Best Zepbound alternatives for weight loss in 2024

Looking for alternatives to Zepbound to help reach your weight loss goals? Whether you can’t get a prescription for it, your insurance won’t cover it, or you don’t want to give yourself injections, the good news is that Zepbound isn’t the only option for weight loss medication. 

Continue reading to learn about the 5 best Zepbound alternatives for weight loss, along with other medications and natural approaches to consider.

Struggling with obesity or overweight and want to try weight loss medication, like Zepbound? Find a provider on Klarity Health today to learn about treatment options.

5 Best Zepbound alternatives

Zepbound (tirzepatide) is a weekly injection that’s U.S. Food and Drug Administration (FDA)-approved for weight loss and chronic weight management in adults with obesity, or overweight with at least 1 weight-related health condition. It works for weight loss by mimicking the effect of 2 hormones, glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP), to help you feel full faster and longer after you eat. 

In clinical trials, people with obesity or overweight who used Zepbound along with diet and exercise lost an average of 20.9% of their body weight after 36 weeks. Those who continued taking Zepbound for another 52 weeks lost another 5.5% body weight. 

But some people have trouble tolerating Zepbound’s side effects, such as nausea, vomiting, indigestion, diarrhea, and constipation. And, while some insurance plans may cover Zepbound with prior authorization, Zepbound’s cost puts the medication out of reach for many at $1,125.54 per month (according to drugs.com with its discount card applied). 

These and other downsides of Zepbound may leave you looking into other options. If so, there are other prescription injections and weight loss pills available. Here are 5 Zepbound alternatives to consider. 

1. Mounjaro rather than Zepbound

Mounjaro (tirzepatide) is the closest alternative to Zepbound. It’s also a once-weekly injection and it delivers the same active ingredient, tirzepatide. It has the same dosages and causes similar side effects. The cost of Mounjaro is also similar at $1,135.24 per month, according to drugs.com with its discount card.

The only real difference is what they’re FDA-approved to treat. While Zepbound is approved for weight loss in certain people with obesity or overweight, Mounjaro is approved for controlling blood sugar levels in people with type 2 diabetes. Healthcare providers can prescribe Mounjaro for weight loss off-label, but insurance plans are more likely to cover it if you have type 2 diabetes.

You may wonder how Zepbound and Mounjaro compare for weight loss. In clinical trials of Mounjaro, people with type 2 diabetes lost up to 13.9% of their body weight over 104 weeks. But these trials focused on its effectiveness for diabetes and weren’t primarily looking at weight loss. Because Zepbound and Mounjaro have the same active ingredient, it’s likely you’ll experience similar weight loss regardless of which brand you take.  

Mounjaro has the same side effects and drug shortage concerns as Zepbound. It’s easier to get Mounjaro covered by insurance if you have type 2 diabetes that isn’t well-controlled despite trying other diabetes medications, such as metformin. 

2. Wegovy as an alternative to Zepbound

Another alternative to Zepbound is Wegovy (semaglutide), which is also a weekly weight loss injection. It’s approved by the FDA for a wider range of uses, including:

• Weight loss and long-term weight maintenance in adults and children 12 years and older with obesity, and adults who are overweight with at least one weight-related health condition, like type 2 diabetes or high blood pressure, and 
• To reduce the risk of cardiovascular events, such as a heart attack, in obese or overweight adults with heart disease.

As a GLP-1 agonist medication, Wegovy works a bit differently than Zepbound, which is a dual GLP-1/GIP receptor agonist. You may lose less weight with Wegovy. Clinical trial participants who made lifestyle changes while taking Wegovy lost an average of 14.9% of their body weight over 68 weeks. 

When comparing Wegovy vs Zepbound, note that Wegovy is more expensive at $1,430.01 per month without insurance (according to drugs.com with its discount card applied). Although you can save with insurance coverage, Wegovy coupons, and/or savings cards. If you have health insurance, you may need prior authorization for Wegovy before your plan will cover it, if they cover it at all. Also, you may have a hard time finding Wegovy in stock at many pharmacies due to ongoing shortages and high demand. 

3. Ozempic instead of Zepbound 

Ozempic (semaglutide), a GLP-1 agonist with the same active ingredient as Wegovy, is another Zepbound alternative. It’s FDA-approved for managing blood sugar levels in adults with type 2 diabetes. It also reduces the risk of major cardiovascular problems in adults with both type 2 diabetes and heart disease. Although not specifically approved for weight loss, Ozempic is widely prescribed off-label for this purpose due to its effectiveness. 

In clinical trials, participants using 2 milligrams of Ozempic once a week for type 2 diabetes lost at least 5% of their body weight in 40 weeks. Some participants lost more than 10% body weight in the same amount of time. Note that Ozempic is used in lower doses for managing diabetes (0.25 to 2 milligrams weekly), and may result in less weight loss than the higher Wegovy doses of semaglutide (up to 2.4 milligrams weekly).

