Zepbound reviews: what studies and users say

If you're considering Zepbound (tirzepatide) for weight loss, understanding how it works, potential side effects, and real-world experiences is crucial. Who better to tell you than Zepbound reviews from real people taking the drug? 

In this article, we'll delve into comprehensive Zepbound reviews from both patients who take it and healthcare providers who prescribe it. We'll also cover how Zepbound works, common side effects, cost considerations, and more to help you make an informed decision.

By examining firsthand accounts and expert insights, you'll gain a clearer picture of what to expect with Zepbound, enabling you to determine if it's the right choice for your weight loss journey.

Zepbound (tirzepatide) is a dual GLP-1/GIP receptor agonist. Those acronyms stand for glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide, which are two hormones your body naturally produces that the drug mimics. In mimicking these hormones, tirzepatide can also target their receptors, which are involved in appetite regulation, blood sugar control, and fat generation. 

Zepbound works for weight loss by slowing down digestion, which leaves food in your stomach longer and helps you feel full sooner. The drug also sends signals of satiety, or fullness, to your brain. Together, these effects lower your appetite and calorie intake, leading to weight loss. 

The active ingredient in Zepbound—tirzepatide—was originally approved in 2022 by the US Food and Drug Administration (FDA) to treat type 2 diabetes under the brand name Mounjaro. As researchers discovered the drug’s powerful effects on body weight, the drugmaker Eli Lilly requested approval for a new indication. In 2023, the FDA approved Zepbound for weight loss in adults with obesity or overweight and a weight-related health condition (e.g. sleep apnea, type 2 diabetes, high cholesterol). In December 2024, the FDA also approved Zepbound to treat moderate to severe obstructive sleep apnea in adults with obesity.

Zepbound comes in vials and prefilled pens. It should be injected once a week, with or without meals, and be taken in combination with a reduced-calorie diet and increased physical activity.

What is the Zepbound vial? 

Like many GLP-1 medications, Zepbound can be expensive. Without insurance, Zepbound costs upwards of $1,000 for a one-month supply of the injectable pens (but there are Zepbound coupons you can access). In an effort to increase access to the drug, Eli Lilly also offers Zepbound vials direct to patients for $399–$549. They’re also available through approved partner pharmacies like Ro. 

Both Zepbound pens and vials contain a single dose. Unlike the pens, which come with a needle pre-attached, the Zepbound vials you to measure and withdraw your dose using a separate syringe and needle. They’re also currently only available in the two lowest dosage strengths of Zepbound: 2.5 and 5 milligrams (mg) (Eli Lilly does have plans to expand strength options in the future). This means you can start Zepbound at a lower price, but if your healthcare provider recommends titrating your dose above 5 milligrams (Zepbound doses go all the way up to 15 mg), you may need to switch to the pens later on.

Before we dive into patient and physician reviews of Zepbound, let’s review the research. 

A clinical trial of over 2,500 adults with obesity or overweight (but without diabetes), found that:  

• Those taking Zepbound lost 15%–21% of their body weight over 72 weeks. By comparison, participants receiving a placebo lost only 3%. 

• Zepbound users also experienced improvements in waist circumference, blood pressure, and cholesterol levels.

• The most common side effects were gastrointestinal, including nausea, vomiting, and diarrhea. 

• These symptoms typically resolved over time once patients reached their maintenance dose. However, side effects were severe enough to cause 4%–7% of participants to discontinue Zepbound, compared to 2.6% of those on placebo.

A separate study of adults with obesity and type 2 diabetes found that: 

• Those taking Zepbound at the two highest maintenance doses (10 mg and 15 mg) lost 13%–15% of their body weight over 72 weeks. 

• Again, placebo participants lost only about 3%. Fewer than 5% of participants discontinued the trial due to side effects.

A review of 12 randomized controlled trials, with a total of over 11,700 patients, found that:

• Tirzepatide (the active ingredient in Zepbound) significantly reduced body mass index (BMI), waist circumference, and overall body weight, with people who took higher doses losing more weight. 

• Gastrointestinal side effects—primarily nausea, vomiting, and diarrhea—were common but generally mild to moderate in severity and temporary.

Zepbound is one of many GLP-1 medications, a drug class that also includes semaglutide, the active ingredient in Ozempic and Wegovy. Studies comparing Ozempic vs. Zepbound show that Zepbound causes more weight loss. Zepbound also outperforms Wegovy, the higher-strength version of semaglutide that’s FDA-approved for weight loss.

Patients reviewing Zepbound typically have positive things to say about the weight loss medication, despite acknowledging that the side effects can be intense. At the time of writing, Zepbound has an average rating of 9.1 out of 10 on drugs.com, based on 207 reviews from real people. Here’s what some of them had to say, after taking the medication for at least one month or longer:

"I've been on Zepbound for about 3 months. I'm 5'3' and started at 167. So far I have lost 12 lbs. trying to maintain a 1,200 calorie diet. The main thing is to watch what you eat and quit when you are full. The only side effects I've seen are fatigue and constipation. The shots don't bother me at all and no nausea, thank goodness. The only thing I'm really worried about is gaining it back when I stop."

