What Are the 4 Main GLP-1 Drugs?

TL;DR: The four main GLP-1 drugs are semaglutide (Ozempic/Wegovy), tirzepatide (Mounjaro/Zepbound), liraglutide (Saxenda/Victoza), and dulaglutide (Trulicity). Tirzepatide shows the greatest weight loss in clinical trials (roughly 20%), followed by semaglutide (roughly 15%). Liraglutide and dulaglutide are older, with more modest results. All four share similar gastrointestinal side effects, and costs range from around $350 to $1,400 per month depending on insurance, savings programs, and the specific drug.

You've probably heard of Ozempic. Maybe Mounjaro, too. But if you've started looking into GLP-1 medications for weight loss or diabetes management, you've likely realized there's an entire class of drugs out there, and figuring out which one does what can feel overwhelming.

Here's a clear breakdown of the four main GLP-1 drugs: what they are, how they work, what the clinical evidence shows, and what they actually cost.

What Are GLP-1 Receptor Agonists?

GLP-1 stands for glucagon-like peptide-1, a hormone your body naturally produces in the gut after eating. It does three important things: it helps regulate blood sugar by stimulating insulin release, it slows down how quickly food moves through your stomach (so you feel full longer), and it sends satiety signals to your brain that reduce appetite.

GLP-1 receptor agonists are medications that mimic this natural hormone, but with a much longer-lasting effect. Where your body's own GLP-1 breaks down within minutes, these drugs are engineered to stay active for hours or even days. The result: sustained appetite suppression, improved blood sugar control, and significant weight loss in many people.

Four GLP-1 drugs dominate the current landscape. Here's what you need to know about each.

1. Semaglutide (Ozempic, Wegovy, Rybelsus)

Semaglutide is the most well-known GLP-1, largely because of the cultural moment Ozempic created starting in 2022. It's available under three brand names: Ozempic (approved for type 2 diabetes), Wegovy (approved for weight management), and Rybelsus (an oral tablet approved for diabetes).

How it works: Semaglutide is a pure GLP-1 receptor agonist. It binds to GLP-1 receptors in the gut and brain, reducing appetite, slowing gastric emptying, and improving insulin sensitivity.

Dosing: Ozempic and Wegovy are once-weekly subcutaneous injections. Dosing typically starts low (0.25 mg) and increases gradually to the target dose: 1 mg or 2 mg for Ozempic, 2.4 mg for Wegovy. Rybelsus is a daily oral tablet at up to 14 mg for diabetes, with a 50 mg version studied for weight loss.

Efficacy: In the landmark STEP 1 trial, participants taking Wegovy lost an average of 14.9% of their body weight over 68 weeks. For context, that translates to roughly 15 kg (33 lbs) for someone starting at 100 kg (220 lbs).

Common side effects: Nausea (20 to 44%), diarrhea (12 to 30%), vomiting (9 to 24%), and constipation. These are typically worst during the dose-escalation phase and tend to improve over time.

Cost: $1,349 to $1,418 per month at retail without insurance. Novo Nordisk offers savings cards that can reduce the cost to as little as $0 to $25 per month for eligible insured patients. Self-pay options start around $349 per month through select programs.

Best for: People seeking an established, well-studied option with strong weight loss and blood sugar data. Semaglutide has the longest track record among the newer-generation GLP-1s.

2. Tirzepatide (Mounjaro, Zepbound)

Tirzepatide is the newer competitor that's been making headlines in clinical trials. It's available as Mounjaro (for type 2 diabetes) and Zepbound (for weight management).

How it works: Tirzepatide is unique in this class because it activates two receptors simultaneously: GLP-1 and GIP (glucose-dependent insulinotropic polypeptide). This dual mechanism appears to produce greater effects on appetite, blood sugar, and fat metabolism than targeting GLP-1 alone.

Dosing: Once-weekly subcutaneous injection. Starts at 2.5 mg and titrates up to a maximum of 15 mg.

Efficacy: In the SURMOUNT-1 trial, participants on the highest dose (15 mg) lost an average of 20.9% of their body weight over 72 weeks. A 2025 head-to-head randomized controlled trial published in the New England Journal of Medicine directly compared tirzepatide to semaglutide in 751 people with obesity: tirzepatide achieved 20.2% weight loss versus 13.7% for semaglutide, a statistically significant difference.

Common side effects: Nausea (17 to 31%), diarrhea (13 to 22%), vomiting (6 to 16%). The GI side effect profile is broadly similar to semaglutide, though some studies suggest slightly lower rates of nausea and vomiting.

Cost: $1,060 to $1,200 per month at retail. Eli Lilly offers a self-pay option through Lilly Direct at $349 to $499 per month, making Zepbound the most affordable FDA-approved GLP-1 for self-pay patients at the time of writing.

Best for: People seeking maximum weight loss, those who haven't responded adequately to semaglutide, or self-pay patients looking for lower costs through manufacturer programs.