You’ll likely get Ozempic covered by insurance if you have type 2 diabetes. If not, or if you don’t have insurance that covers it, Ozempic is priced similarly to Zepbound at $1,029.35 per month, according to drugs.com with its discount card. It may be easier to find Ozempic in stock than other top Zepbound alternatives. But, that could change as it’s been on and off the national shortage list for the last year or so.

4. Saxenda as a Zepbound alternative

Approved in 2010, Saxenda (liraglutide) was the first GLP-1 agonist medication approved for weight loss in the U.S. In combination with lifestyle changes, it’s used for chronic weight management in adults with a BMI of 30 or greater (obesity), or 27 or greater (overweight) with at least 1 weight-related health condition. It’s also approved for use in certain children 12 years and older with obesity.

As an older GLP-1 agonist medication, Saxenda for weight loss has some downsides compared to newer drugs in its class. For example, it’s injected daily instead of weekly. You may also lose less weight with it than other GLP-1 drugs. In clinical trials, people taking Saxenda lost between 5 and 10% of their body weight over 56 weeks, on average. 

Note that side effects are similar when comparing Saxenda vs Zepbound. But, Saxenda is more expensive at $1,430.01 per month without insurance, according to drugs.com with its discount card.

Like Zepbound and Wegovy, insurance plans are less likely to cover Saxenda without prior authorization. But it’s active ingredient, liraglutide, may be covered by insurance if you have diabetes and your healthcare provider prescribes Victoza (liraglutide), a brand-name medication approved for managing diabetes.  

5. Compounded tirzepatide or semaglutide as alternatives to Zepbound

Some compounding pharmacies can create injectable medications that contain the same active ingredients as brand-name GLP-1 agonists, such as compounded tirzepatide and compounded semaglutide. If you have trouble finding Zepbound, can’t afford it, or want customized ingredients, compounded medications are an option to consider. 

If you and your provider decide this is the best choice for you, make sure to choose a reliable, licensed compounding pharmacy that requires a prescription.

Other Zepbound alternatives to ask your provider about

If you’re exploring alternatives to Zepbound for weight loss, consider asking your provider about weight loss pills. These medications are generally less expensive and can help manage weight when combined with a healthy lifestyle. But they typically result in less weight loss than Zepbound, although individual experiences vary.

Phentermine for weight loss

Phentermine is a central nervous system (CNS) stimulant drug that works differently than Zepbound. Phentermine works by stimulating the “fight or flight” part of your nervous system, which speeds up your heart rate, blood pressure, and other body functions. It also suppresses appetite.

Adipex-P (a brand-name for phentermine) is FDA-approved for short-term weight loss when combined with lifestyle changes. It’s intended for people ages 16 or older with a BMI of 30 or higher (obesity) or BMI of 27 or higher (overweight) with other health conditions, such as diabetes or high cholesterol. 

A key difference between Zepbound and phentermine is that Zepbound keeps working long-term to help maintain weight loss, while phentermine tends to lose effectiveness over time. In fact, it’s only approved for short-term use because the body builds a tolerance to it within a few weeks. 

Also, Zepbound leads to more weight loss than phentermine. In clinical trials, participants taking phentermine lost an average of 15 to 19 pounds, or 3 to 5% of their starting body weight. And, as a stimulant, phentermine carries risks of serious cardiovascular side effects and a potential for misuse and addiction. 

Some upsides of phentermine? It’s easier to take than an injection — it comes as tablets or capsules that you swallow. It’s readily available and not affected by drug shortages at the time of publication. Insurance plans usually don’t cover it, but it’s inexpensive without insurance. For example, 30 capsules of phentermine comes to $18.83, according to drugs.com with its discount card applied.  

Qsymia instead of Zepbound

Qsymia (phentermine-topiramate) is an oral capsule that contains 2 active ingredients —  phentermine and topiramate. It’s FDA-approved for weight management in adults with a BMI of 30 or greater (obesity), or 27 or greater (overweight) with at least 1 weight-related health condition, in combination with diet and exercise. It’s also approved for use in certain children ages 12 years and older with obesity.

Based on separate studies, Zepbound leads to more weight loss than Qsymia. In clinical trials, participants taking Qsymia lost 5 to 10% of their initial body weight in 56 weeks. In contrast, people taking Zepbound in studies had a body weight reduction of more than 20%. 

Also, Zepbound and Qsymia have different side effects and risks to consider. Since Qsymia contains phentermine and may raise heart rate, it may not be a safe option for people with certain health problems.

As with phentermine, Qsymia comes in pill form and there’s no shortage or supply issues at the time of publication. Without insurance, it costs $210.53 for a month supply, per drugs.com with its discount card applied. Some insurance plans are unlikely to cover weight loss medications like Qsymia, but coupons and savings programs may be available.

