Medication vs Medication
Mounjaro vs Wegovy
A practical UK comparison focused on what is genuinely different — not which brand has the loudest marketing.
SURMOUNT-5 compared tirzepatide with semaglutide at 1.7/2.4 mg and found greater mean loss with tirzepatide at 72 weeks. Wegovy now also has a UK-licensed 7.2 mg injectable maintenance option in adults with obesity if needed, so the head-to-head result should not be mislabelled as tirzepatide versus 7.2 mg semaglutide.
Mounjaro
Up to ~20%+ mean loss in obesity trials; direct head-to-head 20.2% at 72 weeks vs 13.7% semaglutide 1.7/2.4 mg in SURMOUNT-5
Wegovy injection
STEP 1: mean -14.9% at 68 weeks with 2.4 mg; 7.2 mg is now a licensed maintenance option for adults with obesity if needed
Side-by-side
| Mounjaro | Wegovy injection | |
|---|---|---|
| Active ingredient | tirzepatide | semaglutide |
| Form | Weekly injection | Weekly injection |
| Frequency | Once weekly | Once weekly |
| Licence | UK weight management licence | UK weight management licence |
| NHS context | NICE-recommended; NHS access is phased / pathway-dependent | NICE-recommended in specialist weight-management pathways; access depends on pathway |
| Evidence | Very strong | Very strong |
| Weight-loss evidence | Up to ~20%+ mean loss in obesity trials; direct head-to-head 20.2% at 72 weeks vs 13.7% semaglutide 1.7/2.4 mg in SURMOUNT-5 | STEP 1: mean -14.9% at 68 weeks with 2.4 mg; 7.2 mg is now a licensed maintenance option for adults with obesity if needed |
| Maintenance | Long-term treatment may be needed; stopping can be followed by regain | Long-term support/treatment matters; weight regain after stopping has been demonstrated |
| GI considerations | Common GI effects, especially during escalation | Common GI effects; dose escalation is used to improve tolerability |
Reasons to discuss Mounjaro
- Highest head-to-head mean weight loss among the established injectable options in SURMOUNT-5
- Weekly dosing
- Strong appetite / food-noise effect for many users
- Weight-management and maintenance licence
Trade-offs
- Injection
- GI side effects can be limiting
- Access and NHS rollout are not the same as NICE eligibility
- Ongoing treatment cost/maintenance matters if private
Reasons to discuss Wegovy injection
- Large evidence base
- Weekly dosing
- Cardiovascular outcome evidence in appropriate populations
- 2.4 mg established; 7.2 mg injectable option now licensed for adults with obesity if needed
Trade-offs
- Injection
- GI effects
- The new 7.2 mg option should not be compared using old 2.4 mg-only trial assumptions
- NHS access remains pathway-limited
Which is stronger for weight loss?
Mounjaro is rated 10/10 and Wegovy injection 8/10 in our comparison framework. That rating summarises the obesity evidence available for the licensed formulation; it is not a prediction of your result.
Which is easier to live with?
Mounjaro: Once weekly. Wegovy injection: Once weekly. For some people a weekly injection is easier than a daily tablet; for others avoiding a needle is decisive.
NHS vs private reality
NICE-recommended; NHS access is phased / pathway-dependent. NICE-recommended in specialist weight-management pathways; access depends on pathway. NICE criteria and NHS availability are related but not identical, so check the current pathway rather than assuming a clinically eligible medicine is immediately available through a GP.
Maintenance matters
Long-term treatment may be needed; stopping can be followed by regain. Long-term support/treatment matters; weight regain after stopping has been demonstrated. A treatment comparison that ends at the point of weight loss is incomplete.
Questions to ask a prescriber
- Which option is actually licensed and clinically appropriate for my health history?
- How do the expected benefits compare for someone with my diabetes/cardiovascular history?
- What side effects should make me contact you?
- What will monitoring involve?
- What is the plan if I cannot tolerate the maintenance dose?
- What happens if I stop?
Sources
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