# Semaglutide vs tirzepatide: how the two compare

Canonical page: https://bodienvi.com/blog/semaglutide-vs-tirzepatide

Published September 22, 2026. Updated September 22, 2026. By Bodi Envi Clinical Content Team.

How semaglutide and tirzepatide differ in mechanism, dosing, side effects, trial results and cost at Bodi Envi, and why a licensed provider makes the choice.

## The short answer

Semaglutide and tirzepatide are both once weekly injectable medications built on GLP-1, a hormone your body uses to regulate appetite. Semaglutide acts on the GLP-1 receptor. Tirzepatide acts on the GLP-1 receptor and on a second receptor, GIP. Both have FDA-approved branded forms for weight management, Wegovy® and Zepbound®, and both are also prepared as compounded medications by licensed pharmacies for individual prescriptions, which is what Bodi Envi's programs are built around.

Which one is right for you is not something a comparison page can answer. A licensed healthcare provider decides that from your health history, your current medications, what you have tried before and what you can tolerate. What this guide can do is set the two medications side by side, with every number traced to the FDA-approved label or the trial it came from, so that the conversation with your provider starts from facts.

One caveat runs through the whole page. The trials and the labels describe Wegovy® and Zepbound®, the branded products. Compounded personalized semaglutide and compounded personalized tirzepatide are not FDA-approved, are not reviewed by the FDA for safety, effectiveness or quality before they are marketed, and are not equivalent to the approved products. Brand names are trademarks of their respective owners.

## How each works

Semaglutide, according to the Wegovy® prescribing information, is a GLP-1 analogue with 94 percent sequence homology to human GLP-1 that selectively binds to and activates the GLP-1 receptor. The label describes GLP-1 as a physiological regulator of appetite and caloric intake, and notes that the GLP-1 receptor is present in several areas of the brain involved in appetite regulation.

Tirzepatide, according to the Zepbound® prescribing information, is a GIP receptor and GLP-1 receptor agonist that selectively binds to and activates both receptors, the targets for the body's own GIP and GLP-1. The label states that nonclinical studies suggest the addition of GIP may further contribute to the regulation of food intake, and that both receptors are found in areas of the brain involved in appetite regulation. It also notes that tirzepatide carries a fatty acid chain that lets it bind to albumin in the blood and prolongs its half-life, which is what allows once weekly dosing.

The practical difference, then, is one receptor against two. Whether that second receptor translates into a different experience for you is something the trials below speak to in averages, and only your own course of treatment can answer for you.

Personalized compounded medications differ from commercially available brand-name products in formulation, concentration, excipients, preparation methods, and other characteristics. Accordingly, clinical data from studies involving brand-name products should not be assumed to apply to personalized compounded formulations.

At this time, the studies referenced above have not evaluated the specific personalized compounded formulations being provided. Therefore, no claims of equivalence in safety, efficacy, quality, or clinical outcomes should be inferred from these studies.

## What the trials showed for each

Both medications have a large, published, placebo-controlled trial in adults with obesity or overweight and no diabetes. They are different trials, run by different companies, with different doses and durations, and their results sit next to each other here only so you can see each one clearly. They are not a head-to-head comparison and should not be read as one.

STEP 1, published in the New England Journal of Medicine in 2021 by Wilding and colleagues, enrolled 1,961 adults with a body mass index of 30 or higher, or 27 or higher with at least one weight-related condition, and assigned them to 68 weeks of once weekly semaglutide at 2.4 mg or placebo, alongside lifestyle intervention. According to the abstract on PubMed, mean body weight changed by 14.9 percent with semaglutide and 2.4 percent with placebo. In the semaglutide group, 86.4 percent of participants lost 5 percent or more of their body weight and 50.5 percent lost 15 percent or more. Nausea and diarrhea were the most common adverse events, described as typically transient and mild to moderate, and 4.5 percent of the semaglutide group discontinued because of gastrointestinal events.

