Zepbound (tirzepatide) is a weekly injectable medication that is approved to treat obesity in adults. Read on to learn how Zepbound works, what to consider before taking it, and who it may be right for.
What is Zepbound?
Zepbound is a prescription weight loss medication made by Eli Lilly. It contains the active ingredient tirzepatide, which is also found in Mounjaro (a type 2 diabetes drug). It comes in the form of a prefilled pen with a thin needle on the end and is injected just under the skin once a week.
Zepbound was officially approved by the U.S. Food and Drug Administration (FDA) in November 2023 for chronic weight management. In December 2024, it was also approved to treat obstructive sleep apnea (OSA) in adults with obesity. It is one of the few drugs on the market officially designated for weight management, and the only medication that is approved for certain patients with OSA.
It belongs to a novel class of drugs called dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonists.
How does Zepbound cause weight loss?
Zepbound helps you lose weight by mimicking two naturally occurring hormones: GLP-1 and GIP. These hormones help control your appetite, blood sugar, and how your body uses food for energy. Here's how:
GLP-1:
- Makes you feel full: It sends signals to your brain that you’ve eaten enough, so you stop eating sooner.
- Slows down digestion: It keeps food in your stomach longer. That means you stay full for hours, and you’re less likely to snack or overeat.
- Controls blood sugar: It helps your pancreas release insulin (the hormone that lowers blood sugar) when you eat. It also reduces glucagon (a hormone that raises blood sugar). This balance keeps your energy steady and helps your body avoid storing extra fat.
GIP:
- Stimulates insulin production: Like GLP-1, GIP helps your body release insulin to manage blood sugar.
- Improves how your body uses insulin: This means your body doesn’t need to make as much insulin to get the job done. That can help prevent storing extra fat, especially around the belly.
- Works with GLP-1 to reduce hunger: GIP may help your brain respond better to GLP-1, making you feel even less hungry.
As a result of both of these actions, you eat less, feel satisfied, and your body is able to process sugar from food more easily.
How much weight can you lose with Zepbound?
In clinical trials, adults with obesity saw significant weight loss when taking tirzepatide in combination with diet and exercise.
The highest dose of Zepbound resulted in an average weight loss of 48 pounds, and 1 in 3 patients lost over 58 pounds. The lowest dose led to an average loss of 34 pounds. The placebo group, who did not take tirzepatide, lost an average of 7 pounds.
Are there other benefits to taking Zepbound?
Zepbound is currently only approved to treat obesity and obstructive sleep apnea in adults with .
However, research suggests that it may help lower the risk of serious heart problems like heart attacks, strokes, and heart-related hospital stays (especially in people with type 2 diabetes or obesity).
Many people taking Zepbound see improvements in their blood pressure and cholesterol levels. These effects likely come from weight loss and better metabolic control.
Does Zepbound cause side effects?
While Zepbound is safe and effective for most adults, it has been shown to cause side effects in some patients.
The most common side effects of Zepbound include:
- Upset stomach
- Gas
- Constipation
- Diarrhea
- Loss of appetite
- Injection site reactions
- Fatigue
More severe side effects include:
- Severe stomach pain
- Allergic reactions such as hives, skin rash, swelling, or difficulty breathing
- Vomiting
- Changes in heartbeat
- Fever
- Heartburn
If you experience any side effects while taking Zepbound, you should seek medical guidance from a licensed healthcare provider right away.
What should I tell my doctor before I take Zepbound?
Before starting treatment with any prescription medication, you should tell your doctor about your health history to avoid interactions or adverse reactions. This includes any medical conditions you may have or any medications or supplements you are taking.
Your healthcare provider may avoid prescribing Zepbound if you have the following:
- Pancreatitis or gallbladder disease
- Thyroid problems
- Thyroid tumors
- Multiple endocrine neoplasia syndrome type 2 (MEN2)
- Kidney problems
- Stomach or intestinal problems (such as gastroparesis)
- Allergies to tirzepatide
- Diabetic retinopathy
Zepbound has not been proven safe for use in pregnant women, women who are trying to conceive, or women who are breastfeeding.
