The new Wegovy oral formulation at 25-50mg daily produces 13-14% weight loss, putting it within striking distance of injectable tirzepatide at lower doses
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Common Side Effects (Both Medications): Gastrointestinal Side Effects (Most Common): These typically occur when starting treatment or increasing doses, and often improve over time: Nausea: Most frequent side effect for both medications Semaglutide: 44% of participants in clinical trials Tirzepatide: 30-37% depending on dose Usually mild to moderate Most common in weeks 1-8, improves with continued use Diarrhea: Semaglutide: 30% of participants Tirzepatide: 19-23% depending on dose Often resolves within a few weeks Staying hydrated helps manage symptoms Constipation: Semaglutide: 24% of participants Tirzepatide: 10-17% depending on dose Can alternate with diarrhea Fiber and hydration help Vomiting: Semaglutide: 24% of participants Tirzepatide: 9-17% depending on dose More common at higher doses May require dose reduction Abdominal Pain: Semaglutide: 20% of participants Tirzepatide: 8-11% depending on dose Usually mild, related to slower stomach emptying Other Common Side Effects: Appetite Changes: Decreased appetite (desired effect) Food aversions or taste changes Reduced interest in previously enjoyed foods Early satiety (feeling full quickly) Fatigue: Semaglutide: 11% of participants Tirzepatide: Similar rates Often related to reduced calorie intake May improve as body adjusts Injection Site Reactions: Mild redness, swelling, or itching at injection site Usually resolves within a few days Rotating injection sites helps minimize Headache: Occurs in 10-14% of participants with both medications Usually mild and temporary Often related to dehydration Side Effect Comparison: Why Tirzepatide May Have Fewer GI Side Effects: Despite being more potent, tirzepatide appears to cause slightly less nausea and GI distress

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95% CI, 0.83 to 0.99) [78]
Osman AA, Arslan E, Bartels M, Michikawa C, Lindemann A, Tomczak K, et al