SURMOUNT-1, published in the New England Journal of Medicine in 2022 by Jastreboff and colleagues, enrolled 2,539 adults with a body mass index of 30 or more, or 27 or more with at least one weight-related complication, and assigned them to 72 weeks of once weekly tirzepatide at 5 mg, 10 mg or 15 mg, or placebo, including a 20 week dose escalation. According to the abstract on PubMed, mean weight changed by 15.0 percent, 19.5 percent and 20.9 percent at the three doses and 3.1 percent with placebo. The share losing 5 percent or more was 85 percent, 89 percent and 91 percent against 35 percent with placebo. The most common adverse events were gastrointestinal, mostly mild to moderate, and occurred primarily during dose escalation; discontinuation for adverse events was 4.3 percent, 7.1 percent and 6.2 percent across the doses and 2.6 percent with placebo.

Read together, the numbers say that both medications produced substantial average weight reduction in their own trials, and that the higher tirzepatide doses produced larger averages in its trial than semaglutide 2.4 mg produced in its trial. What they do not say is what would happen if the two were given to the same people under the same conditions, because that is not what either trial tested. They also say nothing about compounded versions of either medication, which neither trial studied. Individual experiences and outcomes vary. Brand name studies cannot be applied to personalized compounded versions of the medications. No studies have been completed on personalized compounded medications and they cannot be compared.

Personalized compounded medications differ from commercially available brand-name products in formulation, concentration, excipients, preparation methods, and other characteristics. Accordingly, clinical data from studies involving brand-name products should not be assumed to apply to personalized compounded formulations.

At this time, the studies referenced above have not evaluated the specific personalized compounded formulations being provided. Therefore, no claims of equivalence in safety, efficacy, quality, or clinical outcomes should be inferred from these studies.

## Dosing schedules per the labels

Both medications start low and step up, and both labels say the escalation exists to reduce gastrointestinal side effects.

The Wegovy® label sets a starting dose of 0.25 mg once weekly for four weeks, then 0.5 mg for weeks five through eight, 1 mg for weeks nine through twelve, 1.7 mg for weeks thirteen through sixteen, and a maintenance dose from week seventeen onward, with 1.7 mg and 2.4 mg both listed as maintenance doses for weight reduction in adults. If a patient does not tolerate a step, the label allows the escalation to be delayed by four weeks.

The Zepbound® label sets a starting dose of 2.5 mg once weekly for four weeks, then allows increases in 2.5 mg steps after at least four weeks at each dose. It lists 5 mg, 10 mg and 15 mg as maintenance doses and 15 mg as the maximum, and describes 2.5 mg as a starting dose for treatment initiation rather than a maintenance dose.

Both are injected subcutaneously in the abdomen, thigh or upper arm, with sites rotated. With a compounded prescription through Bodi Envi, these schedules are a reference. Your provider sets your dose and its timing, and Bodi Envi's pricing does not increase based solely on dosage strength, so a dose change is never a price change.

Personalized compounded medications differ from commercially available brand-name products in formulation, concentration, excipients, preparation methods, and other characteristics. Accordingly, clinical data from studies involving brand-name products should not be assumed to apply to personalized compounded formulations.

At this time, the studies referenced above have not evaluated the specific personalized compounded formulations being provided. Therefore, no claims of equivalence in safety, efficacy, quality, or clinical outcomes should be inferred from these studies.

## Side effect profiles per the labels

Gastrointestinal effects are the most commonly reported adverse reactions for both medications, and both labels carry the same boxed warning and the same core contraindication.

The Wegovy® label reports, in adults treated for weight reduction at 2.4 mg, nausea in 44 percent of patients against 16 percent on placebo, diarrhea in 30 percent against 16 percent, vomiting in 24 percent against 6 percent, constipation in 24 percent against 11 percent, abdominal pain in 20 percent against 10 percent, headache in 14 percent against 10 percent, and fatigue in 11 percent against 5 percent.

