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Among approved drugs, tirzepatide (Mounjaro/Zepbound) produced the largest average weight loss in trials, about 20.9% over 72 weeks at the highest dose in SURMOUNT-1, ahead of semaglutide at roughly 14.9% over 68 weeks in STEP 1

Semaglutide (Wegovy, Ozempic) Semaglutide is the most established alternative and the one most people consider first

When starting semaglutide (a GLP-1 agonist), some people may notice a slight reduction in weight during the first week, though the changes tend to be modest

Patients may also experience associated symptoms such as hoarseness, chronic cough, or a feeling of a lump in the throat