8 Zepbound alternatives for weight loss

There are lots of reasons you might be interested in Zepbound alternatives. For some people, looking for an alternative came from necessity during times of shortages of Zepbound (tirzepatide). For others, they either haven’t had a great experience with Zepbound, or it’s cost prohibitive. Or, you might have some other reason entirely to look for other weight loss medication options.  

Luckily, there are several Zepbound alternatives you can discuss with your healthcare provider, including other GLP-1 injections (and related drugs), oral GLP-1  tablets, and non-GLP-1 weight loss meds. Read on to learn more. 

There are several medications you can take instead of Zepbound to help with weight loss. While some of these are approved by the US Food and Drug Administration (FDA) for chronic weight management, others may be prescribed off-label for weight loss.

Below are several Zepbound alternatives, along with their current availability. All of these drugs work best when combined with lifestyle changes, such as diet and exercise. 

The first five options include injectable and oral medications that hail from a similar drug class as Zepbound, which are called glucagon-like peptide-1 receptor agonists (aka GLP-1s). Because they work in similar ways, these drugs typically share many of the same side effects as Zepbound, including nausea, vomiting, diarrhea, and decreased appetite. 

Also listed below as potential Zepbound alternatives are oral non-GLP-1 medications that have been FDA-approved for weight loss, along with one exciting medication in development. 

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1. Mounjaro (tirzepatide)

One common Zepbound alternative is Mounjaro, which contains the same active ingredient as Zepbound: tirzepatide. Mounjaro comes in the same range of dosage strengths as Zepbound and with similar potential side effects. It’s also injected on a weekly basis.

The key difference between these medications is that Mounjaro is FDA-approved to treat type 2 diabetes, while Zepbound is FDA-approved for chronic weight management. However, as both drugs contain the same active ingredient, healthcare providers may prescribe Mounjaro off-label for weight management. 

In clinical trials, Mounjaro produced an average weight loss of 7.9%–11% within 40 weeks in people with type 2 diabetes.

Like Zepbound, Mounjaro is a dual GIP/GLP-1 receptor agonist. This name refers to the two gut hormones the drug mimics: glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide-1 (GLP-1). Mounjaro was the first drug in its class to target both receptors. 

As a dual GIP/GLP-1 receptor agonist, Mounjaro (like Zepbound) works by increasing insulin and inhibiting glucagon after you eat, which keeps your blood sugar levels in check. GLP-1 drugs can also slow down digestion, so you tend to feel full sooner and may eat less as a result. 

Current availability: At the time of writing, all dosage strengths of Mounjaro are available, as reported by the FDA.

2. Wegovy (semaglutide)

Wegovy (semaglutide) is another FDA-approved medication for weight loss that’s available as an injectable medication or as an oral tablet. The injectable form is injected on a weekly basis, and the tablet is taken daily. It’s intended for people with obesity and overweight as a treatment to achieve weight loss and weight management, alongside diet and exercise. 

Wegovy is also FDA-approved to reduce the risk of major cardiovascular events (e.g., stroke, heart attack, and death from cardiovascular causes) in people with heart disease and obesity or overweight. It shares a similar list of contraindications and side effects with Zepbound.

While Zepbound mimics two gut hormones (GLP-1 and GIP), Wegovy is a GLP-1 only, which means it targets a single receptor. 

While no studies to date have compared Zepbound and Wegovy, indirect comparisons suggest that people lose more weight on the higher 10 mg and 15 mg dosage strengths of Zepbound than the 2.4 mg dosage of Wegovy. Even so, people still tend to lose a substantial amount of weight on Wegovy. In clinical trials, people taking Wegovy lost 15%–16% of their body weight after approximately a year and half. 

Current availability:  At the time of writing, there’s no shortage of Wegovy, as reported by the FDA.

3. Saxenda (liraglutide)

Saxenda (liraglutide) is another injectable medication for weight loss similar to Zepbound and Wegovy. However, it differs from Zepbound in that it must be injected on a daily (vs. weekly) basis, and like Wegovy, it’s a single receptor agonist (GLP-1). 