“I have dropped 18 pounds so far. I have nausea for a day or two after injection (still able to function at work). I still have about 30ish pounds to lose, but I no longer think about food. I am also so happy that my pain from fibromyalgia has gotten so much better. I don't have the inflammation all the time. I am 50 and in menopause, I have done the eat less, move more with little results. I am very happy with this medication. You still have to do the work (eat little sugar, high protein, exercise), but it is nice to see it actually working now!"

"Been on Zepbound 7 weeks now. Lost about 22 lbs so far with no exercise. This stuff is amazing at curbing your appetite. But beware, stick to healthy foods and minimal portions because the nausea is otherworldly. I ate too much too late in the day yesterday. I had to leave work early today for the second time since being on this med. Light-headed, profuse sweating, chills, diarrhea almost non-stop and even puking. This med is a miracle, but you cannot mess around. Take it seriously. Cut back portions, minimal dairy, low sugar and don't eat too late."

"After many years of trying to lose weight only to keep gaining, I finally had enough and decided to start Zepbound last December when I found out my insurance would pay for it… I have lost 55 pounds. I consistently lose 2 pounds per week… I no longer have any side effects. I am still losing weight and I have never felt better. I plan to stay on this long term. I would recommend this to anyone that has tried everything and has been unable to lose the weight. I am 50 years old and want to be able to stay active and have little to no pain. This medicine has changed my life."

You can also find Zepbound reviews on Reddit. On the r/Zepbound subreddit, users lean on each other for support and share their experiences with the medication.

“Guys!!!! It’s been 82 days and getting onto Zepbound has been the best decision I’ve ever made. This is just a gentle reminder to take weekly photos. Sometimes the scale doesn’t move but that doesn’t mean that you’re not still losing fat or having changes happen in your body.” — drivesahonda

“Lost 69.7 lbs in 6 months on Zepbound. Average weekly loss: 2.7 lbs. Managed side effects (mostly subsided), virtually stopped drinking alcohol, and reduced coffee. Ate what I wanted but in smaller amounts. Insurance doesn't cover it; $550/month via HSA. Never missed a dose despite shortages; had a backup plan with my PCP.” — Kessler82

“I have been on for 5 months currently. on my first dose of 10MG and I have gone from 515 to 442 (73lbs lost) as of this morning. Drug has been great. minus a crazy bout with a stomach bug i have had almost no side effects other than sulfur burps and gas. Im nowhere near a healthy BMI yet but Im getting there week by week.” — jkimmel79

We asked clinicians to share their experiences with prescribing Zepbound to their patients. Many emphasized not only the remarkable weight loss caused by the drug, but also the other improvements to their health. 

Luis Vinas, MD, a board-certified plastic surgeon at the Palm Beach Gynecomastia Center, where he frequently treats patients for weight loss with GLP-1s prior to performing surgery after weight loss, said, “My patients’ experience with Zepbound has been positive overall, especially for patients needing to shed significant weight before surgery. By helping patients lose excess fat while curbing metabolic issues, it has led to better surgical outcomes and improved overall health. When patients feel healthier and see progress, it really helps them embrace a lasting transformation. Many of my patients do opt for the Zepbound vials and appreciate the flexibility they provide.”

Raj Dasgupta, MD, FACP, FCCP, FAASM, a quadruple board-certified doctor of Internal Medicine, Pulmonary, Critical Care, and Sleep Medicine, said, "In my experience, Zepbound has been an effective tool for weight loss in many of my patients, particularly when combined with lifestyle changes like diet and exercise. Patients often see significant improvements not just in weight, but also in related health conditions like type 2 diabetes, high blood pressure, cholesterol levels and obstructive sleep apnea symptoms.”

Brandon Richland, MD, a board-certified plastic surgeon in Newport Beach, California, said, “We've had hundreds, if not thousands, of patients who experienced significant weight loss with Zepbound (tirzepatide). This medication is truly a wonder drug. Our patients experience significantly more weight loss with fewer side effects when taking Zepbound (tirzepatide) vs semaglutide. Zepbound helps control blood sugar and regulate insulin levels, and can even improve heart disease, allowing our patients to create a healthier overall lifestyle. Our patients report less binge eating, less snacking, and less alcohol intake. Our patients experience rapid and sustainable weight loss with Zepbound.”

You can get Zepbound vials or pens through Ro. Here, real patients described their experience using Ro to access Zepbound. These reviews were collected from real Ro members through our usual feedback process. Some may have received compensation for their authentic opinions.

“I'm just starting my fifth month. I'm down 30 pounds…I barely drink anymore. I don't spend money on food hardly ever. I eat a normal amount of food. I eat three times a day. But I feel like I just have a lot healthier relationship with food…I'm super happy with what's going on.” — Brian B.

