GLP-1 Medications Available Now

Receptors: GLP-1GIPglucagonamylin −GIP = antagonistStage: filled = reached, dark = currentBeyond weight loss: ✓ benefit ~ early signal ⚠ harm · untested
semaglutide Ozempic (injectable, T2D), Wegovy (injectable, obesity), Wegovy pill (oral semaglutide, obesity), Rybelsus (oral, T2D)15% weight loss
Stage✓ Approved
TargetsGLP-1 receptor agonist
Maker
Routeinjection (weekly); oral daily (Rybelsus for T2D, Wegovy pill for obesity)
Indicationsapproved for type 2 diabetes, obesity, cardiovascular risk reduction; investigating MASH, oral obesity dose
Efficacy~15% mean weight loss (STEP 1, Wegovy 2.4 mg); 20% lower MACE in SELECT source
  • Wegovy (injectable, obesity, 2.4 mg): ~15% mean weight loss (STEP 1)
  • Wegovy pill (oral, obesity, 25 mg): 16.6% adherent / 13.6% overall (OASIS 4)
  • Ozempic (injectable, T2D): diabetes dose, meaningfully less weight loss than Wegovy
  • Rybelsus (oral, T2D, up to 14 mg): diabetes dose, ~3-4% (not a weight-loss dose)
Beyond weight loss
  • ✓ Cardiovascular: 20% lower MACE (CV death/MI/stroke) (SELECT, NEJM 2023 · source)
  • ✓ Knee osteoarthritis: WOMAC pain −59% vs −39%; benefit exceeded what weight loss alone predicts (STEP-9, NEJM 2024)
  • ~ Alcohol use disorder: Reduced craving + heavy drinking at low dose (JAMA Psychiatry 2025 (Phase 2, n=48) · source)
  • ⚠ Bone: Hip BMD −2.6% / spine −2.1% over 52 wks; lean-mass loss (RCT in high-fracture-risk adults)
Access & priceSelf-pay: NovoCare self-pay program · Widely covered for T2D; obesity coverage varies · compare price (GoodRx)
Key trials
  • SELECT (Ph 3, CV outcomes (obesity, no diabetes)) — 20% reduction in CV death / MI / stroke across 17,600+ patients. source
Papers
On DSD
My takeThe OG that really kicked of the revolution. Not the most effective anymore, but most widely studied. Begining to come of patent in some countries.
tirzepatide Mounjaro (T2D), Zepbound (obesity, OSA)21% weight loss
Stage✓ Approved
TargetsGIPGLP-1 dual agonist
Maker
Routeinjection (weekly)
Indicationsapproved for type 2 diabetes, obesity, obstructive sleep apnea; investigating dose maintenance (SURMOUNT-MAINTAIN)
Efficacy~21% mean weight loss (SURMOUNT-1, 15 mg) source
Beyond weight loss
  • ✓ Sleep apnea: Up to 51.5% met OSA disease-resolution criteria — FDA-approved for OSA (SURMOUNT-OSA, NEJM 2024 · source)
  • ✓ Diabetes (A1c): Stronger glycemic control than semaglutide head-to-head (SURPASS-2)
  • ⚠ Bone: ~25% of weight lost is lean mass; retrospective signal of higher fracture risk vs other GLP-1s (RCT + retrospective cohort)
Access & priceSelf-pay: LillyDirect self-pay vials · Covered for T2D; obesity/OSA coverage varies · compare price (GoodRx)
Key trials
  • SURMOUNT-OSA (Ph 3, obstructive sleep apnea) — Up to 51.5% of participants met criteria for OSA disease resolution. source
Papers
On DSD
My takeThe current king of appetite suppression. I have been on this since November 2024 and lost 170lbs. My personal favorite.
orforglipron Foundayo11.2% weight loss
Stage✓ Approved
TargetsGLP-1 receptor agonist (oral, non-peptide small molecule)
Maker
Routeoral (daily, no food/water restriction)
Indicationsapproved for obesity / weight management; investigating type 2 diabetes
Efficacy~11.2% mean weight loss (ATTAIN-1, 36 mg, 72 wks) — more modest than injectable GLP-1s source
Beyond weight loss
  • ✓ Type 2 diabetes: Glycemic efficacy in Phase 3 (oral, daily) (ACHIEVE program · source)
  • · Everything else: Largely untested — newest molecule; CV / OSA / OA / addiction effects not yet studied. Do NOT assume semaglutide's benefits transfer. (no data yet)
Access & priceSelf-pay: LillyDirect (~$149-299/mo self-pay) · Medicare GLP-1 Bridge from Jul 1, 2026 (~$50/mo, eligibility applies) · compare price (GoodRx)
Key trials
  • ATTAIN-MAINTAIN (Ph 3, weight maintenance after injectable) — Maintained weight loss after switching from Wegovy/Zepbound to oral orforglipron. source
Papers
On DSD
My takeVery interesting entry because it avoids the needles and the onerous Wegovy pill protocol.
The pipeline moves fast. I keep this current.
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