Which GLP-1 Is Best for Weight Loss? Wegovy, Zepbound, Pills and More Compared

For the most weight loss, the strongest approved options in October 2026 are Zepbound (tirzepatide) and Wegovy HD (semaglutide 7.2 mg), both averaging about 21% in their main trials. Wegovy 2.4 mg averages about 15%, the Wegovy pill about 13.6%, and Foundayo about 11% to 12%. But "best" depends on more than the top number: diabetes, heart disease, needle preference, side effects and insurance all change the answer.

Choosing between Wegovy tablets and the weekly pen? See our Wegovy pill vs injection comparison of results, routine and cost.

Ozempic and Mounjaro contain the same drugs as Wegovy and Zepbound but are approved for type 2 diabetes. People with diabetes are usually prescribed them; for weight loss alone, Wegovy and Zepbound are the approved brands.

Only one major trial has compared two of these directly: SURMOUNT-5, where tirzepatide produced 20.2% weight loss versus 13.7% for semaglutide 2.4 mg over 72 weeks. Wegovy HD hasn't been compared directly with Zepbound. See Zepbound vs Wegovy and Mounjaro vs Wegovy.

Rybelsus was a diabetes pill and was replaced in the U.S. by Ozempic tablets in 2026; it isn't a weight-loss product. See Rybelsus for weight loss. Retatrutide, Lilly's triple agonist, produced up to 28% weight loss in trials but isn't approved; a filing is expected by early 2027.

All of these drugs cause nausea, diarrhea, vomiting or constipation in many people, mostly while the dose is rising. The higher-dose options tend to cause more. Serious but uncommon risks include pancreatitis, gallbladder problems and dehydration. Weight returns for most people after stopping, so plan for long-term treatment. See what happens when you stop.

There's no single best GLP-1. Zepbound and Wegovy HD lead on average weight loss; Wegovy adds heart and liver approvals; the Wegovy pill and Foundayo suit people who don't want needles. The best choice is the approved drug that fits your health, that you tolerate, and that you can afford over the long term.