Zepbound, a brand name for tirzepatide, is a once-weekly injection approved by the FDA for chronic weight management. This weight-loss drug imitates the actions of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), two naturally occurring gut hormones. Zepbound has shown significant effectiveness in helping many people lose weight.
However, despite its promising results, Zepbound isn’t always the best option for everyone. Some people face high costs, insurance limitations, or even medication shortages that make access difficult. Others may experience side effects such as nausea, vomiting, diarrhea, and constipation or have health conditions that require alternative treatments. These have led many people to explore other options.
This guide will review the top Zepbound alternatives and other natural strategies to consider.
Is There a Zepbound Shortage?
Currently, Zepbound is not in shortage. According to the latest FDA update, all doses of Eli Lilly’s weight loss and diabetes medications, Zepbound and Mounjaro, are now fully available.
Zepbound was previously declared in limited supply in April 2024 due to the overwhelming demand for GLP-1 receptor agonists, but Eli Lilly has since ramped up production to meet the growing needs of patients. Similarly, Mounjaro, which was first added to the FDA’s drug shortage list in 2022, has also returned to full availability.
To address these concerns, Eli Lilly announced plans to expand production. Their new Concord, North Carolina facility is expected to manufacture Zepbound and Mounjaro by the end of 2024, with products ready to ship in 2025. Additionally, the company projects producing one and a half times as many sellable doses this year compared to the same period last year.
Despite these efforts, the company still predicts that demand for Zepbound may exceed supply for the rest of the year. In light of this, it’s wise to find alternatives in case of a Zepbound shortage so that your specific dosage is ready if it is ever impacted.
Top 8 Zepbound Alternatives
If you’re looking for Zepbound alternatives, there are other weight loss injections and pills to consider. Some are FDA-approved for weight loss, and others may be prescribed off-label. Here are 8 options available:
1. Mounjaro (tirzepatide)
One close alternative for Zepbound, is Mounjaro (tirzepatide). As mentioned above, Mounjaro contains the same active ingredient, tirzepatide, and is administered once a week as Zepbound. They also have similar side effects and doses.
The major difference between these drugs is that Zepbound is FDA-approved for managing chronic weight, while Mounjaro is FDA-approved for treating type 2 diabetes. However, because the active ingredient in both medications is the same, doctors may give Mounjaro off-label to help patients manage their weight. But if you have type 2 diabetes, your insurance plan is more likely to cover Mounjaro.
Mounjaro was found to produce an average weight loss of up to 13.9% over 104 weeks in people with type 2 diabetes.
Mounjaro is a dual GIP/GLP-1 receptor agonist, just like Zepbound. This describes the two gut hormones that the medication imitates: glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP). Since Zepbound and Mounjaro have the same active component, you should expect to lose weight similarly, regardless of your brand.
2. Wegovy (semaglutide)
Wegovy (semaglutide) is another FDA-approved weight loss medication, but it only mimics GLP-1 and is known as a GLP-1 receptor agonist, whereas Zepbound is a dual receptor agonist of GIP and GLP-1. While head-to-head studies are ongoing to confirm the differences between these two medications, indirect comparisons show that Zepbound may help people lose more weight than Wegovy. This may be due to the differences in their mechanisms of action.
Zepbound and Wegovy are currently more effective than any other medical weight-loss medication. In a clinical trial comparing Wegovy and Saxenda, Wegovy produced more weight loss than Saxenda. Over 68 weeks, people receiving Wegovy achieved an average weight loss of 15.8 kg, compared to 6.4 kg for those in the Saxenda group.
Like Zepound, Wegovy is administered subcutaneously once weekly. Its active ingredient is semaglutide. It’s also sold under the Ozempic brand, which is approved for type 2 diabetes.
In addition to helping people lose weight, Wegovy has been approved to reduce the risk of major cardiovascular issues in people who are overweight or obese and have heart disease. Another benefit is that Wegovy is authorized for use in adults and adolescents 12 years and older.