The Zepbound® label reports, across its two pooled weight reduction studies, nausea in 25 to 29 percent of patients, diarrhea in 19 to 23 percent, vomiting in 8 to 13 percent, constipation in 11 to 17 percent, abdominal pain and dyspepsia in 9 to 10 percent each, injection site reactions in 6 to 8 percent and fatigue in 5 to 7 percent.

Those two lists come from different trials with different designs and cannot be laid over each other to say one medication is gentler than the other. What they share matters more. Both labels open with a boxed warning that the medication caused thyroid C-cell tumours in rodents and that it is unknown whether it does so in humans, and both list a personal or family history of medullary thyroid carcinoma, or Multiple Endocrine Neoplasia syndrome type 2, as a contraindication. Both labels also warn about pancreatitis, gallbladder disease, kidney injury from dehydration, severe gastrointestinal reactions, hypersensitivity reactions, low blood sugar when combined with insulin or certain other diabetes medications, and diabetic retinopathy complications in people with type 2 diabetes. The safety guide on this site goes through each warning in the label's own terms.

Personalized compounded medications differ from commercially available brand-name products in formulation, concentration, excipients, preparation methods, and other characteristics. Accordingly, clinical data from studies involving brand-name products should not be assumed to apply to personalized compounded formulations.

At this time, the studies referenced above have not evaluated the specific personalized compounded formulations being provided. Therefore, no claims of equivalence in safety, efficacy, quality, or clinical outcomes should be inferred from these studies.

## Cost at Bodi Envi

Bodi Envi publishes one price per program and the price is the same at every dose. Both programs include the online assessment, provider review, messaging with your care team, a GLP-1 ebook and diet plan, and the medication when a provider prescribes it.

| Term | Personalized compounded semaglutide | Personalized compounded tirzepatide |
| --- | --- | --- |
| Monthly, billed monthly | $155 per month | $229 per month |
| 3 months, paid once | $145 per month, $435 | $219 per month, $657 |
| 6 months, paid once | $135 per month, $810 | $205 per month, $1,230 |
| 12 months, paid once | $125 per month, $1,500 | $175 per month, $2,100 |

Personalized compounded semaglutide is the less expensive program by $74 a month on monthly billing and $50 a month on the twelve month plan. Medication is included only when a licensed healthcare provider determines treatment is medically appropriate and issues a prescription, and paying for a program does not guarantee one. The two cost guides on this site set each program against its brand list price and the manufacturer's own savings programs.

## How a provider chooses

A provider choosing between the two is weighing things a comparison table cannot hold. Your medical history, including anything on either label's contraindication or warning list. Other medications you take, especially for diabetes. What you have tried before and how you tolerated it. What you are hoping for and over what period. Your preference, which you can state in your assessment and which the provider will weigh. And the honest fact that both medications have a strong trial behind their branded form and that neither trial studied a compounded product.

A provider may also start with one and, if the response or the tolerance is not what either of you hoped for, discuss the other. That is a clinical conversation for the patient portal, not something to decide from a page. Treatment is not guaranteed, and a licensed healthcare provider determines whether treatment is appropriate for each individual patient.

## At a glance

| Measure | Semaglutide | Tirzepatide |
| --- | --- | --- |
| Mechanism, per label | GLP-1 receptor agonist | GIP receptor and GLP-1 receptor agonist |
| Dosing frequency | Once weekly, subcutaneous | Once weekly, subcutaneous |
| Label dose range for weight reduction | 0.25 mg start, 1.7 mg or 2.4 mg maintenance | 2.5 mg start, 5 mg, 10 mg or 15 mg maintenance |
| FDA-approved brand products | Wegovy® (weight management), Ozempic® (type 2 diabetes) | Zepbound® (weight management, obstructive sleep apnea), Mounjaro® (type 2 diabetes) |
| Headline trial, branded product | STEP 1, 14.9 percent mean weight change at 68 weeks | SURMOUNT-1, 15.0 to 20.9 percent by dose at 72 weeks |
| Most common side effects, per label | Gastrointestinal | Gastrointestinal |
| Bodi Envi monthly price, compounded | $155 | $229 |
| Bodi Envi 12 month plan, compounded | $125 per month, $1,500 paid once | $175 per month, $2,100 paid once |

