1. Zepbound (Tirzepatide)
- Mechanism: Dual GLP-1 and GIP agonist.
- Avg. Weight Loss: ~21% in clinical trials.
- Why Top? Eli Lilly’s blockbuster outperforms rivals, targeting two hunger hormones. FDA-approved in 2023.
- Side Effects: Nausea, diarrhea.
2. Wegovy (Semaglutide)
- Mechanism: GLP-1 agonist.
- Avg. Weight Loss: ~15% over 68 weeks.
- Status: Novo Nordisk’s star drug; approved for obesity in 2021.
- Bonus: Reduces heart disease risk.
3. Mounjaro (Tirzepatide)
- Mechanism: Same as Zepbound (used off-label for weight loss).
- Avg. Weight Loss: ~20% in trials.
- Note: FDA-approved for type 2 diabetes but widely prescribed for obesity.
4. Saxenda (Liraglutide)
- Mechanism: GLP-1 agonist.
- Avg. Weight Loss: ~8-10%.
- Legacy: Novo’s first-to-market injectable; now overshadowed by Wegovy.
5. Qsymia (Phentermine/Topiramate)
- Mechanism: Appetite suppressant + anti-seizure drug.
- Avg. Weight Loss: ~10% over a year.
- Pros: Oral pill; no refrigeration needed.
6. Contrave (Naltrexone/Bupropion)
- Mechanism: Reduces cravings via brain chemistry.
- Avg. Weight Loss: ~5-8%.
- Unique: Combines an opioid blocker with an antidepressant.
7. Rybelsus (Oral Semaglutide)
- Mechanism: GLP-1 agonist (pill form).
- Avg. Weight Loss: ~10-12%.
- Edge: First oral GLP-1 drug; convenient for needle-averse patients.
8. Xenical (Orlistat)
- Mechanism: Blocks fat absorption.
- Avg. Weight Loss: ~5% over 6 months.
- Old-School: Over-the-counter version (Alli) available but limited by GI side effects.
9. Imcivree (Setmelanotide)
- Mechanism: Targets rare genetic obesity (MC4 receptor agonist).
- Niche: For specific genetic disorders like POMC deficiency.
- Weight Loss: ~25% in targeted patients.
10. Retatrutide (In Trials)
- Mechanism: Triple agonist (GLP-1, GIP, glucagon).
- Avg. Weight Loss: ~24% in Phase 2 (Eli Lilly).
- Future Star: Could surpass Zepbound; expected approval by 2026.
Key Considerations:
- Efficacy vs. Access: GLP-1 drugs (Wegovy, Zepbound) lead in weight loss but face supply shortages.
- Cost: Most cost $1,000+/month without insurance.
- Combination Therapies: Drugs like CagriSema (Novo Nordisk’s GLP-1 + amylin) aim to push efficacy beyond 20%.
The Verdict
For maximum weight loss: Zepbound or Wegovy.
For convenience: Rybelsus (oral) or Qsymia.
For rare genetic obesity: Imcivree.
Always pair medications with diet, exercise, and medical guidance. The “best” drug depends on individual health, goals, and tolerance.
Always consult a healthcare provider before starting any medication.
Sharing is Caring