Semaglutide vs The Alternatives: Which GLP-1 Is Right For You?
So here's the thing: I never thought I'd be injecting myself with a diabetes drug to lose weight. But at 35, after my doctor showed me my A1C creeping into pre-diabetic territory and my weight hitting 218 pounds (I'm 5'10"), I knew something had to change. I'd tried everything—keto, intermittent fasting, running myself into the ground. Nothing stuck. Then I started reading about Semaglutide and the whole GLP-1 receptor agonist family. Eighteen months later, I'm down 47 pounds, my A1C is 5.1, and I've learned way more about these peptides than I ever wanted to. Let me break down what I've discovered.
Quick Answer: Semaglutide (Ozempic/Wegovy) is the most researched GLP-1 with proven 15-20% weight loss, but Tirzepatide (Mounjaro/Zepbound) might be more effective at 20-25% loss due to dual GIP/GLP-1 action. Liraglutide is older with less weight loss (5-10%) but daily dosing gives more control. Your choice depends on your goals, budget, and how you handle side effects. I'm not a medical professional—talk to your doctor before trying any of these.
What Are GLP-1 Receptor Agonists Anyway?
Before I get into my experience, here's what these things actually do. Semaglutide and its cousins are medications that mimic GLP-1, a hormone your gut releases after you eat. This hormone tells your brain "hey, we're full now" and slows down how fast your stomach empties. Originally developed for type 2 diabetes, doctors noticed patients were losing significant weight—like, 15-25% of their body weight. That's wild compared to most weight loss drugs that might get you 5-8%.
The main players in this space are:
After reading like 50+ research papers and spending way too much time on Reddit forums, I decided to start with Semaglutide. Here's why, and what happened.
My 18-Month Journey with Semaglutide
I started Semaglutide in June 2023 at 0.25mg weekly. My doctor prescribed Ozempic off-label since my insurance wouldn't cover Wegovy (spoiler: they're the exact same drug, just different dosing pens). The first month was... rough. I'm talking nausea that made me regret every life choice. I couldn't look at chicken without feeling sick. But I stuck with it because the appetite suppression was real—I'd forget to eat lunch, which had literally never happened to me.
By month three at 1mg weekly, I'd lost 22 pounds. My wife asked if I was okay because I was eating like half my normal portions. The nausea had mostly subsided, but I had this weird thing where certain foods just didn't appeal to me anymore. Ice cream? Meh. Pizza? Could take it or leave it. This from a guy who used to demolish an entire large pizza solo.
The results at 18 months on 2mg weekly:
But here's what nobody tells you: the weight loss plateaued hard around month 14. I've been basically maintaining at 171 for four months now. Also, I had to deal with some gnarly constipation—like, we're talking three days between bathroom visits. Not fun.
How Does Semaglutide Compare to Tirzepatide?
Around month 12, I got curious about Tirzepatide because people in my biohacking groups were raving about it. The key difference? Tirzepatide is a dual agonist—it hits both GLP-1 receptors AND GIP (glucose-dependent insulinotropic polypeptide) receptors. In theory, this should mean better results.
The clinical trial data backs this up. The SURMOUNT-1 trial showed Tirzepatide users lost an average of 20.9% body weight at the highest dose (15mg), compared to Semaglutide's 14.9% in the STEP trials. That's a significant difference.
I haven't personally switched to Tirzepatide yet, but here's what I've gathered from friends who have:
Tirzepatide Pros:
Tirzepatide Cons:
My buddy Jake switched from Semaglutide to Tirzepatide at month 10 and lost another 18 pounds over the next four months. His experience made me seriously consider switching, but the cost difference is keeping me on Semaglutide for now.
What About Liraglutide (The Daily Option)?
Liraglutide is the OG in this space—it's been around since 2010. The big difference? You inject it daily instead of weekly. I actually tried this first before Semaglutide because my doctor wanted to "start conservative."
I spent three months on Liraglutide (Saxenda) at 3mg daily and lost... 11 pounds. That's it. For context, I lost 22 pounds in the first three months on Semaglutide. The research backs this up—clinical trials show Liraglutide averages 5-10% body weight loss vs Semaglutide's 15-20%.
Why would anyone choose Liraglutide then?
Honestly? Unless you have a specific reason to need daily dosing or you can't tolerate the weekly injections, I'd skip Liraglutide and go straight to Semaglutide. The convenience of weekly dosing alone is worth it, plus the results are just better.
The Real Talk: Side Effects Nobody Warns You About
Look, the clinical trials mention nausea, diarrhea, constipation—yeah, you'll get those. But here's what actually surprised me:
The Ozempic Face Thing Is Real: Around month 8, I noticed my face looked more hollow. Not terrible, but definitely different. When you lose 20% of your body weight that fast, fat comes off everywhere, including your face. Some people hate this. I honestly don't mind it.
Food Aversions: I can't eat beef anymore. It just tastes... wrong. Same with really sweet desserts. This is common with GLP-1s—they literally change your taste preferences. Wild.
Energy Levels: For the first 4-5 months, I was exhausted. Like, 3pm crashes became my daily ritual. This improved once my body adjusted, but it was rough. I had to supplement with fadogia agrestis and other energy-supporting compounds to maintain my workout routine.
