track record of any GLP-1 weight management medication (FDA-approved 2014). Liraglutide mimics the GLP-1 hormone to reduce appetite and promote satiety. Daily dosing and a shorter half-life mean side effects resolve more quickly. Average weight loss of 8% in the SCALE trials.
Full Saxenda guideContrave
Contrave combines two medications that target different aspects of appetite. Naltrexone blocks the brain's opioid reward pathway for food, reducing cravings and the emotional pull of comfort eating. Bupropion is an antidepressant that also reduces appetite and increases energy. It's particularly effective for patients whose eating is driven by emotion, stress, or reward-seeking behavior. Contrave carries FDA boxed warnings for suicidal thoughts and behaviors and increased seizure risk.
Full Contrave guideHow to choose the right medication
There's no single "best" weight loss medication. The right choice depends on your individual situation. Here's how your PEAK clinician thinks about medication selection:
If maximum weight loss is the goal
Zepbound produces the highest average weight loss in clinical trials, followed by Wegovy. Both are injectable GLP-1 medications that require slow dose titration over 4–5 months. If your insurance covers one or both, these are typically the first recommendation for patients with a BMI of 30 or higher.
If cost is the primary concern
Medication cost and coverage vary by plan, prescribed dose, quantity and pharmacy. Compare your actual insured copay with eligible manufacturer offers and current pharmacy cash quotes before filling. Discuss which clinically suitable options fit your budget before starting.
If emotional eating is a factor
Contrave specifically targets the brain's reward pathways and emotional eating patterns. If you find yourself eating when stressed, bored, or emotional rather than hungry, Contrave may be more effective than appetite-focused medications alone.
If you want a GLP-1 but prefer daily dosing
Saxenda offers the benefits of GLP-1 therapy with a daily injection instead of weekly. Its shorter half-life means side effects tend to resolve within hours, not days. It's also a strong option when insurance covers liraglutide but not semaglutide or tirzepatide.
If you want an oral GLP-1
Foundayo (orforglipron) is the first oral small-molecule GLP-1 for weight loss with no food or water restrictions. Take it any time of day, with or without food. Average ~11% body weight loss at 17.2 mg. It's a strong option for patients who want GLP-1 efficacy without injections.
If you strongly prefer oral medication
Foundayo, phentermine, and Contrave are all oral medications. Foundayo is an oral GLP-1 taken once daily. Phentermine is a once-daily tablet; Contrave is taken twice daily. If self-injection is a barrier, these are your FDA-approved options.
If your insurance requires step therapy
Many insurers require a documented trial of a less expensive medication before approving a GLP-1. Phentermine is the most common step therapy requirement. PEAK manages this process, documenting your response so that when you reapply for Wegovy or Zepbound, the clinical justification is ready.
Unlike clinics that only prescribe one type of medication, PEAK offers all six FDA-approved options. If your first medication isn't the right fit — due to side effects, cost, insurance, or response — your clinician can adjust your treatment plan without referring you elsewhere. Many patients try more than one medication before finding their best match.
Can medications be combined?
In some cases, yes. The most common combination at PEAK is phentermine plus a GLP-1 medication (Wegovy or Zepbound). This approach provides immediate appetite suppression from phentermine while the GLP-1 titrates to its full therapeutic dose over several months.
Combination therapy is always determined by your clinician based on your specific medical history and response to treatment. Not all combinations are safe — for example, two GLP-1 medications should never be taken together, and Contrave has interactions that must be carefully managed.
Frequently asked questions
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In clinical trials, Zepbound (tirzepatide) produced the highest average weight loss at 18–22.5% of body weight, followed by Wegovy at approximately 15%. Phentermine and Contrave typically produce approximately 5–6%. However, the most effective medication is the one you can access, afford, and tolerate consistently. A medication that keeps you on track long-term will produce better results than a theoretically stronger option you can't stay on.
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Medication cost and coverage vary by plan, prescribed dose, quantity and pharmacy. Compare your actual insured copay with eligible manufacturer offers and current pharmacy cash quotes before filling. See the medication pricing guide for current branded offers; no one medication is cheapest for every patient.
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Some combinations are used under medical supervision. The most common is phentermine plus a GLP-1 (Wegovy or Zepbound). However, not all combinations are safe. Two GLP-1 medications should never be taken together. Your PEAK clinician determines if combination therapy is appropriate based on your medical history and treatment response.
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The right medication depends on your BMI, weight loss goals, insurance coverage, budget, medical history, and personal preferences (injection vs. pill, emotional eating patterns, etc.). At PEAK, your clinician evaluates all of these during your first visit and recommends a personalized plan. Many patients try more than one medication before finding their best fit — that's normal and expected.
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Coverage and medication cost depend on the specific prescription, plan, pharmacy and program eligibility. PEAK checks benefits; ask the dispensing pharmacy for the final price before filling.
Boxed warning — thyroid C-cell tumors: GLP-1 receptor agonists (semaglutide, tirzepatide, liraglutide, orforglipron) carry an FDA boxed warning for thyroid C-cell tumors. This warning is based on findings with GLP-1 receptor agonists in rodent studies; notably, orforglipron was not active in rodent thyroid C-cells and did not produce thyroid C-cell tumors in animal studies. All are contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN2). Tell your provider immediately if you notice a lump in your neck, difficulty swallowing, or persistent hoarseness.
Boxed warning — Contrave (naltrexone/bupropion): Contrave carries an FDA boxed warning for suicidal thoughts and behaviors associated with the bupropion component. Patients should be monitored for neuropsychiatric symptoms, especially during early treatment. Contrave also increases seizure risk and should not be used with excessive alcohol consumption or abrupt discontinuation of alcohol, benzodiazepines, or antiepileptics.
References
- Wilding JPH, et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). N Engl J Med. 2021;384(11):989-1002.
- Jastreboff AM, et al. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1). N Engl J Med. 2022;387(3):205-216.
- Pi-Sunyer X, et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management (SCALE). N Engl J Med. 2015;373(1):11-22.
- Greenway FL, et al. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I). Lancet. 2010;376(9741):595-605.
- Zepbound (tirzepatide) prescribing information. FDA/Eli Lilly. NDA 217806.
- Wegovy (semaglutide) prescribing information. FDA/Novo Nordisk. BLA 215256.
- Foundayo (orforglipron) prescribing information. FDA/Eli Lilly. NDA approved April 2026.
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