The GLP-1 showdown: comparing the three most important incretin-based weight loss compounds by mechanism, efficacy, safety, and availability.
| Brand Names | Ozempic / Wegovy / Rybelsus | Mounjaro / Zepbound | LY3437943 (no brand yet) |
| Developer | Novo Nordisk | Eli Lilly | Eli Lilly |
| Receptor Targets | GLP-1 only | GIP + GLP-1 (dual) | GIP + GLP-1 + Glucagon (triple) |
| Mechanism Type | Single agonist | Dual agonist | Triple agonist |
| Max Clinical Dose | 2.4mg weekly (Wegovy) | 15mg weekly (Zepbound) | 12mg weekly (Phase 2) |
| Mean Weight Loss | ~14.9% (STEP 1, 68 wk) | ~22.5% (SURMOUNT-1, 72 wk) | ~24.2% (Phase 2, 48 wk) |
| Key Trial | STEP program | SURMOUNT program | Phase 2 (NEJM 2023) |
| FDA Status | Approved (T2DM + Obesity) | Approved (T2DM + Obesity) | Investigational (Phase 3) |
| Half-Life | ~7 days | ~5 days | ~6 days |
| Dosing | Once weekly SC injection | Once weekly SC injection | Once weekly SC injection |
| GI Side Effects | Nausea 44%, diarrhea 30% | Nausea 31%, diarrhea 23% | Nausea 16-45% (dose-dep) |
| Oral Option | Yes (Rybelsus) | No | No |
| CV Outcomes Data | Yes (SELECT trial: 20% MACE reduction) | Pending (SURPASS-CVOT) | No |
| Unique Advantage | Most clinical data; oral option; CV outcomes proven | Highest approved weight loss; dual mechanism | Highest total weight loss; liver fat clearance |
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