Personalized compounded semaglutide and personalized compounded tirzepatide are not FDA-approved and are not equivalent to FDA-approved products. The FDA does not review compounded drugs for safety, effectiveness or quality before they are marketed.

## Frequently asked questions

### What is the main difference between semaglutide and tirzepatide?

The receptors they act on. The Wegovy® prescribing information describes semaglutide as a GLP-1 receptor agonist. The Zepbound® prescribing information describes tirzepatide as a GIP receptor and GLP-1 receptor agonist, meaning it activates two hormone receptors involved in appetite regulation rather than one. Both are once weekly injections under the skin.

### Which has fewer side effects?

Gastrointestinal effects are the most commonly reported for both, per their labels, and both labels carry the same boxed warning about thyroid C-cell tumours seen in rodents and the same contraindication for people with a personal or family history of medullary thyroid carcinoma or MEN 2. The reported percentages come from different trials and cannot be compared directly. How you tolerate either medication is individual. Brand name studies cannot be applied to personalized compounded versions of the medications, and no studies have been completed on personalized compounded medications, so they cannot be compared. Personalized compounded medications differ from commercially available brand-name products in formulation, concentration, excipients, preparation methods, and other characteristics. Accordingly, clinical data from studies involving brand-name products should not be assumed to apply to personalized compounded formulations. At this time, the studies referenced above have not evaluated the specific personalized compounded formulations being provided. Therefore, no claims of equivalence in safety, efficacy, quality, or clinical outcomes should be inferred from these studies.

### Which costs less at Bodi Envi?

Personalized compounded semaglutide. It is $155 per month billed monthly and $125 per month on the twelve month plan. personalized compounded tirzepatide is $229 per month billed monthly and $175 per month on the twelve month plan. Both prices stay the same at every dose.

### Can I switch from one to the other?

Only through your provider. A switch is a clinical decision that depends on how you have responded, what you have tolerated and your health history, and the provider who reviews your case is the person to raise it with through the patient portal.

### Who decides which medication I get?

A licensed healthcare provider, through Wasef Health, PC for applicable Bodi Envi programs. You can state a preference in your assessment, and the provider weighs it with your history, but the decision is theirs and treatment is not guaranteed.

### Are the compounded versions the same as the brands?

No. personalized compounded semaglutide and personalized compounded tirzepatide are not FDA-approved and are not equivalent to FDA-approved products. The FDA does not review compounded drugs for safety, effectiveness or quality before they are marketed.

## Sources

- Wegovy® (semaglutide) injection prescribing information, DailyMed, revised June 2026: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b (checked September 2026)
- Zepbound® (tirzepatide) injection prescribing information, DailyMed, revised August 2026: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b (checked September 2026)
- Ozempic® (semaglutide) injection prescribing information, DailyMed, revised May 2026: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79 (checked September 2026)
- Mounjaro® (tirzepatide) injection prescribing information, DailyMed, revised August 2026: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2d7da5d-ad07-4228-955f-cf7e355c8cc0 (checked September 2026)
- Wilding et al., Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1), New England Journal of Medicine, 2021, PubMed: https://pubmed.ncbi.nlm.nih.gov/33567185/ (checked September 2026)
- Jastreboff et al., Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1), New England Journal of Medicine, 2022, PubMed: https://pubmed.ncbi.nlm.nih.gov/35658024/ (checked September 2026)
- Bodi Envi plans and pricing: https://bodienvi.com/plans (checked September 2026)