“I haven't weighed myself in a while, but I could definitely tell I'm losing weight. It does show, at least it feels in my shirts and my waist belt.” — Roman P.

When discussing side effects, here is what Ro patients had to say: 

“I notice [nausea] in the morning…it depends on what time I've eaten the night before, but when I wake up in the morning, I feel a little nauseous…and so I now have a little bit of soda and ginger ale in my refrigerator, it helps control it. Other than that, my side effects have been very mild.” — Alyssa H.

“I'm fortunate I didn't have any of the GI side effects that impact a lot of people, and I credit the doctor I talked to giving me some advice on how to avoid that..” — Colleen B.

As you may have gathered from the Zepbound reviews, the drug can produce life-changing results, but it also comes with some downsides—namely, side effects and a high cost. Below, we review some of the key things you should know before taking Zepbound.

Zepbound side effects 

The most common side effects of Zepbound include:

• Nausea

• Diarrhea

• Vomiting

• Constipation

• Stomach pain

• Indigestion

• Injection site reactions (e.g. rash, bruising)

• Fatigue

• Allergic reactions

• Belching

• Hair loss

• Heartburn 

While rare, Zepbound can also cause serious side effects such as:

• Severe gastrointestinal side effects

•  Acute kidney injury

• Acute gallbladder disease

• Acute pancreatitis

• Serious allergic reactions, including difficulty breathing

• Hypoglycemia (low blood sugar)

• Diabetic retinopathy in people with type 2 diabetes

• Suicidal behavior or ideation

• Pulmonary aspiration during general anesthesia or surgical procedures

Who shouldn’t take Zepbound? 

Some people should not take Zepbound, including anyone who is pregnant or who has:

• A personal or family history of medullary thyroid carcinoma (MTC)

• Multiple Endocrine Neoplasia syndrome type 2 (MEN2)

• Severe gastrointestinal disease

• A known allergy to tirzepatide or any of the drug’s inactive ingredients (sodium chloride, sodium phosphate dibasic heptahydrate, hydrochloric acid solution and/or sodium hydroxide solution)

Because Zepbound slows down digestion, it may affect the absorption of other medications you take orally (by mouth). For example, if you are using birth control pills, your healthcare provider may recommend switching to a non-oral contraceptive method (e.g. IUDs) or adding in a barrier method (e.g. condoms) during the first few weeks of treatment or when increasing your dose of Zepbound.

If you take insulin or similar diabetes medications, you may be more likely to experience hypoglycemia, including severe hypoglycemia, on Zepbound.  To minimize this risk, your healthcare provider may reduce your dosage of insulin.

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Zepbound vials

tirzepatide

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semaglutide

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Compounded semaglutide

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tirzepatide

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semaglutide

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Zepbound cost 

Without insurance, the cost of Zepbound pens can range from $1,253–$1,393 per month. The Zepbound vials cost less than half, between $399-$549 for a one-month supply.

If you have insurance that covers Zepbound, you may pay significantly less. You may also be eligible for the Zepbound Savings Card from Eli Lilly, which lowers the cost of Zepbound to $25 for those with a plan that includes coverage for Zepbound, and to $650 for those with a plan that doesn’t. To use the card, you must have commercial drug insurance. People with insurance through state-, federal-, or government-funded programs like Medicare, Medicaid, TRICARE, are not eligible.

If your plan doesn’t cover Zepbound or you pay cash for your prescriptions, you may still be able to save on the cost of Zepbound with a pharmacy discount card. These cards are free to download from sites like SingleCare, GoodRx, Optum Perks, and drugs.com. You just need to search for your preferred pharmacy and prescribed dosage of Zepbound, and then download or print the card to show your pharmacist at checkout.

Zepbound (tirzepatide) has made names for itself as a “wonder drug,” with both clinical trials and real-world reviews highlighting its powerful effects on weight loss. However, like many prescription medications, it also comes with side effects and an out-of-pocket cost to consider. Whether you're thinking about starting Zepbound or simply researching your options, understanding these patient and physician perspectives can help you make an informed decision.

• Research shows that Zepbound causes an average weight loss of 15-21% in people with obesity (but without type 2 diabetes), and 13-15% in people with obesity and type 2 diabetes.

• In patient reviews of Zepbound, many users report significant weight loss and changes in their appetite and food cravings. Some experience significant gastrointestinal side effects like nausea, while others report minimal side effects.

• Healthcare providers generally have positive things to say about Zepbound, including how the drug’s weight loss results help motivate people to embrace other healthy lifestyle changes.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Editorial Guidelines | Medical Review Process

Current version

February 19, 2025

Written by

Amelia Willson

Fact checked by

Patricia Weiser, PharmD

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About the medical reviewer

Patricia Weiser, PharmD

Patricia Weiser, PharmD, is a licensed pharmacist, health content writer, and medical reviewer with more than a decade of clinical experience in community and hospital pharmacy.