Wegovy Alternatives & Comparison
How Wegovy (semaglutide) compares to Zepbound, Saxenda, Foundayo — mechanism, trial weight-loss results, and cost — plus where to compare vetted providers.
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Wegovy Alternatives Compared
Dual GIP/GLP-1 mechanism, generally greater average weight loss in head-to-head data
Zepbound works through tirzepatide's dual GIP/GLP-1 mechanism to reduce appetite through both central brain signals and peripheral metabolic effects.
Zepbound (tirzepatide) wins on raw efficacy: SURMOUNT-5 head-to-head showed −20.2% body weight at 72 weeks vs Wegovy's −13.7% — a 6.5-percentage-point difference. Wegovy wins on cardiovascular outcomes (SELECT trial reduced MACE 20%) — Zepbound's CV outcomes trial (SURPASS-CVOT) reads out 2027. Cash price is identical at $499/mo via NovoCare and LillyDirect. Choose based on whether weight-loss magnitude or CV risk reduction matters more.
Full Zepbound vs Wegovy comparison →Older, once-daily GLP-1 injection with a long approval history
Liraglutide is an acylated, 97%-homologous analog of native human GLP-1, modified with a fatty-acid side chain that lets it bind albumin and resist DPP-4 degradation — extending its half-life from minutes to about 13 hours.
Wegovy is the clear successor to Saxenda — both are Novo Nordisk obesity injectables, but the STEP-8 head-to-head trial showed Wegovy 2.4 mg weekly cut body weight 15.8% vs Saxenda 3.0 mg daily at 6.4% over 68 weeks. Wegovy also has the SELECT cardiovascular outcome (MACE -20%) that Saxenda lacks, and a manufacturer cash-pay tier ($349-$499/mo via NovoCare) that Saxenda has no counterpart for. Saxenda retains a narrow role: shorter half-life (~13 hours) makes washout faster for pregnancy planning, and it remains covered by some plans that exclude Wegovy.
Full Saxenda vs Wegovy comparison →Once-daily oral GLP-1 pill — no injection required
Orforglipron is a non-peptide small molecule that binds and activates the GLP-1 receptor directly.
Wegovy (injectable semaglutide) edges Foundayo (oral orforglipron) by roughly 3-4 percentage points on weight loss and is the only one with proven cardiovascular benefit — SELECT cut MACE 20% in non-diabetic obesity. Foundayo wins on convenience: a daily pill with no food restriction, no injection, no cold-chain handling. Cash prices are comparable via NovoCare and LillyDirect. Choose injection-plus-CV-data or pill-plus-no-needles.
Full Foundayo vs Wegovy comparison →Non-GLP-1 oral option, often chosen for cost or GI-tolerability reasons
Bupropion stimulates hypothalamic pro-opiomelanocortin (POMC) neurons, which release alpha-MSH to reduce appetite, but POMC neurons also release beta-endorphin, which feeds back onto mu-opioid receptors on the POMC neurons themselves and shuts them off — limiting the appetite-suppressing effect.
Wegovy wins on efficacy by a wide margin: STEP-1 reported -14.9% mean body-weight loss at 68 weeks versus about -6.1% for Contrave in COR-I, plus an FDA-approved cardiovascular benefit from SELECT. Contrave wins on cost (about $99/mo cash via Currax vs about $499/mo on Wegovy after the NovoCare intro discount) and on access — it is an oral tablet with no needles and no cold-chain storage. Side effects differ in kind, not severity: Wegovy causes more nausea and GI issues, Contrave more headache, insomnia, and constipation. Pick Wegovy if your goal is the largest possible weight loss or CV risk reduction; pick Contrave if cost, pill form, or food-noise/craving control matter more.
Full Contrave vs Wegovy comparison →Non-GLP-1 oral combination, an established alternative for patients avoiding injectables
Qsymia combines two mechanisms in a single capsule.
Wegovy delivers larger weight loss (-14.9% in STEP-1 vs -10.9% with top-dose Qsymia in EQUIP) and a proven cardiovascular outcome via SELECT, but Qsymia is the only fully-oral option here, costs roughly a quarter as much (~$100-$200/mo vs $499/mo NovoCare Wegovy), and has a pediatric indication. The catch: Qsymia ships only through a REMS that mandates monthly pregnancy testing and contraception, plus dose-related cognitive fog and paresthesias from topiramate.
Full Qsymia vs Wegovy comparison →Compare compounded Semaglutide providers
Compounded semaglutide runs a median of $195/month across 519 vetted-provider price points (range $59–$1,585). Featured partners below, ranked by our partner-economics ordering.
Compare compounded Tirzepatide providers
Compounded tirzepatide runs a median of $249/month across 473 vetted-provider price points (range $69–$1,400). Featured partners below, ranked by our partner-economics ordering.
Compare every Wegovy provider
See current pricing, verification status, form, and states served across every vetted provider in one place.