Which GLP-1 is best for weight loss?

The five drugs actually approved for weight loss

The starting point of any honest answer is which medicines carry an FDA indication for weight management, because that is the set that has been reviewed for this purpose. As of September 2026 there are five, from two manufacturers, and two of them are pills.

All five are approved with the same framing: in combination with a reduced-calorie diet and increased physical activity, for adults with obesity (a BMI of 30 or more), or adults with overweight (BMI 27 or more) who also have at least one weight-related condition such as high blood pressure, high cholesterol, sleep apnea or cardiovascular disease.

Not on this list: Ozempic and Mounjaro, which are approved for type 2 diabetes, and every compounded GLP-1, which is made by a pharmacy and has never been reviewed by the FDA for any indication. Prescribing any of them for weight loss is off-label — legal, common, and a decision for a clinician, but not the same thing as an approved treatment.

What the trials actually found

Every number below comes from the drug's own FDA label — the trial the agency reviewed before approving it for weight management. They are mean changes across everyone randomised, not best cases.

• These are not head-to-head trials. Zepbound's trial ran 72 weeks in people averaging 105 kg; Saxenda's ran 56 weeks; Wegovy's tablet trial ran 64 weeks in 307 people. Reading down the column gives you an ordering, not a measurement of the gaps.
• One comparison inside the table is real. Wegovy 7.2 mg and Wegovy 2.4 mg were tested in the same trial, in the same patients, at the same time: the higher dose produced 3.3 percentage points more weight loss.
• Every arm dieted, including placebo. All of these trials built in a roughly 500-calorie daily deficit and at least 150 minutes of activity a week. The placebo columns — 2% to 4% — are what that produced on its own.
• Plenty of people stopped. In Zepbound's trial 14–16% discontinued the drug; in Foundayo's, 22–24%; with Wegovy tablets, 18%. In every case more people quit the placebo than the drug, which is its own kind of evidence.

The best GLP-1 pill

Until 2026 the answer to "is there a GLP-1 pill?" was Rybelsus, approved only for type 2 diabetes. There are now two oral options approved for weight loss, and they work differently from each other.

Wegovy tablets are the same molecule as the Wegovy injection — semaglutide — escalated over twelve weeks to a 25 mg daily maintenance dose. In a 64-week trial they produced a 13.6% mean weight reduction against 2.4% on placebo. Anyone already on the 2.4 mg injection can switch: one week after the last injection, start the 25 mg tablet.

Foundayo is orforglipron, a different kind of molecule — a small non-peptide that does not need to be protected from digestion. That is why its label carries no food or water restrictions and says it can be taken at any time of day. Its top dose, 17.2 mg, produced 11.1% over 72 weeks.

The trade-off is straightforward: both pills produce less average weight loss than the strongest injections, and both cost less. Wegovy tablets start at $149 a month and rise to $299 at maintenance doses; Foundayo starts at $149 and reaches $299 at its top doses. Neither requires needles, sharps disposal or refrigeration.

A tablet has to be taken every day, not once a week, and adherence is part of the result. Foundayo's tablets must be swallowed whole — not broken, crushed or chewed — and no more than one a day.

If you have type 2 diabetes, expect less

This is one of the most consistent findings in the whole set, and it rarely makes it into comparison articles. Every one of these drugs produces meaningfully less weight loss in people who also have type 2 diabetes, in trials the manufacturers ran specifically in that population.

Zepbound 15 mg produced 14.7% in people with type 2 diabetes against 20.9% in people without. Wegovy 2.4 mg produced 9.6% against 14.9%. Foundayo 17.2 mg produced 9.6% against 11.1%. Same drugs, same doses, same trial lengths — different starting metabolism.

The practical consequence is that a weight-loss expectation set by the headline number will be wrong for a large share of the people taking these drugs. If you have type 2 diabetes, the second number is yours.

What each one costs without insurance

Both manufacturers now sell direct to self-pay patients, and those prices dropped sharply through 2025 and 2026. They are the benchmark for judging any telehealth offer.

