It depends on your goals, medical history, and health insurance coverage.
From AOD9604 to Zepbound, there’s a whole alphabet worth of injectable weight loss drugs on the market. And while figuring out which one is best for you isn’t as simple as reciting your ABCs, it shouldn’t be an overly complicated task either.
“There’s a bit of a strategy and art to choosing the right weight loss injection for you,” says Obesity Medicine Association President Lydia Alexander, M.D. “What works for one person might not work for another.”
Factors like why you’re struggling to lose weight and what other health conditions you might have play a big part in the decision-making process, Alexander adds.
While medications aren’t one-size-fits-all, the root of what they address is universal: “Obesity is a chronic, relapsing condition—it’s not just about willpower. Weight is regulated by the body as much as respiratory rate,” she explains. “You could try hard to change your breathing for a bit, but your body will fight to put it right back where it’s comfortable. Weight works that way as well.”
Lydia Alexander, M.D., is an internal medicine physician with board certification in obesity medicine. She is the President of the Obesity Medicine Association.
Srinivas Kota, M.D., F.M.N.M., is an internal medicine physician with board certification is a physician with board certification in metabolic, nutritional, obesity, internal, and functional medicine. He is the founder of the Kota Metabolic Institute and is an Independent Consulting Physician for Broad Health, Hone Health’s affiliated medical practice.
Ozempic gets all the buzz but many medications are approved for weight loss by the FDA or prescribed off-label. If you’re among the 45 percent of American adults considering trying one, your doctor may discuss one or two of these popular options with you (1):
If you’ve spent any time on the internet in the past two years, you’ve heard of semaglutide—the active ingredient in Ozempic and Wegovy. While Ozempic is prescribed off-label for people, Wegovy is FDA-approved for weight loss.
Semaglutide is a GLP-1 receptor agonist, meaning it mimics the hormone GLP-1 (2), which your stomach releases after eating. GLP-1 triggers the pancreas to release insulin and suppress the production of another hormone called glucagon. Both regulate blood sugar and help you feel full after eating (2).
Research suggests that people who struggle with obesity and overeating often produce less GLP-1, or their bodies don’t respond to it as strongly as people who don’t have obesity (3, 4). This weak response can make them feel less satisfied after a meal, making it harder to resist the temptation of a second or third helping.
If an insatiable appetite is making it hard for you to eat in a calorie deficit, your natural response to GLP-1 might be the cause. Medications like semaglutide can help by tricking your body into thinking it has more GLP-1. As a result, your brain sounds the “I’m full” alarm more quickly.
While semaglutide is frequently touted as a miracle weight loss drug on social media, it may cause side effects like fatigue and brain fog or gastrointestinal issues like nausea, diarrhea, and constipation (5).
Dose frequency: Weekly
Cost: $800 to $1300 a month without insurance coverage
Who qualifies: People who have a BMI of over 30, or a BMI of over 27 with at least one other weight-related condition like high blood pressure or type 2 diabetes.
While tirzepatide is also a GLP-1 receptor agonist, it also mimics another hormone that stimulates insulin release after eating, called GIP, or glucose-dependent insulinotropic polypeptide (GIP) (6).
“Tirzepatide is a double whammy,” Srinivas Kota, M.D., says. “The additional peptide makes it more powerful at promoting insulin release than just GLP-1 alone.”
Kota says that he’s seen greater weight loss in his patients on tirzepatide than semaglutide—and research backs this up.
A 2022 study in the journal Diabetes, Obesity, and Metabolism compared semaglutide with tirzepatide. Semaglutide helped folks achieve an average of 12.4 percent reduction in body weight, whereas tirzepatide resulted in a 17.8 percent loss (7). Another 2024 study found that on-treatment weight loss on tirzepatide was greater than semaglutide at three, six, and 12 months (8).
Kota often prescribes tirzepatide over semaglutide, especially for people with a BMI of 30 or greater. He also sometimes suggests switching to tirzepatide to people who struggle with portion control and binge eating while taking semaglutide.
However, because tirzepatide mimics both GLP-1 and GIP, it can be double the trouble when it comes to side effects. Some people report more intense gastrointestinal (GI) side effects like nausea, constipation, diarrhea, and vomiting compared to semaglutide (9). In those cases, a single mechanism weight loss drug like semaglutide or liraglutide may be a better option.
Dose frequency: Weekly
Cost: $1,000 to $1,200 a month without insurance coverage
Who qualifies: People with BMI of over 30, or a BMI of over 27 with at least one other weight-related condition like hypertension or type 2 diabetes.
