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10.1081/CLT-100102388
Choose Semaglutide (Wegovy) If: Best for people who: Want the longest safety track record (5 years) Have good insurance coverage for Wegovy specifically Prefer lowest discontinuation rate (6.9%) Are satisfied with 15% average weight loss Advantages: Most real-world data, proven track record since 2021 Disadvantages: Lowest efficacy (14.9%), highest cost ($1,349/month) Choose Tirzepatide (Zepbound) If: Best for people who: Want highest efficacy among available options (22.5%) Prefer best tolerability (31% nausea, lowest) Want better value (~$290/month cheaper) Want medication available today Advantages: Superior efficacy, best side effect profile, lower cost Disadvantages: Less long-term data than Semaglutide (3 years vs 5) Consider Waiting for Retatrutide If: Might make sense if you: Can wait until 2027-2028 without health consequences Want maximum weight loss (28.7%) Have tried both Semaglutide and Tirzepatide with insufficient results Have flexible health timeline Advantages: Highest efficacy (28.7%) Disadvantages: a year or more of waiting (realistically until second half of 2027 at the earliest), highest discontinuation (18.2%), no long-term data Realistic Recommendations For most people today: Choose Tirzepatide
Spontaneous reports through systems like the MHRA Yellow Card scheme cannot establish frequency or definitively confirm causality
Semaglutide compounds took off during a nationwide shortage that ended Feb
