The core difference
Semaglutide is a GLP-1 receptor agonist. Tirzepatide is a dual GLP-1 and GIP receptor agonist, so it acts on two hormonal pathways instead of one. In SURMOUNT-5, a 72-week head-to-head trial of the brand-name medications, tirzepatide produced greater average weight loss than semaglutide.
Semaglutide
GLP-1 agonist · Studied in large trials of the FDA-approved version · Weekly injection · Longer clinical track record
Tirzepatide
GLP-1 + GIP dual agonist · Studied in large trials of the FDA-approved version · Weekly injection · Newer, growing evidence
Compounded semaglutide and tirzepatide were not studied in those trials, and individual results vary.
Which should you choose?
Many clinicians start with semaglutide because it has the longest clinical track record and the most long-term safety data. Your provider may suggest tirzepatide depending on your health history and how you’ve responded to other treatments.
Your provider will recommend the right starting medication based on your health history, goals, and existing conditions. You do not need to decide alone.
Not sure which is right?
Let a licensed provider decide.
Your provider uses your assessment to decide whether a treatment is appropriate for you, and which one.