Semaglutide and tirzepatide are both once-weekly injections that reduce appetite by imitating hormones the gut releases after a meal. Semaglutide (sold as Wegovy for weight and Ozempic for type 2 diabetes) acts on the GLP-1 receptor. Tirzepatide (Zepbound for weight, Mounjaro for diabetes) acts on GLP-1 and a second receptor, GIP. In the trials that led to approval, adults without diabetes lost an average of about 15 percent of body weight on semaglutide over 68 weeks and about 20 percent on the higher doses of tirzepatide over 72 weeks. Results vary, and the right choice depends on your health, your plan's coverage and how you tolerate each.
How they work
GLP-1 is a hormone that tells the pancreas to release insulin, slows the rate at which the stomach empties, and signals the brain that you are full. Semaglutide is a long-acting copy of it, so those signals last all week instead of a few minutes after eating. Many patients describe the constant background noise about food going quiet.
Tirzepatide does the same and adds GIP, a second hormone released after meals that also improves the way the body handles insulin and reduces appetite. Acting on both appears to produce more weight loss than acting on GLP-1 alone.
How each is dosed
Both start low and rise slowly, which is how side effects such as nausea are kept manageable. The standard Wegovy schedule is 0.25 mg once a week for four weeks, then 0.5 mg, 1 mg and 1.7 mg for four weeks each, reaching the 2.4 mg maintenance dose at around week 17. Tirzepatide starts at 2.5 mg for four weeks and rises by 2.5 mg every four weeks as tolerated, with maintenance doses of 5 mg, 10 mg and 15 mg, reaching the top dose at about 20 weeks. Not everyone needs the top dose of either. If you are losing weight steadily and feeling well at a lower dose, we hold there.
You inject either one yourself once a week, under the skin of the abdomen, thigh or upper arm, on the same day each week. The pen is prefilled and our medical assistants teach you at the first visit.
Who qualifies
Both are approved for chronic weight management in adults with a BMI of 30 or more, or 27 or more with a weight-related condition such as osteoarthritis, high blood pressure or sleep apnea. Zepbound is also approved for moderate to severe obstructive sleep apnea in adults with obesity, and Wegovy to reduce the risk of heart attack and stroke in adults with established heart disease and excess weight. Neither is for people with a personal or family history of medullary thyroid cancer, anyone who is pregnant or planning to be, or anyone with a history of pancreatitis.
How our physicians choose
The decision usually comes down to three things. Coverage first: some commercial plans cover one and not the other, most cover Mounjaro and Ozempic for type 2 diabetes, and Medicare does not cover either for weight loss alone. Then your other conditions, since the approvals differ. Then tolerance: if one causes side effects you cannot live with, switching is an option. For a pain patient, the doctor also weighs how quickly weight needs to come off a painful knee or spine. The semaglutide and tirzepatide pages give the detail on each, and the medical weight loss page describes the program around them.
Starting the program
At AffordaHealth in Davie and Boynton Beach the program begins with a consultation and labs. The physician prescribes, increases the dose every few weeks as you tolerate it, and sees you monthly. Book an appointment online and the front desk will check what your plan covers before you come in.
Questions patients ask
Which causes more weight loss, semaglutide or tirzepatide?
In the approval trials, tirzepatide produced more: about 20 percent of body weight at the 10 mg and 15 mg doses over 72 weeks, versus about 15 percent on semaglutide over 68 weeks. Individual results vary, and diet and activity still matter.
Is Ozempic the same as Wegovy?
Same molecule, semaglutide, sold under two names. Wegovy is approved for weight management and Ozempic for type 2 diabetes. The doctor prescribes the one that matches your diagnosis, because that is what your insurer looks at. The same applies to Zepbound and Mounjaro, which are both tirzepatide.
Does Medicare cover semaglutide or tirzepatide for weight loss?
Not for weight loss alone. Some commercial plans cover Wegovy or Zepbound with prior authorization, and most cover Ozempic and Mounjaro for type 2 diabetes. AffordaHealth checks your plan before your visit and explains the self-pay option if the medication is not covered.
Can I switch from one to the other?
Yes, under physician supervision. Switching is an option if one causes side effects you cannot tolerate or if your coverage changes. The doctor sets the starting dose of the new medication rather than matching the old one.