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Choose Semaglutide If: Budget is a Primary Concern: Compounded semaglutide starts at $199/month Significantly more affordable than tirzepatide Excellent results at lower cost Can always switch later if desired You Have Cardiovascular Disease: Semaglutide has proven cardiovascular benefits SELECT trial showed 20% reduction in major cardiac events Longer safety track record for heart patients May be preferred by your cardiologist You Want Established Long-Term Data: Been on market since 2017 (Ozempic) and 2021 (Wegovy) More real-world experience and data Longer history of safety monitoring Some people prefer tried-and-tested medications Your Insurance Covers It: If insurance covers Wegovy but not Zepbound Take advantage of coverage when available Brand-name semaglutide with insurance often costs less than compounded tirzepatide Youre Starting GLP-1 Therapy: Good entry point to test GLP-1 tolerance Lower cost if you decide its not for you Can escalate to tirzepatide if you want more weight loss Choose Tirzepatide If: Maximum Weight Loss is Your Goal: Clinical trials show 7.6% more weight loss on average Better chance of reaching 20%+ body weight loss More potent appetite suppression for some people Worth the extra $150/month for enhanced results You Have Significant Weight to Lose: Starting BMI over 35 Need to lose 50+ pounds Previous weight loss attempts unsuccessful Want the most effective medication available Youve Plateaued on Semaglutide: Hit a weight loss plateau Looking for additional results Already tolerate GLP-1 medications well Want to try the stronger option You Experienced GI Side Effects with Semaglutide: Tirzepatide has lower rates of nausea and vomiting Some people tolerate tirzepatide better Worth trying if semaglutide side effects were problematic Cost Isnt Your Primary Concern: Can afford $349/month (compounded) Prioritize effectiveness over cost Want best possible results regardless of price Decision-Making Framework: Step 1: Assess Your Weight Loss Goals How much weight do you need to lose