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What to know about new weight-loss drug Zepbound and how it compares to Ozempic

The medication is now available in the U.S. Here’s what patients need to know about its cost and side effects.
/ Source: TODAY

A new weight-loss drug that promises to offer powerful results for Americans struggling with obesity — potentially surpassing the success patients have seen with Ozempic and Wegovy — is now available in U.S. pharmacies.

Prescriptions for Zepbound, which was approved by the U.S. Food and Drug Administration on Nov. 8, can be filled at retail and mail-order pharmacies as of Dec. 5, drug maker Eli Lilly announced.

The medication has been getting a lot of attention from doctors concerned about the toll many extra pounds can have on people’s health.

“We’re all extremely excited in the obesity community because it will be the most effective medication on the market,” Dr. Shauna Levy, medical director of Tulane’s Bariatric and Weight Loss Center in New Orleans, Louisiana, told NBC’s Stephanie Gosk.

The amount of weight shed with the medication approaches the weight loss seen with bariatric surgery, which is “a big deal,” added Dr. Christopher McGowan, a gastroenterologist who runs a weight loss clinic in Cary, North Carolina, in an interview with NBC News.

Here’s what to know about the new drug:

What is Zepbound?

The prescription drug, which patients self-inject once a week, is the same medication as Type 2 diabetes treatment Mounjaro, said Dr. Roshini Rajapaksa, a gastroenterologist at NYU Langone Health, on TODAY on Nov. 9.

Both drugs are made by Eli Lilly, contain the same active ingredient, tirzepatide, and are available in the same doses.

“It’s not like a new medication. They just are going to... re-package, re-brand,” added NBC News medical contributor Dr. Natalie Azar on the show.

Tirzepatide works by mimicking two different hormones, GLP-1 and GIP, which the body produces after eating. The first helps curb appetite and reduce how much someone eats, while the second works to improve how the body breaks down sugar and fat, as previously reported.

“You’re kind of getting a double whammy effect on appetite control, which is regulated by the brain,” Rajapaksa said. “It also has some effects on insulin, so blood sugar metabolism and fat metabolism as well.”

Studies have found there’s a “synergistic action” when the body’s receptors for both GIP and GLP-1 are activated, leading to greater weight loss.

Azar called it “quite a significant amount."

In a trial of adults without diabetes, those randomized to receive Zepbound lost 18% of their body weight on average after a year and five months, compared to those randomized to a placebo, the FDA noted.

Meanwhile, a trial of Wegovy, the version of Ozempic approved for weight loss, showed adults without diabetes who took the drug lost an average of 12.4% of their initial body weight after a year and four months compared to people who received a placebo, according to the FDA.

An analysis published ahead of peer review in November found people taking tirzepatide were up to three times more likely to achieve weight loss than those using semaglutide, the active ingredient in Ozempic and its sister drug, Wegovy.

Who can take Zepbound?

Zepbound has been approved for a specific population — adults with obesity or those who are overweight and have at least one weight-related condition, such as high blood pressure, Type 2 diabetes or high cholesterol.

“This is not for the person who wants to lose a few pounds before their wedding,” Rajapaksa noted.

Patients taking the drug should still make lifestyle changes such as eating less and exercising more, the FDA advised.

Zepbound cost

The list price is about $1,060 for a month’s supply, according to Eli Lilly.

In comparison, Wegovy has a list price of about $1,350 per month, according to Novo Nordisk.

Many insurance plans, including Medicare, don’t cover anti-obesity drugs so cost “remains a huge barrier,” McGowan previously told

There is legislation with bipartisan support proposed to change Medicare’s policy, but it’s stuck in Congress, Gosk noted. If it passes, most other insurance companies would have a hard time denying coverage, she added.

Zepbound side effects

The most common side effects include nausea, diarrhea, vomiting, constipation, stomach pain, indigestion, injection site reactions, feeling tired, allergic reactions, belching, hair loss and heartburn, according to Eli Lilly.

Gastrointestinal issues usually happen when patients first start taking the drug and the dose is increased too quickly, Azar said.

There can also be serious side effects such as kidney and gallbladder problems, severe stomach problems, pancreatitis, serious allergic reactions, low blood sugar, changes in vision in patients with Type 2 diabetes, and depression or thoughts of suicide, the company added.

“These are still not magic pills. There are side effects,” Rajapaksa said.

“Make sure you’re doing this with someone who knows how to prescribe the medication and could monitor you,” Azar added.

Zepbound causes thyroid C-cell tumors in rats, though it’s unknown whether it causes such tumors in humans, the FDA noted. Patients with a personal or family history of medullary thyroid cancer or those with multiple endocrine neoplasia syndrome type 2 should not use the drug, it cautioned.

Zepbound vs. Ozempic

Zepbound is specifically approved for weight management in adults with obesity. Ozempic is a Type 2 diabetes treatment to control blood sugar, though it also leads to weight loss so many people use it off-label for that purpose.

The medications have different active ingredients, but similar side effects:

  • tirzepatide in Mounjaro and Zepbound targets two different hormones the body produces after eating.
  • semaglutide in Ozempic and Wegovy targets just one hormone.

"The studies did show (Zepbound) had a little bit of an increased efficacy compared to the prior injectables, so that’s always good news," Rajapaksa said.