Many of Saxenda’s side effects are similar to those that may occur with Zepbound, but this Zepbound alternative can also cause headache, hypoglycemia (low blood sugar), dizziness, increased lipase levels, fever, and gastroenteritis.

Weight loss with Saxenda is less profound than with Wegovy or Zepbound, but it’s still significant. In clinical trials, people lost an average of 8% of their body weight after about a year of taking Saxenda (compared to 2.6% of their body weight in people taking placebo).

Current availability: Saxenda is currently experiencing a shortage and will be discontinued in January 2027, according to the FDA.

4. Ozempic (semaglutide)

Ozempic (semaglutide) shares the same active ingredient as Wegovy, and it’s also available as an injectable or a tablet. It is either injected on a weekly basis or taken daily as an oral tablet.

It is FDA-approved to control blood sugar levels in people with type 2 diabetes and, in those who also have heart disease, to lower their cardiovascular risk. Unlike Zepbound, it is not FDA-approved specifically for weight loss.

Ozempic and Wegovy share a similar backstory to Mounjaro and Zepbound, where their active ingredient was first developed to treat type 2 diabetes. Then, as researchers discovered the drug’s ability to produce weight loss as well, the manufacturers sought FDA approval for weight management and released a separate brand name version of the drug. 

However, while Zepbound and Mounjaro are available in similar dosage strengths and share similar side effects, Ozempic comes in more limited dosage strengths than Wegovy.

Ozempic also has a shorter list of side effects than Wegovy, although it’s still common to experience gastrointestinal symptoms similar to the other drugs on this list of Zepbound alternatives, such as nausea, vomiting, diarrhea, abdominal pain, and constipation. 

In clinical trials, people with type 2 diabetes lost an average of 13–15 pounds after about 10 months of taking Ozempic.

Current availability: At the time of writing, all dosage strengths of Ozempic are available, according to the FDA. 

5. Trulicity (dulaglutide)

Trulicity (dulaglutide) is another medication for type 2 diabetes that may be prescribed off-label for weight loss. Similar to Ozempic, it helps lower blood sugar levels in people with type 2 diabetes who have not found success with other treatments, such as metformin. 

It can also lower the risk of heart attack, stroke, or death in people who have type 2 diabetes and heart disease. 

Trulicity is available in four dosage strengths, with people taking higher dosage strengths typically losing more weight. In one study, people with type 2 diabetes lost between 7–10 pounds after about 9 months of taking Trulicity. Trulicity’s side effects are similar to those of other Zepbound alternatives (e.g., nausea, diarrhea, vomiting, and abdominal pain).

Current availability: At the time of publication, Trulicity is not in shortage, according to the FDA.  

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6. Foundayo (orforglipron)

Foundayo (orforglipron) is the newest oral GLP-1 on the market. Unlike the other GLP-1s on this list, orforglipron is a non-peptide, which helps it be better absorbed by the gut. It is FDA-approved for weight loss — specifically for adults with obesity or adults with overweight and at least one weight-related comorbid condition.

It’s available in six dose strengths: 0.8 mg, 2.5 mg, 5.5 mg, 9 mg, 14.5 mg, and 17.2 mg.

This oral pill is taken daily, with or without food. This makes it unique compared to other oral GLP-1s (like the Ozempic tablet or Wegovy tablet), which are less flexible. When you take the Ozempic or Wegovy tablet, you have to wait 30 minutes before eating or drinking anything else. 

Research shows that people without diabetes who took orforglipron daily over the course of 72 weeks lost 7.5%–11.2% of their body weight, depending on what dose they took. 

Foundayo’s side effects are similar to those of the other GLP-1s on this list, including gastrointestinal side effects (nausea, constipation, vomiting, and diarrhea), headache, and fatigue.

Current availability: At the time of writing, there is no shortage of Foundayo, according to the FDA.

