Saxenda vs. Zepbound for weight loss

Saxenda is a GLP-1 receptor agonist, while Zepbound is a dual GIP/GLP-1 receptor agonist. Both are injectable medications for weight loss. But they differ in several ways, including effectiveness, dosage, and side effects.

Want a head-to-head comparison of these weight loss medications? Here’s the rundown on Saxenda vs. Zepbound.

The biggest differences between Saxenda (liraglutide) and Zepbound (tirzepatide) are effectiveness and dosage frequency. Zepbound is a weekly injection that can help people lose 15%–21% of their body weight. Saxenda is a daily injection shown to help people lose an average of about 18.5 pounds (8.4 kg); around two-thirds of people taking Saxenda lose at least 5% of their body weight, and about one-third lose more than 10%.

Saxenda and Zepbound also have different uses approved by the US Food and Drug Administration (FDA).

• Saxenda is FDA-approved for weight loss and long-term weight management in:

  • Adults and adolescents 12 and older with body weight greater than 132 pounds (60 kg) and obesity

  • Adults with overweight and at least one weight-related condition

• Zepbound is FDA-approved for:

  • Long-term weight management in adults with obesity or overweight and at least one weight-related condition 

  • Obstructive sleep apnea in adults with obesity

Here’s the overview of Saxenda vs. Zepbound:

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Saxenda and Zepbound work very similarly — by imitating appetite-regulating hormones naturally produced by the body.

Saxenda 

Saxenda is a daily injection. It contains one active ingredient, liraglutide, which mimics the gut hormone GLP-1 (glucagon-like peptide-1). This supports weight loss in a few ways:

• Triggers the release of insulin, lowering blood sugar

• Slows stomach emptying

• Reduces the release of glucagon (a hormone that raises blood sugar)

Together, these effects make you feel full more quickly and stay full for longer so that you eat fewer calories and, in turn, lose weight.

Zepbound

Zepbound is a weekly injection. Its active ingredient, tirzepatide, works by targeting two gut hormones:

• GLP-1 (glucagon-like peptide 1), which lowers blood sugar, slows stomach emptying, and reduces the release of glucagon

• GIP (glucose-dependent insulinotropic polypeptide), which helps regulate metabolism 

Where Saxenda targets one gut hormone, Zepbound targets two — meaning it works in similar ways but Zepbound adds an extra mechanism that may support greater weight loss.

Data suggest that Zepbound leads to more weight loss than Saxenda. 

That said,  individual weight loss journeys vary. Lifestyle preferences, including whether you’re more likely to remember weekly versus daily injections or which side effects you can tolerate, play a role in which one is better for your weight loss goals. 

How much weight can you lose on Saxenda vs. Zepbound?

In separate clinical trials, people lost around 6% of their body weight after 56 weeks on Saxenda, compared with 15%–21% after 72 weeks on Zepbound. 

A meta-analysis of six randomized trials compared the weight loss results of Zepbound vs. Saxenda vs. semaglutide (Wegovy) in adults with overweight or obesity. Zepbound 10 mg and 15 mg led to the greatest weight loss — about 13%–14% more than liraglutide and roughly 5% more than semaglutide. The Zepbound 5 mg dose also outperformed Saxenda.

Both Saxenda and Zepbound cause weight loss, but Zepbound tends to cause more. The weight you can lose on either may depend on your starting weight, dose, eating habits, and exercise routine.

How long does it take to see results on Saxenda vs. Zepbound?

Weight loss usually begins within the first few months of GLP-1 treatment and may slow or plateau as you get closer to your goal weight.

While timelines can vary from person to person, here’s a look at the average weight loss timelines for clinical trials of Saxenda vs. Zepbound:

Saxenda and Zepbound are both administered as subcutaneous (under the skin) injections, but the dosing frequency is very different. 

Saxenda

Saxenda is a once-daily injectable medication that comes as a multi-use prefilled injector pen.