Like semaglutide and tirzepatide, liraglutide is also a GLP-1 receptor agonist. But, instead of taking one dose once a week, liraglutide is delivered in small, daily doses (10).
While studies show semaglutide is better at suppressing appetite than liraglutide (11), Alexander says some of her patients experience more sustained weight loss on liraglutide, possibly because daily dosing may encourage people to make healthy choices on a day-to-day basis.
“It supports the mentality that they’re doing something for their weight loss every day, which motivates them to engage in other daily habits like eating well and exercising,” Alexander says.
Liraglutide has a half-life of just 13 hours, compared to semaglutide’s seven days (11). This means the effects wear off faster and you may experience hunger again between doses more abruptly than on other weight loss injections.
Dose frequency: Daily
Cost: Around $1,350 a month without insurance coverage
How to qualify: People with a BMI of over 30, or a BMI of over 27 with at least one other weight-related condition like hypertension or type 2 diabetes.
GLP-1s aren’t the only injectable medications that can jumpstart your weight loss journey. Sermorelin is a synthetic version of growth hormone-releasing hormone (GHRH). As the name implies, GHRH tells your body to release growth hormone into your bloodstream.
Growth hormone plays a role in a few processes linked to weight loss, including your basal metabolic rate (the number of calories your body burns at rest) and building lean muscle mass (12).
However, because sermorelin can also increase your appetite, Kota notes it may not be appropriate as a stand-alone treatment for someone who is already struggling with cravings or binge eating. In some cases, doctors will prescribe sermorelin alongside other weight loss medications to balance out this effect. Sermorelin may also help prevent muscle loss while taking drugs like Ozempic.
Dose frequency: Daily
Cost: $200 to $400 per month
Who qualifies: Usually requires a documented hGH deficiency, but your doctor may prescribe sermorelin if you struggle to lose weight or are experiencing decreased muscle mass on a GLP-1.
Low testosterone is an underrated cause of weight issues in men, says Kota. Around 40 percent of men over 45 years old have low testosterone (13), and many of them struggle with weight gain.
Testosterone helps even out fat distribution across the body, according to research from the journal PLoS One (14). If your levels are low, excess weight tends to gather in one place: around the belly. Belly fat—also called visceral fat—is linked to an increased risk of high blood pressure, heart disease, cancer, and diabetes (15).
Testosterone is also a key player in building and maintaining lean muscle mass. When your levels are low, you may have trouble getting and keeping gains, which leads to a lower metabolic rate (16). As your body burns fewer calories, you may find yourself gaining weight.
Physical symptoms of low testosterone like low energy and motivation can further challenge your ability to lose weight. Getting your levels within a normal range for your age via testosterone replacement therapy (TRT) can help you sidestep some of these challenges (17).
“I sometimes prescribe testosterone replacement therapy for weight loss in men as a first treatment,” Kota says. “I’ve seen some men respond better to testosterone than to GLP-1 medications like Ozempic.”
Qualifying for testosterone replacement therapy is a different process than getting approved for a GLP-1: Your doctor will test your free and total testosterone levels to confirm your levels are low and that you qualify for treatment.
If your testosterone is in the normal range and you don’t have any other symptoms of low T, another weight loss injection may be a better option, Kota says.
Dose frequency: Depends on delivery method
Cost: $20 to $3,200 annually, depending on insurance coverage and provider
Who qualifies: People who have a confirmed testosterone deficiency.
Although weight gain is still stigmatized, there’s no need to feel apprehensive about asking for weight loss medication, Alexander says.
“Weight loss medication is a great tool and you shouldn’t feel that it’s a crutch or that you failed by needing it,” she explains. “As a doctor, I’m happy to prescribe a tool that helps you stick to other interventions like diet and exercise.”
Be open with your doctor about your lifestyle habits, medical history, and weight loss goals. If you have specific concerns or think one of the injections might be a good fit for you, don’t hesitate to bring them up, Alexander says.
Related Articles
Mar 19, 2024
Fasting fans can’t shut up about this cellular recycling. Here's why.
Mar 18, 2024
Double down on fat loss with these two metabolic firecrackers.
Apr 17, 2024
Your strength workout doesn’t hold a candle to cardio when it comes to calorie burn, unless you do this.
Aug 28, 2024
Here’s what experts have to say about the quick-fix stick-ons.
Mar 19, 2024
Here’s what you need to get a prescription for the appetite-suppressing medication.
Jul 22, 2022
The ‘Stranger Things’ star used intermittent fasting, pilates, and kettlebell training to achieve his most drastic physical transformation yet.
Apr 14, 2023
The People's Shark's new health habits are his latest power move.
Aug 19, 2024
Your body is changing—here’s how your mind needs to respond.
