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Recently, its impact on heart health has garnered attention
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DOI: 10.1111/dom.70209 Jastreboff, A.M., et al
Tirzepatide tends to be the better choice if: You have a higher starting BMI (say, above 35) and want maximum weight loss You also have type 2 diabetes and need stronger glycemic control You've tried semaglutide and plateaued before reaching your goal Cost is similar for you (LillyDirect direct-pay vials currently undercut Wegovy on entry tiers) Semaglutide tends to be the better choice if: You have established cardiovascular disease and want a drug with proven CV outcome benefit (SELECT) [9] You tolerated 1 mg Ozempic well in the past and your insurance covers Wegovy You prefer the longer real-world track record (Wegovy approved 2021 versus Zepbound 2023) You need an oral option (Rybelsus, though it's FDA-approved for diabetes, not weight loss) Either is reasonable if: You're starting from BMI 30 to 35 with no major comorbidities Your insurance pushes you toward one over the other You're in the early titration period and haven't yet seen what your response looks like A real-world example
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