Wegovy vs. Trulicity: how they compare

Wegovy (semaglutide) and Trulicity (dulaglutide) are both GLP-1 medications that work in similar ways, but they're approved for very different purposes. If you're weighing Wegovy vs. Trulicity for weight loss, here's how they actually stack up.

Wegovy produces far greater weight loss than Trulicity. (And it’s the only option of the two that’s actually approved by the US Food and Drug Administration (FDA) for that purpose.) 

In the STEP 1 trial, people taking 2.4 mg of injectable Wegovy lost an average of 15% of their body weight over 68 weeks, compared with 2.4% with placebo.

In the newer STEP UP trial, people taking the higher 7.2 mg dose of Wegovy (aka Wegovy HD) lost an average of 18.7% of their body weight over 72 weeks overall, with average weight loss reaching 20.7% of body weight in those who stayed on treatment. 

Wegovy is also available as a once-daily tablet; its maintenance dose — 25 mg daily — produced approximately 14% weight loss in its own clinical trial.

On the other hand, Trulicity has been studied primarily in people with type 2 diabetes, where its highest dose (4.5 mg weekly) produced a mean weight loss of about 5 kg (roughly 11 pounds) over 52 weeks.

When researchers tested Wegovy vs. Trulicity head-to-head in people with type 2 diabetes, semaglutide at doses of 0.5 mg and 1 mg (lower than doses used for weight loss) came out ahead. Semaglutide helped people lose an average of 4.6 kg (on 0.5 mg) and 6.5 kg (on 1 mg), compared with 2.3 kg and 3.0 kg for Trulicity at its matched 0.75 mg and 1.5 mg doses, over 40 weeks.

Both drugs are glucagon-like peptide-1 (GLP-1) medications, meaning they slow digestion and curb appetite. So why the gap in weight loss results?

Mainly because semaglutide has been shown to reduce hunger and food intake more substantially, which likely drives the bigger weight loss numbers.

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Beyond the numbers, Wegovy's FDA approvals also go further than Trulicity's.

Wegovy is approved for long-term weight management in adults and children 12 and older with obesity, or in adults with overweight who have at least one weight-related health condition, like high blood pressure or high cholesterol.

Additionally, it's approved to reduce the risk of major cardiovascular events, such as heart attack and stroke, in adults with established heart disease and either obesity or overweight. Wegovy is also approved to treat a liver condition called MASH (metabolic dysfunction-associated steatohepatitis) in adults with moderate to advanced liver scarring.

Trulicity is approved for type 2 diabetes and cardiovascular risk reduction; any weight loss it produces is a secondary effect, not its primary purpose.

No, Trulicity isn’t the same as Wegovy. They’re both GLP-1 medications, but they contain different active ingredients, carry different FDA approvals, and produce different weight loss results. 

Both are prescription-only, and neither has a generic version available in the US yet.

Wegovy side effects (whether you take the injection or tablet) and Trulicity side effects overlap quite a bit. Both drugs can cause:

• Nausea

• Diarrhea

• Vomiting

• Abdominal pain

• Fatigue

Nausea is the most widely reported side effect for both, and it tends to be worse during the dose escalation phase at the start of treatment.

That said, Wegovy may have a higher rate of intolerable digestive side effects compared to dulaglutide, which could be worth factoring in if you have a sensitive stomach.

For some people, digestive side effects are significant enough to discontinue treatment altogether.

Both medications also carry the same serious warnings:

• Risk of thyroid tumors: Both Wegovy and Trulicity carry a boxed warning about the potential risk of medullary thyroid cancer (MTC). Neither should be taken by anyone with a personal or family history of MTC or multiple endocrine neoplasia syndrome type 2 (MEN 2), a rare hormonal condition.

• Pancreatitis: Both carry a risk of acute pancreatitis. Contact your healthcare provider straight away if you experience severe or persistent abdominal pain.

• Low blood sugar: The risk is low when either drug is taken alone, but it can increase when combined with insulin or other diabetes medications. Thankfully, your healthcare provider can work with you to adjust the doses of your medications as needed to help lower the chances of low blood sugar. 

Since these effects can vary from person to person, talk with your healthcare provider about which medication's risk profile makes more sense for you.

Both medications carry high list prices, and what you actually pay depends on your insurance, dose, and how you access them.

On Ro, the Wegovy pen and pill are the lowest-cost GLP-1s when paying cash*:

• Wegovy injection: $199–$399 per month, depending on dose

• Wegovy pill: $149–$299 per month, depending on dose

Wegovy's list price is $1,349.02 per month for both the pen and the pill, while Trulicity has a full list price of $1,006.93 per month, though what you pay could vary depending on where you live and your insurance coverage.

Coverage works differently for each:

• Trulicity is more consistently covered by insurance when prescribed for type 2 diabetes.

• Wegovy coverage for weight loss varies widely depending on your insurance. Your specific plan, state, and diagnosis can all affect what's covered. Check with your provider or insurer directly to see what applies to you. (If interested in the Wegovy pen, you can also figure out your coverage by using Ro’s free insurance coverage checker.)

• Neither has a cheaper alternative currently available, and a generic Wegovy isn't on the horizon in the US anytime soon either.

If cost is a concern, it's worth exploring how you access Wegovy. Ro offers Wegovy with the option to use insurance or pay cash (if prescribed), and connects you with a licensed healthcare provider as part of the process.

*Prices reflect a limited-time offer and are subject to change.

No, you shouldn't take Wegovy and Trulicity together.

Both are GLP-1 medications, so combining them means taking two drugs that work through the same mechanism at the same time. That raises the risk of side effects like nausea, vomiting, and constipation, and is unlikely to add any therapeutic benefit.

If you're switching from one to the other, ask your healthcare provider to change your prescription and be sure to follow their instructions. (You should never switch medications without first consulting a healthcare provider and then following their guidance.) Dulaglutide has a half-life of approximately five days, which your provider will factor into the timing of the switch.

In many cases, a formal washout period may not be required, but the transition is still worth doing under medical supervision.

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When it comes to Wegovy vs. Trulicity for weight loss, both work through the same mechanism, but they’re built for different jobs, and the weight-loss data makes that clear.

• Wegovy wins on weight loss. It's FDA-approved for weight management, with average losses of 15% at the 2.4 mg dose and potentially reaching over 20% at the newer 7.2 mg dose when taken consistently — far outpacing what Trulicity produces in its own trials. Semaglutide also beat dulaglutide when directly compared in a diabetes study, though at lower matched doses.

• Trulicity treats diabetes, not obesity or overweight. It’s approved for cardiovascular risk reduction and type 2 diabetes, and any weight loss it produces is incidental rather than the intended outcome.

• Side effects of the two drugs overlap significantly. Nausea is among the most frequently reported issues with both, and each carries warnings for thyroid tumor risk and pancreatitis.

• Combining Wegovy and Trulicity isn't recommended. Stacking two GLP-1 medications increases side effect risk and is unlikely to add any benefit.

If you're living with obesity or carrying excess weight and want to explore whether a GLP-1 medication is right for you, Ro connects you with licensed healthcare providers who can review your health history and help you find the right option.