If your healthcare journey has led you to Wegovy® (semaglutide), you know it can be a powerful tool for weight management. However, ongoing shortages, insurance complexities, and cost can make consistent access challenging. You’re not alone in seeking alternatives. This guide provides a clear, science-based comparison of other medications, helping you have an informed conversation with your provider about the option that best fits your health needs and personal circumstances.
Why Patients Consider Alternatives to Wegovy
People explore alternatives to Wegovy for several practical reasons. Persistent supply chain issues can make the medication difficult to find at pharmacies . Furthermore, even with insurance, coverage for weight management medications can be unstable and subject to change, sometimes with little notice . The high monthly cost, often over $1,300 without coverage, is a significant barrier . Some individuals may also seek a different option due to side effects or a preference for a non-injectable form of treatment.
GLP-1 and Dual Agonist Alternatives to Wegovy
The most similar alternatives to Wegovy are other incretin-based medications, which work on the same hormonal pathways to regulate appetite and blood sugar. These fall into two main sub-classes: GLP-1 receptor agonists (like Wegovy) and the newer dual GIP/GLP-1 receptor agonists.
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Zepbound® (tirzepatide): This is a dual GIP/GLP-1 receptor agonist approved for chronic weight management. It requires a once-weekly injection like Wegovy . A 2025 meta-analysis of scientific studies found that tirzepatide may lead to significantly greater weight loss compared to semaglutide (the active ingredient in Wegovy).
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Saxenda® (liraglutide): This is a daily injectable GLP-1 receptor agonist also approved for weight management . While effective, the daily injection schedule can be less convenient than weekly options.
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Oral Medications (e.g., Rybelsus®): For those who prefer a pill, Rybelsus is an oral form of semaglutide. However, it is currently FDA-approved only for type 2 diabetes, not weight management, and clinical trials show more modest weight loss compared to the injectable form .
Non-GLP-1 Medications Suitable as Wegovy Alternatives
Older prescription weight-loss medications work through different mechanisms and can be effective, often at a lower cost. A 2025 retrospective study found that while a higher percentage of patients on GLP-1 agonists achieved ≥5% weight loss, other medication classes remain a viable option for many .
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Qsymia® (phentermine/topiramate): This combination pill suppresses appetite and is taken daily. It is typically much less expensive than GLP-1 medications .
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Xenical® (orlistat): This daily capsule works by blocking the absorption of dietary fat. A lower-dose version is also available over-the-counter as Alli® .
Effectiveness Comparison vs. Wegovy
Weight loss outcomes can vary based on the individual and the medication. The table below summarizes expected results based on available clinical research.
| Medication (Generic) | Expected Average Weight Loss (vs. Wegovy) | Key Scientific Insight |
|---|---|---|
| Zepbound (tirzepatide) | Greater weight loss | A 2025 meta-analysis concluded tirzepatide produces significantly greater weight reduction than semaglutide. |
| Saxenda (liraglutide) | Less weight loss | As a GLP-1 agonist, it is effective but clinical trials generally show lower average weight reduction compared to semaglutide. |
| Qsymia (phentermine/topiramate) | Comparable in some studies | An average of -8.3% at 56 weeks, which can be comparable to some GLP-1 results. |
| Xenical (orlistat) | Less weight loss | Tends to produce a more modest weight reduction of 3.1% compared to newer injectable agents. |
Side Effects Across Alternatives
All prescription weight-management medications carry the potential for side effects. Gastrointestinal (GI) issues like nausea, vomiting, diarrhea, and constipation are the most common across GLP-1 and dual agonist medications . These effects are often dose-dependent and may lessen over time. The side effect profile can vary between individuals, making one medication more tolerable than another for some people .
Non-GLP-1 medications have different side effect profiles. For example, orlistat can cause oily stool and fecal urgency, while phentermine may cause dry mouth, insomnia, or increased heart rate. A healthcare provider can help determine which medication’s side effect profile best aligns with your health history.
Availability and Insurance Coverage Differences
Availability and insurance coverage are two of the most dynamic and challenging factors.
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Availability: Wegovy has faced well-documented shortages, and supply can be intermittent . While Zepbound and Saxenda have also experienced high demand, their availability may vary by pharmacy and region.
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Insurance Coverage: Coverage for weight-loss medications is complex and can change suddenly. For instance, as of July 2025, the major pharmacy benefit manager CVS Caremark stopped covering Zepbound for new prescriptions in many plans, while continuing to cover Wegovy, in an effort to lower drug costs through competition . Some insurers, like certain Blue Cross Blue Shield plans, may exclude obesity medications altogether, covering GLP-1 drugs only for diabetes . It is essential to verify your plan’s current formulary and prior authorization requirements.
