Ranking the Weight Loss Drugs: Tirzepatide, Injected Semaglutide, Oral Wegovy
At MD Total Wellness in Orange County, we help patients achieve lasting weight loss through our medically supervised program using GLP-1 medications like injectable semaglutide and tirzepatide. If you’re searching for “tirzepatide vs semaglutide weight loss” or “oral Wegovy vs injectable Wegovy,” you’ve come to the right place.
Our board-certified providers, with over 20 years in weight loss, focus on personalized dosing and guidance for safe, healthy results. In this post, we’ll break down the options based on real studies, keeping it simple and straightforward.
Note: Oral Wegovy was just FDA-approved in December 2025, and with its big Super Bowl ad buzz featuring celebrities like Kenan Thompson, DJ Khaled, and Danielle Brooks, interest is skyrocketing — but we’ll explain why it might not be the top choice for everyone.
What Are These Weight Loss Medications?
These drugs mimic gut hormones to help you feel full longer, eat less, and lose weight. Injectable Wegovy (semaglutide) is a once-weekly shot that’s been around longest. Oral Wegovy is the new daily pill version of the same drug, approved recently for weight management. Injectable Zepbound (tirzepatide) works similarly but targets two hormones, potentially giving it an edge.
All need a doctor’s supervision, plus diet and exercise, for best results. At our clinic, we customize plans to fit your life.
Weight Loss Results: Tirzepatide Wins
Studies show all three help with weight loss, but the amounts differ.
- Oral Wegovy (semaglutide):
In a major trial, people lost about 15% of their body weight on average over 68 weeks – that’s more than a year of daily pills. Solid, but it takes time and consistency.
- Injectable Wegovy (semaglutide):
Similar results – around 15% average weight loss over the same long period. The weekly shot, and fewer side effects as you’ll see below, makes it easier for many to stick with.
- Injectable Zepbound (tirzepatide):
This one stands out with better average weight loss results (21% average weight loss), and with a significant fraction of people losing over 25% of their weight. Head-to-head trials confirm Tirzepatide is better than Semaglutide for weight loss.
In our experience at MD Total Wellness, tirzepatide users generally report better control over hunger and cravings, with less need to keep increasing the dose, and with fewer side effects -matching what studies show.
Side Effects: Tirzepatide Wins, Oral Loses
All can cause GI side effects like nausea, vomiting, diarrhea, or constipation, but they usually get better over time. Here’s the breakdown:
· Oral Wegovy: Side effects hit 3-4 times more often than with the shot, mainly because you need much higher doses (up to 50mg daily vs. 2.4mg weekly) to get through your gut. Absorption varies day-to-day, which can spike symptoms and lead more people to quit.
· Injectable Wegovy: More steady delivery straight into your system means fewer ups and downs, so side effects are often milder and easier to handle.
· Tirzepatide: Side effects are similar or better than with injectable semaglutide – mostly mild gut issues that fade over time. In our practice, patients report fewer side effects with tirzepatide despite the greater weight loss.
We always personalize dosage to avoid side effects and optimize hunger and cravings control.
Our Ranking: Based on the Evidence
From the studies, tirzepatide tops the list for most weight loss and good tolerability. Injectable semaglutide comes next – reliable results with fewer side effects than the pill. Oral Wegovy is third: convenient but with more risks from variable dosing and higher side effects. Your best pick depends on your health, preferences, and goals – talk to a doctor.
Who Can Benefit?
These meds are for adults with obesity (BMI 30+) or overweight (BMI 27+) or weight maintenance after weight loss when diet and exercise aren’t enough. At MD Total Wellness, our supervised program focuses on behavior change for ongoing weight maintenance without medication, or with ongoing medication if necessary. These medications are highly effective tools to make behavior change (e.g. cutting out processed carbs and sugar) much easier.
Why Choose MD Total Wellness?
We offer injectable semaglutide and tirzepatide in our program, with same-day medication available. Our board-certified team provides in-person care, monitoring, customized dosing, and personalized guidance for sustainable success – all at great prices, no insurance needed. Serving Brea, Yorba Linda, Anaheim Hills, and Fullerton.
Ready to take the next step? Schedule a free consult – call 714-671-2005 or send us an online contact form – to get started on your weight loss journey today!
Frequently Asked Questions
What is the difference between oral Wegovy and injectable Wegovy?
Oral Wegovy is a daily pill (semaglutide tablets), while injectable Wegovy is a weekly shot. The injectable version offers more consistent absorption and typically fewer gastrointestinal side effects due to lower dosing requirements and bypassing the gut. Oral versions require higher daily doses (e.g., up to 25 mg) to achieve similar effects, which can lead to more variable results and increased nausea or other GI issues.
How much weight can you lose on oral Wegovy?
In clinical trials like OASIS 4, oral semaglutide (Wegovy pill) led to an average weight loss of about 13.6–16.6% over 64 weeks (depending on adherence), with many achieving 15%+ when staying on treatment. This is solid but generally less than the 19–22%+ seen with tirzepatide injections or slightly less consistent than injectable semaglutide.
Is tirzepatide better than semaglutide for weight loss?
Yes — head-to-head studies (including SURMOUNT and recent 2025 comparisons) show tirzepatide (Zepbound) delivers greater average weight loss (around 20–21%) compared to semaglutide (around 14–15%), with more patients reaching 20%+ reductions. Tirzepatide's dual hormone action (GLP-1 + GIP) gives it an edge in appetite control and metabolic benefits.
Does oral Wegovy have more side effects than the injection?
Generally yes. Oral forms often cause more frequent or intense GI side effects (nausea, vomiting, diarrhea) because of higher doses needed for gut absorption and day-to-day variability. Injectable versions provide steadier delivery, leading to milder, more predictable side effects that improve with slow titration.
Which weight loss drug is best for me — tirzepatide, injectable semaglutide, or oral Wegovy?
It depends on your goals, tolerance for side effects, preference for pill vs. shot, and medical history. Tirzepatide often ranks highest for maximum weight loss and tolerability in studies. Injectable semaglutide is reliable with fewer GI issues than the pill. Oral Wegovy offers convenience but may not match the others in efficacy or side effect profile. A personalized consult helps determine the best fit.
Are these medications safe long-term?
Under medical supervision with proper monitoring, yes — they have strong safety profiles from large trials. Common side effects are mostly GI and improve over time. We focus on slow dosing, nutrition support, and regular check-ins to ensure safe, sustainable use.
References
- Knop FK, et al. Oral semaglutide 50 mg taken once per day in adults with overweight or obesity (OASIS 1): a randomised, double-blind, placebo-controlled, phase 3 trial. The Lancet. 2023;402(10403):705-719. https://doi.org/10.1016/S0140-6736(23)01185-6
- Wilding JPH, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine. 2021;384(11):989-1002. https://doi.org/10.1056/NEJMoa2032183
- Jastreboff AM, et al. Tirzepatide Once Weekly for the Treatment of Obesity. New England Journal of Medicine. 2022;387(3):205-216. https://doi.org/10.1056/NEJMoa2206038
- Frías JP, et al. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. New England Journal of Medicine. 2021;385(6):503-515. https://doi.org/10.1056/NEJMoa2107519
- Karagiannis T, et al. Efficacy and safety of once-weekly semaglutide versus daily oral semaglutide for weight loss in overweight or obese adults: a systematic review and meta-analysis. Diabetes, Obesity and Metabolism. 2023;25(5):1263-1274. https://doi.org/10.1111/dom.14974
