Monitor for Mild Effects : Temporary symptoms, such as nausea or decreased appetite, may occur but typically subside as your body adjusts to the medication
Direct comparisons with semaglutide or tirzepatide should be interpreted with caution, as no head-to-head trials have been conducted

Choose Semaglutide (Wegovy) If: Best for people who: Want the longest safety track record (5 years) Have good insurance coverage for Wegovy specifically Prefer lowest discontinuation rate (6.9%) Are satisfied with 15% average weight loss Advantages: Most real-world data, proven track record since 2021 Disadvantages: Lowest efficacy (14.9%), highest cost ($1,349/month) Choose Tirzepatide (Zepbound) If: Best for people who: Want highest efficacy among available options (22.5%) Prefer best tolerability (31% nausea, lowest) Want better value (~$290/month cheaper) Want medication available today Advantages: Superior efficacy, best side effect profile, lower cost Disadvantages: Less long-term data than Semaglutide (3 years vs 5) Consider Waiting for Retatrutide If: Might make sense if you: Can wait until 2027-2028 without health consequences Want maximum weight loss (28.7%) Have tried both Semaglutide and Tirzepatide with insufficient results Have flexible health timeline Advantages: Highest efficacy (28.7%) Disadvantages: 2+ year wait, highest discontinuation (18.2%), no long-term data Realistic Recommendations For most people today: Choose Tirzepatide

Nayfach, S., Shi, Z
Double blind, cluster randomised trial of low dose supplementation with vitamin A or beta carotene on mortality related to pregnancy in Nepal