Twelve GLP-1 products hold current US labels. Four of them are approved for weight management, and their labels print what happened to body weight in the trials that got them approved.
This page ranks those figures. It does not score the products, rate them or pick one, because the evidence does not support that: there is a single head-to-head trial in the entire class, and everything else on this page is a comparison between separate studies that were never designed to be compared.
The one direct comparison
SURMOUNT-5 (NCT05822830) randomised adults with obesity, or overweight with a weight-related comorbidity and without diabetes, to tirzepatide 15 mg or maximum tolerated dose against semaglutide 2.4 mg or maximum tolerated dose, for 72 weeks. Its results are posted on the registry, which is where the figures below were read on 2026-09-20 rather than from any summary of them.
| Posted outcome | Tirzepatide | Semaglutide |
|---|---|---|
| Percent change in body weight, week 72 (LS mean) | −20.2% | −13.7% |
| Patients reaching ≥10% weight reduction | 87.7% | 66.7% |
Two things about it are worth stating plainly. It covers two products out of twelve. And its semaglutide comparator, 2.4 mg, is no longer that molecule's highest labelled dose — WEGOVY's label now provides for 7.2 mg once weekly, which was not in this trial.
An inclusion criterion is also worth recording, because it shapes what the number means: participants had to have "a history of at least 1 unsuccessful dietary effort to lose body weight."
Every labelled figure, side by side
Each row is that product's own label, section 14, read 2026-09-20. The placebo column is the placebo arm of that same trial. The last column subtracts one from the other, which is the only honest way to set trials with different placebo arms next to each other — and it is still a cross-trial comparison.
| Product | Molecule | Dose | Trial, weeks | Treated | Placebo | Difference |
|---|---|---|---|---|---|---|
| ZEPBOUND | tirzepatide | 15 mg weekly | Study 1, 72 w | −20.9% | −3.1% | −17.8 |
| ZEPBOUND | tirzepatide | 10 mg weekly | Study 1, 72 w | −19.5% | −3.1% | −16.4 |
| WEGOVY injection | semaglutide | 7.2 mg weekly | Study 8, 72 w | −18.8% | −3.9% | −14.9 |
| ZEPBOUND | tirzepatide | 5 mg weekly | Study 1, 72 w | −15.0% | −3.1% | −11.9 |
| WEGOVY injection | semaglutide | 2.4 mg weekly | Study 8, 72 w | −15.5% | −3.9% | −11.6 |
| WEGOVY injection | semaglutide | 2.4 mg weekly | Study 2, 68 w | −14.9% | −2.4% | −12.4 |
| WEGOVY tablets | semaglutide | 25 mg daily | Study 7, 64 w | −13.6% | −2.4% | −11.2 |
| FOUNDAYO | orforglipron | 17.2 mg daily | Trial 1, 72 w | −11.1% | −2.1% | −9.0 |
| FOUNDAYO | orforglipron | 9 mg daily | Trial 1, 72 w | −8.3% | −2.1% | −6.2 |
| FOUNDAYO | orforglipron | 5.5 mg daily | Trial 1, 72 w | −7.4% | −2.1% | −5.3 |
| SAXENDA | liraglutide | 3 mg daily | Study 1, 56 w | −7.4% | −3.0% | −4.5 |
The bolded rows are each product's highest labelled weight-management dose.
What the placebo column does to the ranking
The placebo arms are not identical and they are not small. They run from −2.1% to −3.9%, a spread of 1.8 points — comparable to the entire placebo-adjusted effect of SAXENDA divided in half.
That matters for one pair in particular. WEGOVY 7.2 mg and ZEPBOUND 10 mg sit within 0.7 points of each other on the raw figure (−18.8% against −19.5%), and 1.5 points apart once each is set against its own control (−14.9 against −16.4), because WEGOVY's Study 8 placebo arm lost more weight than ZEPBOUND's Study 1 placebo arm did. Neither adjustment makes this a fair test. It makes it a less unfair one.
The same drug, two numbers
WEGOVY 2.4 mg injection appears twice in the table because its label reports it twice, in two trials: −14.9% at week 68 and −15.5% at week 72. The same molecule, the same dose, the same manufacturer, a 0.6-point spread.
That figure is the useful one to hold on to. It is the class's own estimate of how much a result can move for reasons that have nothing to do with the drug — trial to trial, cohort to cohort, week 68 to week 72. Any cross-trial ranking that separates two products by less than about a point is separating them by noise.
Diabetes lowers every figure
Every product studied in both populations reports a smaller reduction in the trial that enrolled patients with type 2 diabetes.
| Product and dose | Without diabetes | With type 2 diabetes |
|---|---|---|
| WEGOVY injection 2.4 mg | −14.9% | −9.6% |
| WEGOVY injection 7.2 mg | −18.8% | −13.2% |
| ZEPBOUND 15 mg | −20.9% | −14.7% |
| ZEPBOUND 10 mg | −19.5% | −12.8% |
The pattern is consistent across two sponsors and four products, and it is large: roughly a third of the reduction. A figure quoted without the population it came from is a figure that can be wrong by five points.
What the averages hide
The labels also report how many patients crossed each threshold, and those columns say more about the range of outcomes than the mean does.
| Product and dose | ≥5% lost | ≥10% lost |
|---|---|---|
| ZEPBOUND 15 mg (Study 1) | 90.9% | 83.5% |
| ZEPBOUND 5 mg (Study 1) | 85.1% | 68.5% |
| WEGOVY 2.4 mg (Study 2) | 83.5% | 66.1% |
| WEGOVY 25 mg tablets (Study 7) | 76.3% | 59.8% |
| FOUNDAYO 17.2 mg (Trial 1) | 71.5% | 54.5% |
| SAXENDA 3 mg (Study 1) | 62.3% | 33.9% |
| Placebo, ZEPBOUND Study 1 | 34.5% | 18.8% |
| Placebo, WEGOVY Study 4 (intensive lifestyle) | 47.8% | 27.1% |
Two readings follow. On the strongest product at its highest dose, about one patient in six did not reach 10%. And the placebo groups are a long way from nothing — between roughly a quarter and a half of them lost at least 5%, because every placebo patient in these trials was also given a prescribed diet and an activity programme. That is covered separately in what the GLP-1 trials actually prescribed alongside the drug.
What this page is not
It is not a ranking of products by anything except the weight change their own labels report. It does not weigh side effects, cost, availability, the schedule a person has to keep, or whether a given product is appropriate for a given person — a question for a clinician and not for a table.
It also does not average the trials together. Pooling figures from studies with different durations, populations, comparators and imputation rules would produce a tidier list and a less honest one.
Cost is on the dated price page, coverage on why the indication decides, the counted adverse reactions on the side-effects page, and the escalation each label requires before any of these doses is reached on the titration schedules.
Sources
- SURMOUNT-5, NCT05822830, posted results, ClinicalTrials.gov, read 2026-09-20.
- ZEPBOUND label (tirzepatide), DailyMed SPL, version dated 2026-09-02, read 2026-09-20.
- WEGOVY label (semaglutide injection and tablets), DailyMed SPL, version dated 2026-06-30, read 2026-09-20.
- FOUNDAYO label (orforglipron), DailyMed SPL, version dated 2026-08-13, read 2026-09-20.
- SAXENDA label (liraglutide), DailyMed SPL, version dated 2026-06-15, read 2026-09-20.