How to take it: Inject Saxenda into the skin of the upper arm, thigh, or abdomen at the same time each day.

Starting dose: 0.6 mg daily

Maintenance dose: 3 mg once daily

Maximum dose: 3 mg once daily

Dosing: After one week of 0.6 mg injections, the dose is typically increased to 1.2 mg. After one more week, the dosage increases to 1.8 mg; another week, to 2.4 mg; and then again to 3 mg for the rest of the treatment.  

Zepbound 

Zepbound is a once-weekly injectable medication available in three forms: a single-use prefilled autoinjector pen (available at pharmacies), a multi-dose KwikPen (a cash-pay option that ships directly to you and uses a new needle attachment each week for four weeks), or a single-dose vial.

How to take it: Inject Zepbound into the upper arm, thigh, or abdomen on the same day each week.

Starting dose: 2.5 mg once weekly

Maintenance dose: 5 mg, 10 mg, or 15 mg once weekly

Maximum dose: 15 mg once weekly

Dosing: After four weeks of 2.5 mg injections, the dose is typically increased to 5 mg. Dosage may increase by 2.5 mg every four weeks (maxing out at 15 mg) until you reach the Zepbound dosage that works for you.

Saxenda and Zepbound belong to overlapping drug classes, so they share a lot of the same side effects — mostly gastrointestinal problems such as nausea, diarrhea, or vomiting.

Here are the most common side effects of Zepbound vs. Saxenda, per the medication labels:

Saxenda side effects 

The most common side effects of Saxenda include: 

• Nausea

• Diarrhea

• Constipation

• Vomiting 

• Injection site reactions

Serious but uncommon adverse effects include pancreas or gallbladder problems, dangerously low blood sugar, severe gastrointestinal pain, and allergic reaction to the medication. If you experience more serious side effects of Saxenda, contact your healthcare provider.

Zepbound side effects 

The most common side effects of Zepbound include: 

• Nausea

• Diarrhea

• Vomiting

• Constipation

• Abdominal pain

Stay alert to uncommon but serious adverse events, including severe gastrointestinal reactions, pancreas or gallbladder problems, kidney injury, dangerously low blood sugar, serious allergic reactions, and, in people with type 2 diabetes, vision changes. If you experience more serious side effects of Zepbound, contact your healthcare provider.

Saxenda isn’t right for everyone. Neither is Zepbound. Share your full health history and medication list with your healthcare provider before starting one of these weight loss injections.

Who shouldn’t take Saxenda?

Don’t take Saxenda if you have a history of:

• Medullary thyroid carcinoma (MTC), or if a family member has had it

• Multiple endocrine neoplasia syndrome type 2 (MEN2)

• Severe gastroparesis

You also should not use Saxenda if you’re:

• Pregnant or trying to become pregnant

• Allergic to liraglutide or any other Saxenda ingredients

• Taking another GLP-1 (semaglutide or orforglipron)

Who shouldn’t take Zepbound?

Don’t take Zepbound if you have a history of:

• Medullary thyroid carcinoma (MTC), or if a family member has had it

• Multiple endocrine neoplasia syndrome type 2 (MEN2)

• Severe gastroparesis

You also should not use Zepbound if you’re:

• Pregnant or trying to become pregnant

• Allergic to tirzepatide or any other Zepbound ingredients

• Taking another GLP-1/GIP (Mounjaro) or GLP-1

At face value, Saxenda costs more than Zepbound. But the price you pay can vary depending on insurance, manufacturer discounts, and pharmacy. Both are brand-name medications, which means they tend to be expensive — and may be less likely to be covered by insurance.

However, Saxenda has a generic version available, liraglutide, that may make it more affordable. There’s no generic version of  Zepbound.  

Saxenda

The list price for a one-month supply of brand-name Saxenda is $1,349.02. 

• Insurance coverage: Insurance may or may not cover Saxenda. The only way to find out is to look at your policy’s drug formulary (list of covered drugs) or contact your provider.