• Prepaid plans go lower. Novo's multi-month subscription prices Wegovy injections at $329, $299 or $249 a month on 3, 6 or 12-month terms, and the tablets at $289, $269 or $249. It is sold through telehealth partners rather than directly.
• Telehealth adds a membership. Providers selling these brand-name drugs typically charge $39 to $149 a month on top of the medication, which buys the consultation and the prescription rather than a discount. Our dated tables show both numbers: GLP-1 cost without insurance and the cheapest GLP-1 overall.
• Insurance is a separate world. These medicines are widely covered for diabetes and widely excluded for weight loss. Where commercial coverage exists, both manufacturers run copay programmes that bring the monthly cost far below the self-pay prices above.

Where compounded versions fit

Most of the cheapest offers online are not for any of the five drugs above. They are for compounded semaglutide or compounded tirzepatide — the same active molecules, mixed by a pharmacy rather than manufactured by Novo Nordisk or Eli Lilly, sold from about $60 to $216 a month at starting doses.

The distinction that matters for this page is evidence. None of the trial results above belong to a compounded product. They were run on a specific manufactured formulation, at defined strengths, in a particular device; a pharmacy-made version at a different concentration in a multi-dose vial is not the product that was studied, and the FDA has not reviewed it for safety, effectiveness or quality.

That does not make compounded products useless, and for many people it is the only affordable route. It does mean the honest comparison is not "Zepbound at $449 versus tirzepatide at $149" but "a reviewed product versus an unreviewed one at a lower price". We cover what that trade-off involves in is compounded semaglutide safe? and compounded tirzepatide vs Zepbound.

What they all share: warnings and side effects

The five drugs have more in common than not. All carry the same boxed warning and the same contraindications, and their most common side effects are gastrointestinal and dose-dependent.

• Boxed warning: in rodents, these molecules caused dose-dependent thyroid C-cell tumors. Whether they do so in humans is unknown.
• Contraindicated for anyone with a personal or family history of medullary thyroid carcinoma or with Multiple Endocrine Neoplasia syndrome type 2, and for anyone who has had a serious hypersensitivity reaction to the drug.
• Most common reactions: nausea, diarrhea, vomiting, constipation, abdominal pain. Wegovy 2.4 mg reported nausea in 44% of patients against 16% on placebo; Zepbound 25–29% against 8%.
• Also warned about: acute pancreatitis, gallbladder disease, acute kidney injury from dehydration, severe gastrointestinal reactions, hypoglycemia when combined with insulin or a sulfonylurea, worsening of existing diabetic retinopathy, and food being aspirated into the lungs under general anesthesia — tell any surgeon you are on one.
• Do not combine them. Several of these labels state that taking two GLP-1 receptor agonists at the same time is not recommended.

So which is best?

On the published evidence, Zepbound produced the largest average weight loss, with Wegovy's 7.2 mg dose close behind. That is the answer to the question as asked — and it is the least useful part of the answer, because these drugs only work while you take them, and what decides real-world results is whether you can get one, tolerate it and keep paying for it.

The questions that actually determine the outcome:

• Will insurance cover any of them? A covered drug at a $25 copay beats an uncovered one with a better trial number, every time.
• Injection or pill? A weekly injection you will actually give yourself beats a daily tablet you forget, and the reverse is equally true.
• How did you tolerate the last dose increase? The strongest drug at a dose you cannot stay on produces less weight loss than a gentler one you keep taking.
• Do you have other conditions in play? Wegovy is the only one of the five with approved cardiovascular and liver indications; Zepbound is the only one approved for obstructive sleep apnea.
• What does it cost at the dose you will end up on, not the starting dose? Most of these prices rise as you titrate, and the starting price is the one in the advertisement.
• Who is prescribing it? A clinician licensed in your state who has seen your history. Every provider profile here answers that first, and the ranked list of brand-name providers starts from providers whose prices we have verified.