Semaglutide is one of the most effective GLP-1 medications for weight loss and type 2 diabetes. It’s also the one with the most FDA-approved uses. It beats older GLP-1s like liraglutide and dulaglutide for weight loss by a wide margin. In a head-to-head trial, people lost 15.8% of their body weight on semaglutide vs 6.4% on liraglutide. Tirzepatide, a dual GLP-1 and GIP drug, leads to more weight loss than semaglutide, and newer pills and triple-action drugs are arriving. Still, semaglutide stands out for its pill and injection options, proven heart and kidney benefits and affordable self-pay prices. Here’s how semaglutide compares with every GLP-1 option available in 2026.
Key takeaways
- Semaglutide is sold as Wegovy (injection and pill) for weight loss, and as Ozempic and Rybelsus for type 2 diabetes
- Semaglutide leads to more weight loss than liraglutide (Saxenda) and dulaglutide (Trulicity), the older GLP-1 medications
- Tirzepatide (Zepbound, Mounjaro) leads to more weight loss than semaglutide: 20.2% vs 13.7% in the SURMOUNT-5 trial
- Semaglutide has proven benefits for the heart, kidneys and liver, and it’s the only GLP-1 with both weekly injection and daily pill options for weight loss
- Exenatide (Byetta, Bydureon BCise) and lixisenatide (Adlyxin) have been discontinued in the US
- Foundayo is a newer daily GLP-1 pill, and retatrutide is an investigational drug that isn’t approved yet
What are GLP-1 receptor agonists?
GLP-1 (glucagon-like peptide-1) is a hormone your gut releases after you eat. GLP-1 receptor agonists are medications that mimic it. They work in four main ways:
- Reduce appetite by signaling fullness to the brain
- Slow stomach emptying, so you feel full longer
- Boost insulin release when blood sugar is high
- Lower glucagon, a hormone that raises blood sugar
GLP-1 medications were first developed for type 2 diabetes. Researchers then found that higher doses lead to significant weight loss. Today, several are FDA approved for weight management.
The GLP-1 medications list for 2026
| Active ingredient | Brand names | Dosing | FDA-approved for weight loss? | Status |
|---|---|---|---|---|
| Semaglutide | Wegovy, Ozempic, Rybelsus | Weekly injection or daily pill | Yes (Wegovy) | Available |
| Tirzepatide (GLP-1 and GIP) | Zepbound, Mounjaro | Weekly injection | Yes (Zepbound) | Available |
| Liraglutide | Saxenda, Victoza, generics | Daily injection | Yes (Saxenda) | Available |
| Dulaglutide | Trulicity | Weekly injection | No | Available, for type 2 diabetes |
| Orforglipron | Foundayo | Daily pill | Yes | Available since April 2026 |
| Exenatide | Byetta, Bydureon BCise | Twice daily or weekly injection | No | Discontinued in the US |
| Lixisenatide | Adlyxin | Daily injection | No | Discontinued in the US |
| Retatrutide (GLP-1, GIP and glucagon) | None yet | Weekly injection | No | Investigational, in phase 3 trials |
Semaglutide: the benchmark GLP-1
Semaglutide is a once-weekly GLP-1 injection, and it’s also available as a daily pill. It comes in four brands:
| Brand | Form | Approved for | Approved since |
|---|---|---|---|
| Wegovy | Weekly injection, up to 2.4 mg (7.2 mg as Wegovy HD) | Weight management, heart risk reduction, MASH | 2021 |
| Wegovy pill | Daily tablet, up to 25 mg | Weight management, heart risk reduction | 2025 |
| Ozempic | Weekly injection, up to 2 mg | Type 2 diabetes, heart and kidney risk reduction | 2017 |
| Rybelsus | Daily tablet | Type 2 diabetes | 2019 |
Weight loss results: In the STEP 1 trial, people on Wegovy 2.4 mg lost 14.9% of their body weight over 68 weeks. In the STEP UP trial, Wegovy HD (7.2 mg) led to about 19% to 21% weight loss. The 25 mg Wegovy pill led to about 14% to 17% weight loss over 64 weeks in OASIS 4.