Contrave as an alternative to Zepbound

Contrave (bupropion-naltrexone) is another weight loss pill that contains 2 active ingredients — bupropion, an antidepressant, and naltrexone, an opioid antagonist. It’s FDA-approved for weight management alongside increased physical activity and a reduced-calorie diet. It’s meant for adults with a BMI of 30 or greater (obesity), or 27 or greater (overweight) with at least 1 weight-related condition. 

Alongside diet and exercise changes, Contrave can lead to 5 to 10% reduction in body weight after 56 weeks, according to clinical trial results in people with obesity. Some Zepbound and Contrave side effects are similar, such as nausea. But they can also cause different side effects, such as insomnia with Contrave. They also have different risks and boxed warnings.  

Contrave comes in oral tablets that you’ll likely take twice a day once you find the right dose. The cost without insurance is $667.84 per month, assuming the typical dosage, according to drugs.com with its discount card applied. You should be able to find it in stock. And, you’ll likely pay less if you have an insurance plan that covers it. If not, coupons and savings programs may lower your costs.  

Metformin instead of Zepbound

Metformin is a generic medication FDA-approved to treat type 2 diabetes. It’s a pill taken by mouth once or twice a day. It’s a popular medication, but not because of its weight loss effects. Instead, it’s highly effective at lowering blood sugar and reducing the risk of diabetes complications. 

You may lose weight while taking metformin, though it isn’t approved for this purpose. In clinical trials, people with type 2 diabetes who took metformin lost an average of 8.4 pounds over 29 weeks, compared to no weight loss in those who took a placebo. 

Experts generally consider metformin a “weight neutral” medication — meaning it typically doesn’t cause weight loss or weight gain. So it isn’t really the best option for people looking for Zepbound alternatives for weight loss. But at least it’s widely available without shortages and inexpensive at $12.14–$17.11 per month for the 500 milligram dose, according to drugs.com with its discount card applied. 

Xenical or Alli as Zepbound alternatives

Orlistat is another potential Zepbound alternative to consider. It’s the active ingredient in 2 different brand-name weight loss drugs — Xenical, a 120-milligram capsule that requires a prescription, and Alli, a 60-milligram capsule that you can buy over the counter (OTC). Generic versions are also available. The brand and generic forms of orlistat aren’t affected by drug shortages at this time.

Orlistat works differently for weight loss than Zepbound. It blocks your body from absorbing some of the fat you eat, causing it to leave your body as waste. This mechanism has 1 notable downside — you may have unpleasant side effects from orlistat such as fatty stools, fecal leakage, and more frequent, urgent bowel movements. It’s best to use orlistat with a low-fat diet to reduce side effects. 

You’ll likely lose less weight with orlistat than Zepbound. People taking Xenical in clinical trials lost 5% or more body weight after 1 year. But, orlistat is less expensive than Zepbound. Prices range from $55.82 per month for Alli to $803.15 for a 1-month supply of Xenical (according to drugs.com with its discount card applied).

Natural alternatives to Zepbound

Some people prefer herbal or natural remedies over prescription medications. But keep in mind that dietary supplements aren’t regulated by the FDA. This means that the manufacturers of these products aren’t required to prove their safety or effectiveness to the FDA to be sold in the U.S. 

While there’s limited evidence to support their weight loss benefits, the following herbs are commonly found in over-the-counter weight loss supplements:

• Garcinia cambogia
• Ginger
• Green tea
• Hibiscus sabdariffa
• Licorice
• Spirulina
• Turmeric
• Yerba maté

Herbs and natural supplements may cause side effects and interact with medications. Talk to your healthcare provider before starting a dietary supplement to confirm it’s safe for you. 

How to maximize weight loss on any medication

To get the most out of any weight loss medication, adopting a healthy lifestyle is key. This looks different for everyone depending on where you’re at in your journey. Talk to your healthcare team for tips on how to eat a nutritious diet, reduce calorie intake, increase physical activity, and manage stress. These steps are often part of a medical weight loss program, a long-term approach to reaching and maintaining a weight that’s healthy for you.

Key takeaway 

• If you’re having trouble finding or affording Zepbound or don’t want to inject yourself, the good news is that Zepbound isn’t the only medication option for weight loss. 
• Mounjaro, Wegovy, Ozempic, and Saxenda are alternative medications FDA-approved for weight loss that offer similar benefits to Zepbound.
• Incorporate lifestyle changes like diet, exercise, sleep, and stress management to maximize the effectiveness of Zepbound or other weight loss medications, such as GLP-1s, phentermine, Contrave, Qsymia, or orlistat.
• Discuss Zepbound alternatives with your healthcare provider to find the safest and most effective option for you.

Talk to a provider about Zepbound and its alternatives in 24 hours

Schedule an appointment in as little as 24 hours to discuss Zepbound or other weight loss treatments. Find a provider on Klarity Health today to get in touch with experienced healthcare professionals. 

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