3. Liraglutide (Saxenda, Victoza)

Liraglutide was the first GLP-1 to gain widespread use for weight management. It's available as Saxenda (for weight loss) and Victoza (for type 2 diabetes).

How it works: Like semaglutide, liraglutide is a GLP-1 receptor agonist. It reduces appetite, slows gastric emptying, and improves blood sugar regulation. The key difference is its shorter duration of action, which requires more frequent dosing.

Dosing: Liraglutide requires a daily subcutaneous injection, compared to the once-weekly dosing of semaglutide and tirzepatide. The target dose is 3.0 mg for Saxenda and up to 1.8 mg for Victoza.

Efficacy: Clinical trials showed an average weight loss of approximately 8% of body weight over 56 weeks. That's meaningful, though noticeably less than semaglutide or tirzepatide. For diabetes management, liraglutide remains a solid, well-established option.

Common side effects: Similar GI profile to the other GLP-1s: nausea, diarrhea, constipation, and vomiting. Some studies suggest liraglutide may produce slightly fewer GI side effects than higher-potency GLP-1s at their maximum doses.

Cost: Approximately $1,350 per month at retail for Saxenda. Generic versions have brought the price closer to $650 per month. Insurance coverage for the weight loss indication varies.

Best for: People who prefer a well-studied medication with a long safety track record, or those who find the daily injection schedule easier to remember. Liraglutide is also sometimes more accessible through insurance or at a lower cost than the newer alternatives.

4. Dulaglutide (Trulicity)

Dulaglutide is the workhorse GLP-1 in the diabetes world. It's prescribed primarily for type 2 diabetes management and carries the brand name Trulicity.

How it works: Dulaglutide is a GLP-1 receptor agonist with a mechanism similar to semaglutide and liraglutide. It improves blood sugar control, supports modest weight loss, and has demonstrated cardiovascular benefits.

Dosing: Once-weekly subcutaneous injection. Doses range from 0.75 mg to 4.5 mg.

Efficacy: Dulaglutide produces modest weight loss, generally in the range of 3 to 5% of body weight. That's less dramatic than semaglutide or tirzepatide, which is why it's rarely prescribed specifically for weight management. Where dulaglutide excels is in consistent, long-term blood sugar control with a well-tolerated side effect profile.

Common side effects: Nausea, diarrhea, vomiting, and abdominal pain. Rates are generally comparable to liraglutide and slightly lower than semaglutide at higher doses.

Cost: Generally in line with other branded GLP-1s. Insurance coverage for diabetes tends to be broader than for weight loss indications.

Best for: People managing type 2 diabetes who want a convenient once-weekly injection with solid A1C reduction. Less suited for those whose primary goal is significant weight loss.

How Do You Choose?

The right GLP-1 depends on your situation. A few factors worth discussing with your doctor:

• Primary goal: If maximum weight loss is the priority, tirzepatide has the strongest clinical data. Semaglutide is close behind with a longer track record. If the goal is blood sugar management with modest weight benefits, liraglutide and dulaglutide are established choices.
• Dosing preference: Some people prefer the simplicity of a once-weekly injection (semaglutide, tirzepatide, dulaglutide). Others find a daily injection like liraglutide easier to incorporate into their routine.
• Cost and access: Insurance coverage varies significantly by plan and indication. Tirzepatide's Lilly Direct program offers competitive self-pay pricing. Liraglutide's generic versions may be the most affordable option for some. Manufacturer savings cards can make any of these drugs significantly cheaper for eligible patients.
• Side effect tolerance: All GLP-1s share a similar GI side effect profile. If nausea is a concern, starting at a low dose and titrating slowly is standard practice regardless of which drug you choose. Individual responses vary more than drug-class differences.

A February 2025 meta-analysis of nearly 6,000 patients found that head-to-head comparisons between these drugs show smaller differences than cross-trial comparisons might suggest. Your prescriber can help identify the best fit based on your medical history, insurance, and goals.

Beyond Medication: Addressing Food Noise at the Source

All four GLP-1 drugs work by reducing appetite and quieting what many users describe as "food noise": the constant background chatter about what to eat next. For many people, this effect is genuinely life-changing.

It's worth knowing that the appetite suppression and craving reduction these drugs produce are driven by neurochemical changes in the brain's reward and satiety pathways. Behavioral approaches, including self-hypnosis and subconscious reprogramming, target those same pathways through a different mechanism: changing the learned patterns and emotional associations that drive automatic eating behavior.

For people exploring natural alternatives to GLP-1 medications, or those looking to build a behavioral foundation alongside their prescription, the psychological layer matters. Addressing the subconscious drivers of eating behavior can complement whatever path you choose.

This article is for educational purposes and does not constitute medical advice. GLP-1 medications are prescription drugs with potential risks and side effects. Consult a healthcare provider to determine whether a GLP-1 is appropriate for your situation. Pricing information is approximate and subject to change.

Ready to stop fighting your cravings and start reprogramming your mind for lasting success? The Hypna AI 21-day self-hypnosis program is designed to help you rewire subconscious patterns and build a healthier relationship with food from the inside out.