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The question I get asked most often: "Which GLP-1 should I use?" After personally trying Ozempic, Wegovy, and Mounjaro over the past 18 months, I can finally give you my honest take. Spoiler alert: the answer is more complicated than you might hope.

The Quick Summary

Ozempic (semaglutide): FDA approved for type 2 diabetes, often prescribed off-label for weight loss. Weekly injection. Moderate effectiveness for weight loss.

Wegovy (semaglutide): Same active ingredient as Ozempic but FDA approved specifically for weight loss. Weekly injection. Higher maximum dose than Ozempic.

Mounjaro (tirzepatide): Newer medication that works on two hormone receptors instead of one. Weekly injection. Often more effective for weight loss than semaglutide medications.

My Experience with Ozempic

I started with Ozempic because it was the first one my doctor suggested and my insurance covered it for my pre-diabetic diagnosis. The dosing schedule started low (0.25mg) and gradually increased every four weeks.

What I Liked: Clear appetite suppression kicked in around week 2. Gradual, steady weight loss without dramatic fluctuations. Side effects were manageable after the first couple weeks.

What I Didn't Like: Weight loss plateaued after about 4 months at around 35 pounds lost. The nausea in weeks 1-3 was rough. Insurance battles because I was using it "off-label" for weight loss.

Results: Lost 37 pounds over 6 months before plateauing.

Switching to Wegovy

When my weight loss stalled on Ozempic, my doctor suggested switching to Wegovy. Since it's the same active ingredient (semaglutide) but approved for weight loss, we could potentially go to a higher dose.

What I Liked: Breaking through the plateau and losing another 15 pounds. Insurance coverage was actually easier because it's approved for weight loss. Familiar side effect profile since it's the same drug.

What I Didn't Like: Supply shortages were a nightmare—I had to switch pharmacies three times. Higher cost than Ozempic. Eventually plateaued again around the 52-pound mark.

Results: Additional 15 pounds lost over 4 months, total 52 pounds from starting weight.

My Current Experience: Mounjaro

When I plateaued on Wegovy, my doctor suggested trying Mounjaro. The dual-action mechanism (it works on both GIP and GLP-1 receptors) theoretically makes it more effective.

What I Like: Broke through my plateau almost immediately. Appetite suppression feels stronger than semaglutide. Energy levels seem better. Currently down another 25 pounds and still losing.

What I Don't Like: More expensive (though currently have a savings card). Slightly worse digestive side effects than semaglutide. Less long-term data since it's newer. Occasional injection site reactions.

Results So Far: 25 pounds lost over 3 months, bringing total weight loss to 77 pounds.

Head-to-Head Comparison

Effectiveness for Weight Loss

In my personal experience: Mounjaro > Wegovy > Ozempic. Clinical trials generally support this ranking, with tirzepatide (Mounjaro) showing superior weight loss outcomes compared to semaglutide medications.

Side Effects

All three caused nausea, especially when starting or increasing doses. Mounjaro gave me more digestive issues (constipation, then diarrhea). Semaglutide medications were more predictable in side effects.

Cost and Insurance

This varies wildly by insurance. Ozempic was cheapest for me because insurance covered it for diabetes prevention. Wegovy was mid-range with insurance. Mounjaro is most expensive but manufacturer savings cards help significantly.

Availability

Wegovy had the worst supply issues during my experience. Ozempic and Mounjaro were generally available, though you might need to call around to different pharmacies.

Which Should You Choose?

Here's the truth: you probably don't get to just "choose" one. Your options depend on:

Insurance coverage: What your plan covers and for which indications.

Medical history: Some conditions make certain medications preferable.

Cost: Out-of-pocket costs can range from under $25 to over $1,000 per month.

Availability: Supply issues can force your hand.

Doctor's recommendation: Based on their experience and your specific situation.

My Honest Recommendation

If I had to start over knowing what I know now, I'd try to get on Mounjaro first. The weight loss has been more dramatic and sustained. However, I probably wouldn't have gotten here without first trying the semaglutide medications—both for insurance reasons and because starting with the "gentler" option helped me adjust to GLP-1s gradually.

That said, Ozempic or Wegovy are excellent medications that work extremely well for many people. Some people tolerate semaglutide better than tirzepatide. And frankly, the best GLP-1 is the one you can afford, access, and actually take consistently.

The Bottom Line

All three medications have been game-changers for my weight loss journey. They all work through similar mechanisms, all require weekly injections, and all have manageable side effects for most people.

The differences are real but not necessarily dramatic. Don't stress too much about choosing the "perfect" one. Start with whatever your doctor recommends and your insurance covers, and be willing to switch if it's not working.

And please, please work with a qualified healthcare provider. These are powerful medications that require medical supervision. This post is my personal experience, not medical advice.

Want to learn more? Check out our detailed reviews of Ozempic, Wegovy, and Mounjaro. (Affiliate links—we earn commission if you purchase.)