Muscle Loss: Despite hitting the gym 4x weekly, I definitely lost some muscle along with the fat. My bench press dropped from 225 lbs to 185 lbs. The rapid weight loss makes it hard to preserve muscle mass, which is why I'm now incorporating IGF-1 LR3 to help maintain lean tissue.
Gallbladder Issues: This is rare but worth mentioning. Rapid weight loss increases gallstone risk. I didn't have issues, but my doctor monitors my liver enzymes every three months just in case.
The Cost Reality: How to Actually Afford These Things
Let's be real: retail prices are insane. Wegovy costs $1,400/month. Mounjaro is $1,000+. Saxenda is $1,200+. Insurance might cover them if you have diabetes and jump through hoops, but for weight loss? Good luck.
Here's how I've made it work:
Option 1: Compounding Pharmacies
This is what I use. Compounding pharmacies make their own versions of Semaglutide for $250-400/month. It's the same active ingredient, just not the fancy branded pen. I found mine by searching "semaglutide compounding pharmacy near me" and calling around. Make sure they're licensed and require a prescription—if they don't, run away.
Option 2: Manufacturer Coupons
Novo Nordisk (makes Ozempic/Wegovy) offers savings cards that can drop your cost to $25/month... if your insurance covers it at all. Catch-22, right? Worth checking though—search for "semaglutide coupon" and see what's available.
Option 3: Online Prescription Services
Places like Ro, Hims, and Found offer online ozempic prescriptions with compounded versions for $300-500/month including doctor consultations. I haven't used these personally, but friends have had good experiences.
Option 4: Medical Tourism
Some people buy Ozempic from Canadian or Mexican pharmacies for $300-400/month. I'm not going to recommend this because of legality questions, but I know it happens.
Whatever you do, avoid places advertising "ozempic without prescription"—that's a red flag for counterfeit products or scams.
Which One Should You Actually Choose?
Alright, decision time. Here's my totally non-medical-professional opinion based on 18 months of experience:
Choose Semaglutide if:
Choose Tirzepatide if:
Choose Liraglutide if:
Honestly? For most people, I'd say start with Semaglutide. It's the sweet spot of effectiveness, cost, and availability. If you plateau or want more dramatic results, consider switching to Tirzepatide. Liraglutide makes sense for specific situations but isn't my first choice.
FAQ: Your Burning Questions Answered
Can I switch between these GLP-1s?
Yes, and many people do. I switched from Liraglutide to Semaglutide without issues. Your doctor will typically have you stop one for a few days before starting the other, especially when going from daily to weekly dosing. Some people cycle between them if they plateau—my friend rotates between Semaglutide and Tirzepatide every six months.
Will I gain the weight back when I stop?
Real talk? Probably some of it, yeah. The clinical trials show people regain about 2/3 of the lost weight within a year of stopping. These medications work while you're on them, but they're not magic bullets. You need to use the time on them to build better habits. I've been incorporating VIP peptide to help with metabolic health as I think about eventually tapering off.
What about the cancer risk I keep hearing about?
This comes from studies in rodents showing increased thyroid tumors at massive doses. In humans, the data doesn't show increased cancer risk after 7+ years of monitoring. That said, if you have a personal or family history of medullary thyroid carcinoma or MEN2 syndrome, these drugs are contraindicated. Always discuss your specific risk factors with your doctor.
Can I use these just for body recomposition if I'm not overweight?
Technically, they're only FDA-approved for people with BMI over 30 (or 27+ with weight-related health conditions). But yeah, some people use them off-label for body recomposition. I'd say this is getting into murky ethical territory—these drugs are in short supply, and people with diabetes actually need them. Plus, the muscle loss issue is worse if you don't have much fat to lose. If you're already lean and want to get leaner, there are better options in the peptide world.
My Final Take After 18 Months
Semaglutide changed my life. Full stop. I'm healthier, more confident, and I've avoided what was likely a progression to full-blown type 2 diabetes. But it's not perfect—the side effects are real, the cost is ridiculous, and you can't stay on it forever without thinking about long-term effects.
If I were starting over today, I'd probably still choose Semaglutide first. The track record is solid, the results speak for themselves, and the compounding pharmacy options make it financially doable. Once I hit a plateau (which I have), I'd seriously consider switching to Tirzepatide for the final push.
But here's the thing nobody wants to hear: these drugs work best when combined with actual lifestyle changes. I had to learn to lift weights properly, dial in my sleep, manage stress, and build better eating habits. The Semaglutide made all that easier by killing my food noise and cravings, but I still had to do the work.
Whatever you choose—Semaglutide, Tirzepatide, Liraglutide, or something else entirely—make sure you're working with a doctor who actually knows this stuff. Not every GP is up to speed on GLP-1s yet. Find someone who specializes in obesity medicine or has experience managing patients on these medications.
And seriously, talk to your doctor before trying any of this. I'm just a former software engineer who got obsessed with biohacking, not a medical professional. This is my experience, but yours might be totally different. Be smart, be safe, and good luck on your journey.