• Medicare Part D coverage: Unlikely. Medicare coverage excludes weight loss drugs.

• How to save: The best way to lower the out-of-pocket cost of Saxenda is to enroll in an insurance plan that covers it or the generic version.

  • Teva is a generic drug manufacturer that offers a savings card for liraglutide. Eligible patients may pay as little as $20/month. 

Zepbound 

The list price for a month's supply of Zepbound pens is $1,086.37. The cash price for Zepbound KwikPen and vials range from $299 to $449, depending on the dose.

• Insurance coverage: Coverage varies by provider and policy. Some insurance plans cover Zepbound, especially for sleep apnea. 

• Medicare Part D coverage: Medicare does not cover weight loss drugs.  There might be an exception if you’re prescribed Zepbound for sleep apnea. Eligible Medicare Part D beneficiaries may soon qualify to get Zepbound or similar medications for $50 per month through the BALANCE program.

• How to save on Zepbound:

  • Use the KwikPen: The Zepbound Kwikpen is a cash-pay option available on Ro that ships directly to you. Each multi-dose pen lasts four weeks, with a new needle attachment used per injection.

  • Use vials or KwikPen: With cash-pay options on Ro, single-dose Zepbound vial prices start at $299 per month and max out at $449 per month for higher doses.

  • Get insurance coverage: People with commercial insurance that covers Zepbound can pay as little as $25 for a one- or three-month supply through the manufacturer’s savings program (if eligible). 

  • Without insurance coverage: Zepbound savings card offers a discounted price of $650 per month for people who have an insurance policy that doesn’t cover Zepbound. 

Wegovy, Qsymia, generic phentermine, and Foundayo (orforglipron) are other FDA-approved weight loss medications. Like Zepbound vs. Saxenda, each of these has its benefits and drawbacks.

*Terms and restrictions may apply for certain doses. 

Several other medications not specifically approved for weight loss can still support weight loss. These include:

• Ozempic is a once-weekly semaglutide injection for people with type 2 diabetes, but it is commonly used off-label for weight loss. A daily pill version has also been approved.

• Rybelsus is a daily oral semaglutide tablet that is also sometimes used off-label for weight loss.

• Mounjaro is a weekly injection containing tirzepatide, the same active ingredient in Zepbound, for managing type 2 diabetes.

• Victoza is a daily injection containing liraglutide, the same active ingredient as Saxenda. But it’s approved for people with type 2 diabetes and has a lower dosage.

• Metformin is a generic oral medication frequently prescribed to people with diabetes.

There’s no one-size-fits-all answer to whether Saxenda or Zepbound is best. It’s important to consider effectiveness, dose frequency, side effects, and cost when deciding.

Consider choosing Saxenda if you…

• Prefer the routine of a daily injection

• Are concerned about Zepbound-specific side effects like hair loss and belching

• Have better insurance coverage for Saxenda vs. Zepbound

Consider choosing Zepbound if you…

• Prefer the flexibility of once-weekly dosing over daily

• Want more significant weight loss results

• Have better insurance coverage for Zepbound vs. Saxenda

• Have obstructive sleep apnea

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Saxenda and Zepbound are both FDA-approved weight-loss medications, but they work a bit differently and have different weight-loss effectiveness. 

Here’s the recap on Zepbound vs. Saxenda:

• Saxenda is a daily commitment, and Zepbound is weekly. But they’re both injections, and they’re both intended to be used alongside healthy eating habits and exercise.

• Zepbound typically leads to more weight loss than Saxenda. Both are effective, FDA-approved weight loss options, especially when combined with lifestyle changes.

• Cost and insurance coverage vary. The best way to save on either Saxenda or Zepbound is to enroll in an insurance plan that covers it. Plans may be more likely to cover liraglutide, the generic version of Saxenda.

• You’ve got options. Talk to your healthcare provider about whether Saxenda or Zepbound is best for you. And remember, there are also several other weight loss treatments, including Wegovy, Foundayo, and Qsymia.