3. Ozempic (semaglutide)
Ozempic has the same active ingredient, semaglutide, as Wegovy and is administered weekly. Unlike Zepbound, Ozempic has FDA approval to regulate blood sugar levels in people with type 2 diabetes and to reduce cardiovascular risk in those with heart disease.
Like Mounjaro and Zepbound, Ozempic and Wegovy’s active ingredient was initially created to treat type 2 diabetes. The manufacturers then applied for FDA approval for weight management and marketed a different brand-name version of the medication when researchers found that it may also cause weight loss. While Mounjaro and Zepbound have the same doses, Ozempic has lower dosage strengths of semaglutide than Wegovy.
In a 40-week clinical trial, people with type 2 diabetes who took 2 mg of Ozempic once a week lost at least 5% of their body weight, with some participants losing almost 10%.
Ozempic has a shorter list of adverse effects than Wegovy, although gastrointestinal side effects are still common. Your insurance will probably cover Ozempic if you have type 2 diabetes.
4. Saxenda (liraglutide)
Saxenda was the first GLP-1 agonist drug approved for weight loss in the United States. It is in the same class as Wegovy and works in the body similarly to the gut hormone GLP-1. Unlike Zepbound, Saxenda is injected once daily.
Saxenda, like Zepbound, has no demonstrated cardiovascular benefits. However, it’s approved for adolescents 12 years of age and older. Individual clinical studies, however, suggest that Zepbound might result in greater weight loss than Saxenda.
In clinical trials, Saxenda users dropped 5–10% of their body weight over 56 weeks. Many of the side effects of Saxenda are comparable to those of Zepbound.
5. Phentermine (adipex, lomaira)
Phentermine and Zepbound belong to different classes of medications. Phentermine is a generic drug that was approved in 1959. It works as an anorectic or appetite suppressant. It’s also a stimulant that helps you feel less hungry and eat less. The result is weight loss.
Phentermine can be a great alternative if you’re looking for a weight loss pill. It’s available as a tablet, capsule, extended-release, or disintegrating tablet. Your doctor will determine the exact dosage and schedule, but you will usually take it once daily, before or after breakfast.
The main difference between Zepbound and phentermine is that Zepbound may be prescribed for long-term weight management, while phentermine is only approved for short-term use because of the possibility of dependence and other negative effects.
Phentermine is usually prescribed with a reduced-calorie diet and exercise regimen to enhance weight loss efforts. Its common side effects include insomnia, dry mouth, and nervousness.
6. Contrave (naltrexone-bupropion)
Contrave is a prescription medication that combines two active ingredients, naltrexone and bupropion, to help people lose weight. It works by targeting the brain’s reward and hunger systems, reducing food cravings, and controlling appetite.
Unlike Zepbound, a weekly injection, Contrave is taken as two tablets in the morning and two in the evening.
Studies show that Contrave can lead to significant weight loss when combined with a reduced-calorie diet and increased physical activity. On average, patients using Contrave lose about 5% to 10% of their body weight over 56 weeks.
Contrave may have similar side effects to Zepbound, such as nausea, but it may cause different side effects like increased blood pressure and insomnia.
7. Qsymia (phentermine/topiramate ER)
Qsymia is another oral Zepbound alternative that combines two medications: phentermine, an appetite suppressant, and topiramate, a drug initially used to treat seizures and migraines. These two medications combine to help people lose weight by decreasing appetite, which may help you to eat less. Topiramate may also promote feelings of fullness.
Unlike Contrave, Qsymia is taken orally once daily with a healthy diet and regular exercise routine.
Separate studies suggest that Zepbound causes greater weight loss than Qsymia. In a 56-week study, people using Qsymia lost 5–10% of their starting body weight.
Additionally, there are differences in risks and side effects of Zepbound and Qsymia. Because Qsymia contains phentermine, which can increase heart rate, it may not be a good choice for those with specific medical conditions.
