The Definitive GLP-1 Comparison Table

Here's how every major GLP-1 medication compares on the metrics that actually matter for weight loss:

Clear winner for weight loss: Tirzepatide produces 40% more weight loss than semaglutide and nearly 3x more than liraglutide. The data isn't close.

Tirzepatide: The Best GLP-1 for Maximum Weight Loss

If your primary goal is losing the most weight possible, tirzepatide is the clear choice. Here's the clinical data:

SURMOUNT-1 Trial Results (72 weeks, no diabetes)

• 15mg dose: 20.9% average body weight loss
• 10mg dose: 19.5% average body weight loss
• 5mg dose: 15.0% average body weight loss
• 50% of patients on 15mg lost ≥20% of body weight
• 32% of patients lost ≥25% of body weight (bariatric surgery territory)

Why Tirzepatide Works Better: The Dual Mechanism

Tirzepatide activates both GIP and GLP-1 receptors simultaneously—a fundamentally different approach than semaglutide:

• GLP-1 activation: Reduces appetite, slows gastric emptying, enhances insulin secretion
• GIP activation: Increases energy expenditure, improves fat metabolism, activates brown adipose tissue
• Synergistic effects: The combination produces outcomes greater than either pathway alone

Blood Chemistry Improvements with Tirzepatide

These aren't just weight numbers—they're markers of cardiovascular risk, metabolic health, and systemic inflammation. Tirzepatide improves them all.

Semaglutide: The Best GLP-1 for Proven Heart Protection

While tirzepatide wins on weight loss, semaglutide has something tirzepatide doesn't yet: proven cardiovascular outcomes data.

SELECT Trial Results (2023)

The SELECT trial studied semaglutide in 17,604 patients with established cardiovascular disease:

• 20% reduction in major adverse cardiovascular events (MACE)
• 18% reduction in heart attacks
• 21% reduction in strokes
• 15% reduction in cardiovascular death

STEP Trial Weight Loss Results

• STEP 1: 14.9% average weight loss at 68 weeks
• STEP 3: 16.0% with intensive behavioral therapy
• 32% of patients achieved ≥20% weight loss

When to Choose Semaglutide Over Tirzepatide

• Existing heart disease: SELECT trial proves cardiovascular protection
• High cardiovascular risk: Family history, elevated ASCVD score
• Preference for established data: 8+ years of real-world experience
• Previous good response: If semaglutide is working well, no need to switch

Head-to-Head: Tirzepatide vs. Semaglutide Direct Comparison

The SURPASS-2 trial directly compared tirzepatide to semaglutide in patients with type 2 diabetes. The results were definitive:

Key finding: Tirzepatide produced nearly double the weight loss with LESS nausea. The dual GIP activation may have anti-nausea effects that partially offset GLP-1-induced nausea.

Side Effect Profiles: Which GLP-1 Is Easier to Tolerate?

All GLP-1 medications cause gastrointestinal side effects. Here's how they compare:

Bottom line: Tirzepatide is generally better tolerated despite producing greater weight loss. This counterintuitive finding may be due to GIP's modulatory effects on the GI system.

Best GLP-1 by Specific Goal

Different GLP-1 medications excel in different situations. Here's our recommendation by goal:

🏆 Maximum Weight Loss → Tirzepatide

The data is unambiguous: tirzepatide produces 40% more weight loss than semaglutide. If losing the most weight possible is your primary goal, tirzepatide is the best GLP-1.

❤️ Proven Cardiovascular Protection → Semaglutide

The SELECT trial demonstrated 20% reduction in major cardiovascular events. Tirzepatide's CV outcomes trial (SURPASS-CVOT) is still ongoing. If you have heart disease or high cardiovascular risk, semaglutide currently has the evidence edge.

😊 Best Tolerability → Tirzepatide

Despite greater efficacy, tirzepatide causes less nausea than semaglutide. If you're sensitive to GI side effects or had issues tolerating other medications, tirzepatide may be better tolerated.

📊 Most Established Track Record → Semaglutide

Semaglutide has 8+ years of clinical and real-world data. If you prefer medications with extensive long-term safety data, semaglutide has the longer history.

💉 Avoiding Injections → Oral Semaglutide (Rybelsus)

If you absolutely cannot do injections, oral semaglutide is an option—though weight loss is significantly less than injectable formulations.

Where to Get the Best GLP-1 Medications

Having identified which GLP-1 is best for weight loss, the next question is where to get it. We've analyzed over 15 telehealth providers:

Why Coreage RX is #1: Coreage RX is the only provider offering pharmaceutical-grade tirzepatide AND semaglutide at telehealth prices. When you're injecting a peptide to fundamentally alter your metabolism, medication quality matters.

The Future: Next-Generation GLP-1 Medications

The GLP-1 field is rapidly evolving. Here's what's coming:

Retatrutide (Triple Agonist)

Eli Lilly's next-generation molecule activates GIP, GLP-1, AND glucagon receptors. Phase 2 trials showed 24.2% weight loss—even more than tirzepatide. Expected FDA approval: 2026-2027.

Orforglipron (Oral GLP-1)

A once-daily pill that may produce weight loss comparable to injectable semaglutide. Phase 3 trials underway.

CagriSema (Semaglutide + Cagrilintide)

Combining GLP-1 with amylin receptor activation. Early data shows enhanced weight loss versus semaglutide alone.

For now, tirzepatide remains the most effective approved GLP-1 for weight loss. Coreage RX will likely add new medications as they become available.

Frequently Asked Questions

Which GLP-1 is best for someone new to weight loss medications?

For most new patients, we recommend tirzepatide through Coreage RX. It produces the best weight loss with actually better tolerability than semaglutide. Start at 2.5mg and titrate up as tolerated.

Can I switch from semaglutide to tirzepatide?

Yes, many patients who plateau on semaglutide see renewed weight loss when switching to tirzepatide. The different mechanism (dual GIP/GLP-1) can restart progress. Your provider will guide appropriate dosing.

Is compounded GLP-1 as effective as pharmaceutical-grade?

Variable. Compounded medications lack FDA oversight and can have purity, potency, or stability issues. Pharmaceutical-grade medications like those from Coreage RX guarantee you're getting exactly what was studied in clinical trials.

How long do I need to take GLP-1 medications?

Most research suggests GLP-1s work best as long-term therapy. Weight typically rebounds when medication is stopped. Think of them like blood pressure medications—ongoing treatment for ongoing benefit.

What if neither tirzepatide nor semaglutide works for me?

About 5-10% of patients don't achieve significant weight loss with GLP-1s. Options include: dose optimization, combining with other interventions, or considering bariatric surgery. Your provider can discuss alternatives.