Cost Breakdown
List prices are high, but your actual out-of-pocket cost depends on insurance, manufacturer savings programs, telehealth discounts, and pharmacy.
| Medication | Approximate Monthly List Price | Potential Cost-Saving Notes |
|---|---|---|
| Wegovy | ~$1,350 | Manufacturer coupons may be available if insured. |
| Zepbound | ~$1,060 | Eli Lilly offers a savings card and a direct-pay program for ~$550/month for eligible patients . |
| Saxenda | ~$1,350 | Similar list price to Wegovy; check for savings programs. |
| Qsymia | ~$100 | Significantly lower cash price than injectable alternatives. |
| Xenical | ~$900 | Higher cash price; generic orlistat and OTC Alli® are lower-cost options. |
How to Pick the Right Wegovy Alternative
Choosing an alternative is a personal medical decision. Here are key factors to discuss with your provider:
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Primary Goal: Is it maximum weight loss, managing a condition like sleep apnea, or finding the most tolerable option?
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Insurance & Cost: What does your plan cover today? What can you realistically afford long-term?
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Lifestyle Fit: Do you prefer a weekly injection, daily injection, or a daily pill?
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Health History: Your personal and family medical history will rule in or out certain medications (e.g., history of thyroid cancer may contraindicate GLP-1 drugs).
Conclusion
Several effective alternatives to Wegovy exist, from the potent dual agonist Zepbound to daily pills like Qsymia. The “best” choice depends on a balance of scientific evidence, insurance logistics, personal tolerance, and cost. With recent insurance changes and ongoing supply considerations, having a knowledgeable healthcare partner is more important than ever.
At Heally, our licensed providers are here to help you navigate these complex decisions. We can review your health profile, discuss the latest clinical evidence, and work with you to find a safe, sustainable path toward your wellness goals.
Schedule a free consultation with Heally today to explore whether Ozempic, Wegovy, or another solution is right for you.
Sources
- PubMed: Once-Weekly Semaglutide in Adults with Overweight or Obesity
- JAMA: Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity
- Science Direct: GLP-1 physiology informs the pharmacotherapy of obesity
- National Library of Medicine: Reductions in Insulin Resistance are Mediated Primarily via Weight Loss in Subjects With Type 2 Diabetes on Semaglutide
- NIH: Semaglutide StatPearls
- New England Journal of Medicine – STEP 1 Trial: Once‑Weekly Semaglutide for Weight Loss
- Nature: Two-Year Effects of Semaglutide (STEP 5 Trial)
- FDA Alert: Overdose Risks from Semaglutide and Other GLP-1 Agonists
- Eli Lilly Investors: Zepbound (tirzepatide) showed superior weight loss over Wegovy (semaglutide) in complete SURMOUNT-5 results published in The New England Journal of Medicine
- CNN: Major insurance changes are coming to GLP-1 drugs for weight loss. Here’s how that could affect patients
- PubMed Central: Comparative Efficacy of Tirzepatide vs. Semaglutide in Reducing Body Weight in Humans: A Systematic Review and Meta-Analysis of Clinical Trials and Real-World Data
- FDA Label: OZEMPIC (Semaglutide Injection) Medication Guide
- FDA Label: WEGOVY (Semaglutide Injection) Medication Guide
- FDA Label: RYBELSUS (Oral Semaglutide) Medication Guide
- FDA Label: MOUNJARO (Tirzepatide Injection) Medication Guide
- FDA Label: ZEPBOUND (Tirzepatide Injection) Medication Guide
Important Medical Information and Disclaimers
MEDICAL DISCLAIMER
This information is for educational purposes only and is not intended as medical advice, diagnosis, or treatment recommendation. Semaglutide is the active ingredient in three FDA-approved prescription medications: Ozempic and Rybelsus, approved for improving blood sugar control in adults with type 2 diabetes, and Wegovy, approved for chronic weight management in adults with obesity or overweight who have at least one weight-related medical condition. Although these medications contain semaglutide, they are approved for different uses and have different dosing schedules. Always consult a qualified healthcare provider before starting, stopping, or changing any treatment plan.
INDIVIDUAL RESULTS VARY
Outcomes with semaglutide treatment vary from person to person. Clinical trial data may not reflect typical real-world experiences. A variety of factors can affect your results, including medication adherence, lifestyle habits such as diet and exercise, metabolic differences, other health conditions, and concurrent medications. No specific result is guaranteed.
IMPORTANT SAFETY INFORMATION
Common side effects of semaglutide may include: Nausea, Vomiting, Diarrhea, Constipation, Stomach pain, Decreased appetite, Indigestion, Belching or gas, Injection site reactions
These side effects are often mild and may lessen over time. Always inform your healthcare provider about any medical conditions, allergies, and all medications you are currently taking before starting semaglutide. Ongoing monitoring is recommended during treatment.
WARNING: Semaglutide has a boxed warning about the potential risk of thyroid C-cell tumors. Do not use this medication if you or a family member has a history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
FDA ADVERSE EVENT REPORTING
You are encouraged to report negative side effects of prescription drugs to the U.S. Food and Drug Administration (FDA).
Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Adverse events may also be reported directly to the manufacturer.