Beyond weight loss: Semaglutide has proven heart benefits. In the SELECT trial, Wegovy lowered the risk of heart attack, stroke and heart-related death by 20%. It also protects the kidneys in people with type 2 diabetes and chronic kidney disease, and it’s approved for MASH liver disease with fibrosis.
Semaglutide vs liraglutide (Saxenda, Victoza)
Liraglutide is an older GLP-1 taken as a daily injection. Saxenda is approved for weight loss, and Victoza is approved for type 2 diabetes.
| Feature | Semaglutide (Wegovy) | Liraglutide (Saxenda) |
|---|---|---|
| Dosing | Once weekly | Once daily |
| Average weight loss, STEP 8 head-to-head (68 weeks) | 15.8% | 6.4% |
| Stopped due to side effects in STEP 8 | 3.2% | 12.6% |
| Generic available | No | Yes, since 2024 to 2025 |
Semaglutide clearly wins on weight loss and convenience. Liraglutide’s advantages are that generic versions are available, it clears from the body quickly and Saxenda is approved for teens aged 12 and up. For what to expect on liraglutide, see how long liraglutide takes to work. Thinking of combining or switching them? Read can you take semaglutide and liraglutide together.
Semaglutide vs dulaglutide (Trulicity)
Dulaglutide (Trulicity) is a weekly GLP-1 injection approved for type 2 diabetes, but not for weight loss.
| Feature | Semaglutide (Ozempic 1 mg) | Dulaglutide (Trulicity 1.5 mg) |
|---|---|---|
| HbA1c reduction, SUSTAIN 7 head-to-head (40 weeks) | -1.8% | -1.4% |
| Weight loss, SUSTAIN 7 | About 6.5 kg | About 3.0 kg |
| Heart benefits | Proven (SUSTAIN-6, SELECT) | Proven (REWIND) |
| Approved for weight loss | Yes, as Wegovy | No |
Semaglutide lowers blood sugar and weight more than dulaglutide. Dulaglutide remains a solid diabetes option, with an easy-to-use pen and proven heart benefits.
Semaglutide vs tirzepatide (Zepbound, Mounjaro)
Tirzepatide acts on two hormone receptors, GLP-1 and GIP, so it’s not a pure GLP-1 drug. It’s sold as Zepbound for weight loss and sleep apnea, and as Mounjaro for type 2 diabetes.
- Weight loss: In the SURMOUNT-5 head-to-head trial, tirzepatide led to 20.2% weight loss vs 13.7% with semaglutide over 72 weeks
- Side effects: Similar for both, mainly digestive
- Approvals: Semaglutide has more, including MASH and a pill form. Tirzepatide is approved for sleep apnea and, since 2026, heart risk reduction in type 2 diabetes
- Cost: Self-pay prices are similar, about $299 to $449 a month for Zepbound vs $349 for Wegovy pens
We cover this comparison in depth in tirzepatide vs semaglutide: what’s the difference and the dose-by-dose guide tirzepatide vs semaglutide dosage.
Weight loss care at Heally: weight loss prescription · weight loss lab panel · meet our doctors
Oral semaglutide vs Foundayo (orforglipron)
Two daily GLP-1 pills are now approved for weight loss:
| Feature | Wegovy pill (oral semaglutide) | Foundayo (orforglipron) |
|---|---|---|
| Type of drug | Peptide GLP-1 | Small-molecule (non-peptide) GLP-1 |
| How to take it | Empty stomach, a little water, wait 30 minutes to eat | With or without food and water |
| Average weight loss in main trial | About 14% to 17% (64 weeks) | About 11% to 12% (72 weeks) |
| Self-pay starting price | $149 a month | $149 a month |
The Wegovy pill led to more weight loss in its trial, while Foundayo is easier to take. Compare pills and shots in Wegovy pills vs injection.