You should avoid Qsymia during pregnancy because it can harm the developing baby. Topiramate, one of the drugs used to treat Qsymia, has been shown to raise the risk of cleft lip in the first trimester.
Also, if you consider this medication, discuss with your doctor about suitable birth control methods since it causes more spotting with certain birth control medications.
8. Xenical (orlistat)
Xenical is another oral Zepbound alternative containing the active ingredient, orlistat. It’s also known by its over-the-counter version, Alli.
Unlike the other Zepbound alternatives in this list, Xenical functions differently to promote weight loss. It prevents fat from being absorbed by your body from the food you consume. However, you must take Xenical three times a day within 1 hour after a meal with fat.
Xenical is likely to cause less weight loss than Zepbound. Clinical research showed that consuming Xenical caused participants to lose an average of 8.5% of their initial body weight.
One significant drawback of Xenical’s action is that it may cause unpleasant side effects like oily stools, fecal leaks, and frequent, urgent bowel movements.
Natural Zepbound Alternatives
It is important to note that all weight loss medications are prescribed with a balanced diet and increased exercise.
Optimizing metabolic health with a nutrient-rich and calorie-controlled diet not only helps maintain a healthy weight and control blood sugar levels; it also promotes adequate nutrition, enhances gastrointestinal and cardiovascular health, lowers inflammation, and promotes general well-being.
Eat lean proteins like fish, lean meat, and beans; incorporate fruits and vegetables; healthy fats; whole grains; and low-fat dairy alternatives.
General recommendations for exercise include 150–300 minutes per week of moderate-intensity aerobic activity (such as jogging, swimming, or brisk walking) mixed with 75–150 minutes of more intense exercise. Frequent exercise has been shown to support blood pressure and weight control, enhance insulin sensitivity, support metabolic health, and improve lipid profiles, including triglyceride management and HDL levels.
While natural supplements can be used as Zepbound alternatives, it is important to discuss them with a healthcare provider before starting them. Your provider will recommend reputable supplement brands and monitor their effects and safety.
How to switch from Zepbound to Another Weight Loss Medication
Talk to your doctor if you were prescribed Zepbound and would like to switch to another alternative. If they think it’s a good option, they’ll give you the right dose to start you on to ensure an easy transition.
Switching weight loss medications can be effective if Zepbound isn’t meeting your weight loss needs. With the right guidance and a personalized approach, transitioning can lead to better outcomes and a more comfortable experience.
FAQs About Zepbound and Its Alternatives
Can you combine Zepbound with other weight-loss medications?
Combining Zepbound with other weight-loss medications is not recommended unless prescribed by a healthcare provider. Always consult your healthcare provider before considering combination treatments. They can assess your medical history, goals, and potential risks to determine the safest and most effective weight loss plan for your needs.
Are natural methods effective compared to prescription drugs?
Natural methods, such as healthy eating, regular exercise, and stress management, are effective for gradual and sustainable weight loss. However, they may take longer to show results compared to prescription drugs like Zepbound. While medications often provide faster results, natural methods improve overall health and help maintain weight loss long-term. Combining both approaches under medical guidance can be the most effective strategy.
What medications can I use for weight loss if I’m pregnant?
Weight loss during pregnancy is not recommended as it can cause potential risks to the developing baby. You should, therefore, not take any weight-loss medication during pregnancy.
Choose the Best Option for Your Weight Loss Journey
While Zepbound is an effective medication for obesity or overweight, it’s not the only option available. There are other medications approved for the same purpose. If you want to switch because of Zepbound side effects, shortage, or your insurance no longer covers it, or you feel another medication might be a better option, consult your healthcare provider. They will discuss the benefits and side effects of the different options and help you make an informed decision.
At NP2GO, we help people achieve their ideal body sizes with healthy weight loss options. With licensed healthcare providers, we can help you determine what Zepbound alternative is right for you. Let us help you achieve your weight loss goals in a way that works best for you. Book an appointment with us today for personalized weight loss support.