Semaglutide vs Tirzepatide for Weight Loss, Side Effects and Choosing Treatment

Tirzepatide helps you lose more on average than semaglutide. In 751 adults with obesity without diabetes, average weight fell 20.2% after 72 weeks on tirzepatide and 13.7% on semaglutide, and waist size fell more on tirzepatide too (SURMOUNT-5 trial). Both drugs caused mainly mild to moderate gut symptoms while doses rose, and both call for medical screening and ongoing dose support.

How much more weight do people lose with tirzepatide?

The trial gave each person the highest weekly dose they could tolerate for 72 weeks (SURMOUNT-5 trial). Tirzepatide users lost 20.2% on average compared with 13.7% for semaglutide users. Waistlines shrank 18.4 cm on average with tirzepatide and 13.0 cm with semaglutide. More tirzepatide users reached each milestone the researchers tracked, which was loss of at least 10%, 15%, 20% and 25%.

Those numbers are averages from one open trial in people without diabetes, not promises for any one woman. Your change will depend on the dose you tolerate, how long you stay on treatment and your health history.

What do side effects feel like and which is easier to stay on?

Both drugs upset your gut most, with nausea, vomiting and diarrhea. Most reports were mild to moderate and clustered while the dose increased (SURMOUNT-5 trial).

Fewer tirzepatide users stopped for gut reasons. Gut events that led to stopping happened in 2.7% of tirzepatide users and 5.6% of semaglutide users (ACC review). One writer suggested the added GIP action in tirzepatide may calm nausea pathways and help users stay on treatment. GIP is one of the gut hormone signals tirzepatide targets. That explanation remains a hypothesis, not a trial result (NEJM correspondence).

How do I choose and start through HOD?

Pick based on your goal and your gut history. The larger average weight and waist change favors tirzepatide. A history of severe nausea, vomiting or trouble staying on a similar shot should shape the decision, so share that history when you screen. In this trial, which included 35% men, men lost about 6% less weight than women in both drug groups (ACC review).

To start, take the HOD quiz. A clinician reviews your history and weight goals, then you receive your plan and ongoing dose support through the HOD website.