Discontinued GLP-1 medications: exenatide and lixisenatide
Two older GLP-1 drugs are no longer sold in the US:
- Exenatide (Byetta and Bydureon BCise). Byetta was the first GLP-1 approved in 2005. Both were discontinued in the US in 2024
- Lixisenatide (Adlyxin). A daily injection for type 2 diabetes, discontinued in the US in 2023
If you took one of these, your provider can help you switch to a current option such as semaglutide, dulaglutide or tirzepatide.
Coming soon: retatrutide
Retatrutide is an investigational once-weekly injection that acts on three hormone receptors: GLP-1, GIP and glucagon. In the phase 3 TRIUMPH-1 trial, people on the highest dose lost an average of 28.3% of their body weight over 80 weeks. That’s more than any approved weight loss drug so far. It isn’t FDA approved, and any product sold as retatrutide today isn’t a legal or tested medication.
Semaglutide vs other GLP-1s: side effects
All GLP-1 medications share a similar side effect profile:
- Nausea, the most common, usually during dose increases
- Diarrhea, constipation and vomiting
- Reduced appetite and early fullness
- Injection site reactions, for injected forms
Side effects differ more by dose and how fast the dose is increased than by drug. In STEP 8, fewer people stopped semaglutide because of side effects than liraglutide. For semaglutide vs tirzepatide specifically, see which has fewer side effects. For why nausea happens and how to ease it, read why GLP-1 medications cause nausea.
All of these medications carry warnings about pancreatitis and gallbladder problems. Semaglutide, tirzepatide, liraglutide and dulaglutide also carry a boxed warning about thyroid C-cell tumors.
Semaglutide vs other GLP-1s: benefits beyond weight loss
| Benefit | Semaglutide | Tirzepatide | Liraglutide | Dulaglutide |
|---|---|---|---|---|
| Heart risk reduction | Yes (diabetes and obesity) | Yes (type 2 diabetes) | Yes (type 2 diabetes) | Yes (type 2 diabetes) |
| Kidney protection | Yes (type 2 diabetes with kidney disease) | Not approved | Not approved | Not approved |
| MASH liver disease | Yes (Wegovy) | Not approved | Not approved | Not approved |
| Sleep apnea | Not approved | Yes (Zepbound) | Not approved | Not approved |
| Approved for teens with obesity | Yes (Wegovy, 12+) | No | Yes (Saxenda, 12+) | No |
Semaglutide vs other GLP-1s: cost in 2026
| Medication | Typical self-pay price per month |
|---|---|
| Wegovy pens | 349(199 for the first 2 fills for new patients through December 31, 2026) |
| Wegovy pill | $149 to $299 |
| Ozempic | $349 (up to 1 mg) or $499 (2 mg) |
| Zepbound (LillyDirect) | $299 to $449 |
| Foundayo | From $149 |
| Liraglutide | Varies by pharmacy; generics may cost less than brand |
| Trulicity | Usually covered for diabetes; list price around $1,000 |
Prices as of October 2026 and subject to change.
For ways to lower your cost, see the cost of semaglutide and where to find discounts.
Which GLP-1 is best for weight loss?
There’s no single best GLP-1 for everyone. A general guide:
- Most weight loss: Tirzepatide (Zepbound), or Wegovy HD for people already on semaglutide
- Heart disease without diabetes: Semaglutide (Wegovy), with the strongest heart data
- Prefer a pill: The Wegovy pill for more weight loss, or Foundayo for fewer rules about food
- Type 2 diabetes: Semaglutide (Ozempic), tirzepatide (Mounjaro) or dulaglutide (Trulicity), depending on goals and coverage
- Lower cost or a daily option: Generic liraglutide
- Sleep apnea: Tirzepatide (Zepbound)
- MASH liver disease: Semaglutide (Wegovy)
Your provider will also consider your health history, other medications, side effects and insurance. Some people ask about very low doses to limit side effects. See GLP-1 microdosing for what the evidence shows.