7. Non GLP-1s

In addition to Zepbound, Wegovy, Saxenda, and Foundayo, the FDA has approved other medications for weight loss that are not GLP-1s. These include:

• Qsymia (phentermine/topiramate)

• Adipex-P and Lomaira (phentermine)

• Contrave (naltrexone/bupropion)

• Xenical or Alli (orlistat)

These medications are taken orally on a daily basis. (In the case of orlistat, the recommended dosage schedule is three times daily). 

Similar to GLP-1 drugs, though, these medications may cause gastrointestinal upset and other digestive side effects. Depending on the medication, other side effects may include headache, insomnia, dizziness, tingling sensations, anxiety, and irritability. 

All of these weight loss pills have been shown to produce an average weight loss of at least 5% in clinical trials.

 In one year, when compared to people taking placebo, people taking Qsymia (phentermine/topiramate) lost an average of 19 more pounds, those taking Contrave (naltrexone/bupropion) lost an average of 11 more pounds, and those taking Xenical (orlistat) lost an average of almost 6 more pounds. 

A comprehensive observational study on phentermine showed people who took phentermine continuously for more than one year lost an average of just over 7% more of their body weight after 24 months than people who took it for 3 months or less.

Current availability: None of the drugs on this list are reported to be experiencing a drug shortage at the time of writing, according to the FDA, though availability may change depending on your local pharmacy. 

8. Retatrutide

Although it isn’t officially available yet, retatrutide is an exciting development in the field of weight loss medicine. It’s being developed by Eli Lilly — the same manufacturer of Zepbound. 

Retatrutide is an “investigational molecule” that’s a triple hormone receptor agonist, meaning it targets GLP-1, GIP, and a third hormone: glucagon. Since it targets three hormones, it may be more potent than current weight-loss medications on the market.

In the Phase 3 TRIUMPH-4 clinical trial, participants with obesity and knee osteoarthritis lost 26.4%–28.7% of their body weight over the course of 68 weeks. This translated into an average weight loss of up to 71.2 pounds.

It will still be a while before retatrutide is FDA-approved and publicly available, but it’s certainly an exciting area of research. 

You shouldn’t stop taking Zepbound without first talking to a healthcare professional. If a Zepbound shortage disrupts your treatment, or you want to switch to a different medication for any other reason, talk to your healthcare provider about your options. They may be able to help you find a refill or direct you towards an alternative treatment. 

If you have to stop Zepbound, it’s important to keep up with the lifestyle changes you started during treatment, such as following a healthy, balanced diet and exercising regularly. 

Zepbound has a half-life of about five days, but it will take some time for the drug to fully flush out of your system. Once you stop taking Zepbound, you may notice a few changes as the effects of the medication wear off:

• Side effects should subside.

• Your appetite may return.

• You may regain weight.

At the time of this writing, there’s no Zepbound shortage, but if a shortage in the future forces you to stop taking the medication, we understand that can be disheartening. But you can still make lifestyle changes, including dietary changes and exercise, to keep weight off and potentially lose even more. And the Zepbound alternatives in this article will give you plenty to discuss with your provider. 

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If you’re worried about a Zepbound shortage or want to switch away from Zepbound for any other reason, there are effective Zepbound alternatives you can ask your healthcare provider about.

• Mounjaro is the closest Zepbound alternative since it contains the same active ingredient, tirzepatide, but it’s not FDA-approved for weight loss and will need to be prescribed off-label for this purpose.

• Other GLP-1 (and related) medications include Wegovy or Ozempic (semaglutide), Saxenda (liraglutide), Trulicity (dulaglutide), and Foundayo (orforglipron). 

• Non-GLP-1s are also an option, including  Qsymia (phentermine/topiramate), Contrave (naltrexone/bupropion), Adipex-P or Lomaira (phentermine), and Xenical or Alli (orlistat). 

• Weight loss medication is an emerging area of research, and new, effective medications like retatrutide are in the pipeline.