Who is eligible for a Zepbound prescription?
To be prescribed Zepbound for weight loss, a person must have a body mass index (BMI) of 30 or higher OR a BMI of 27 or higher AND at least one weight-related health condition, such as:
- Type 2 diabetes
- High blood pressure (hypertension)
- High cholesterol (dyslipidemia)
- Obstructive sleep apnea
- Heart disease
- Insulin resistance or prediabetes
While some healthcare providers may prescribe Zepbound off-label for other conditions, insurance companies are unlikely to cover the cost of Zepbound for anything other its FDA-approved use.
How much does Zepbound cost?
Without insurance, a monthly supply of 4 single-dose Zepbound pens usually costs around $1,050.
However, Zepbound is also available as a single-dose vial, which is more affordable: the cash price for a month’s supply of 2.5 mg/0.5mL Zepbound vials is $349, while a month’s supply of 5.0mg/0.5mL Zepbound vials is $499.
What is the storage and dosage information for Zepbound?
Zepbound single-dose injection pens are pre-filled and are injected directly under the patient’s skin. Zepbound single-dose vials, which are pre-measured, require the user to draw the medication out of a vial with a syringe before injecting the medication under the skin. The typical starting dose is 2.5 mg.
Patients will take this preliminary dosage for 4 weeks before increasing it to 5 mg. If needed, your provider will increase the dose in 2.5 mg increments until the maintenance dose is reached. Maintenance doses of Zepbound are 5 mg, 10 mg, or 15 mg, depending on the medication’s efficacy and your tolerance to it.
Zepbound should be stored as directed by your healthcare provider or according to the medication's packaging instructions. Follow the recommended storage conditions, keeping the medication in the refrigerator between 36-46℉.
Do not freeze Zepbound or use Zepbound if the medication is frozen.
What’s the difference between Zepbound and Wegovy?
Zepbound and Wegovy are both FDA-approved for the treatment of obesity. But while both of these medications can help you lose weight, there are key differences in how they work, their weight loss results, and pricing.
How they work: Wegovy (made by Novo Nordisk) contains the active ingredient semaglutide, a GLP-1 receptor agonist that mimics the hormone GLP-1. Zepbound (made by Eli Lilly) contains the active ingredient tirzepatide, a dual GLP-1/GIP medication that mimics two hormones (GLP-1 and GIP).
Weight loss results: As of now, there are no peer-reviewed studies directly comparing Wegovy and Zepbound. However, in specific clinical trials, tirzepatide affected more significant weight loss than semaglutide. Patients who took semaglutide for weight loss lost about 15% of their body weight, while those taking Zepbound lost about 26.7%.
Pricing: Zepbound is less expensive than Wegovy overall. The monthly list price for Zepbound pens is $1,060, while Wegovy pens cost $1,349. For single-dose vials (for cash-pay patients only), Zepbound costs $349 for a 2.5 mg dose and $499 for a 5 mg dose. Wegovy is $499 per vial, regardless of the dose. In other words, Zepbound not only has a lower monthly cost for pens but also offers cheaper options for lower doses in vial form.
How do I get a prescription for Zepbound?
Zepbound is a prescription drug, meaning that you must have a written order from a licensed healthcare provider to get it. It cannot be purchased over the counter, and there are no generic versions available.
Weight loss drugs are prescribed to individuals with obesity or individuals who are overweight and managing a weight-related health condition. If you are curious about Zepbound or any other weight loss drug, talk to your healthcare provider about your treatment options.
Can I get a prescription for Zepbound on Sesame?
Yes! If appropriate, providers on Sesame can prescribe Zepbound through Success by Sesame. Success by Sesame is a month-to-month online weight loss program that includes video visits with a weight loss doctor or specialist of your choice, a prescription for weight loss medication like Zepbound (if appropriate), unlimited messaging with your provider, ongoing support, and more.
Note that all prescriptions are at the discretion of your healthcare provider.