The bottom line
Semaglutide is one of the most effective and versatile GLP-1 medications. It leads to much more weight loss than liraglutide and dulaglutide, and it has the most approved uses, including heart, kidney and liver benefits. It also comes as both a weekly injection and a daily pill. Tirzepatide leads to more weight loss on average, Foundayo is an easier-to-take pill and retatrutide may raise the bar further once approved. The best GLP-1 for you depends on your goals, health conditions and coverage.
Want help choosing between semaglutide and other GLP-1 options? See how Heally works and talk to a licensed provider.
FAQ
Is semaglutide better than other GLP-1s?
Semaglutide leads to more weight loss than liraglutide and dulaglutide, and it has more approved uses than any other GLP-1. Tirzepatide, a dual GLP-1 and GIP drug, leads to more weight loss than semaglutide.
What is the strongest GLP-1 for weight loss?
Among approved medications, tirzepatide (Zepbound) leads to the most weight loss on average, about 20% to 21% in trials. Wegovy HD (semaglutide 7.2 mg) comes close. Retatrutide showed about 28% in a phase 3 trial but isn’t approved yet.
What is the difference between semaglutide and liraglutide?
Both are GLP-1 medications, but semaglutide is taken weekly and liraglutide daily. In the STEP 8 trial, semaglutide led to 15.8% weight loss vs 6.4% for liraglutide. Liraglutide is available as a generic.
Is Trulicity the same as Ozempic?
No. Trulicity contains dulaglutide and Ozempic contains semaglutide. Both are weekly GLP-1 injections for type 2 diabetes. In a head-to-head trial, Ozempic lowered blood sugar and weight more than Trulicity.
Is there a GLP-1 pill for weight loss?
Yes. The Wegovy pill (oral semaglutide) and Foundayo (orforglipron) are both approved for weight loss. Rybelsus is a semaglutide pill approved for type 2 diabetes.
Which GLP-1 medications have been discontinued?
Exenatide (Byetta and Bydureon BCise) and lixisenatide (Adlyxin) are no longer sold in the US.
Which GLP-1 has the fewest side effects?
Side effects are similar across GLP-1 medications and depend mostly on the dose and how fast it’s increased. In STEP 8, fewer people stopped semaglutide because of side effects than liraglutide.
Sources
- Rubino DM, et al. “Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial.” JAMA, 2022.
- Pratley RE, et al. “Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7).” The Lancet Diabetes & Endocrinology, 2018. thelancet.com
- Aronne LJ, et al. “Tirzepatide as Compared with Semaglutide for the Treatment of Obesity” (SURMOUNT-5). New England Journal of Medicine, 2025. nejm.org
- Wilding JPH, et al. “Once-Weekly Semaglutide in Adults with Overweight or Obesity” (STEP 1). New England Journal of Medicine, 2021.
- Eli Lilly and Company. “Lilly’s triple agonist, retatrutide, delivered powerful weight loss in pivotal Phase 3 obesity trial,” May 2026. investor.lilly.com
- Eli Lilly and Company. “Foundayo (orforglipron) now available in the US,” April 2026. biospace.com
- UnitedHealthcare. “Discontinuation of Bydureon BCise and Byetta,” 2024. uhcprovider.com
- Cleveland Clinic. “GLP-1 agonists.” clevelandclinic.org
- Novo Nordisk. “Wegovy price guide,” April 2026. novocare.com
This article is for educational purposes only and is not a substitute for professional medical advice. GLP-1 medications are available by prescription only. Semaglutide, tirzepatide, liraglutide and dulaglutide carry an FDA boxed warning about the risk of thyroid C-cell tumors. Do not use them if you or a family member has had medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2.
