Which GLP-1 medication works best for weight loss?

In clinical studies, tirzepatide (Mounjaro) gives the strongest average weight loss (~18-22%), followed by high-dose semaglutide (Wegovy, ~14-17%), Ozempic (~10-15%, lower dose), and Saxenda (~5-8%). 'The best', however, depends on individual factors: tolerance of side effects, the dose you can tolerate, availability, price and your medical history. A doctor decides which medication is appropriate for you.

What is the difference between Ozempic and Wegovy?

Both contain the same active ingredient (semaglutide). The difference lies in dosing and indication: Ozempic is registered for type 2 diabetes with a maximum of 1.0 mg, Wegovy is registered for weight management with a higher dose of up to 2.4 mg. In the Netherlands, Ozempic is more often used off-label for weight loss.

Why does Mounjaro work more strongly than Ozempic?

Mounjaro (tirzepatide) acts on two receptors: GLP-1 and GIP. Both receptors influence appetite and insulin sensitivity. In studies, the combination gives stronger weight loss than medication that acts on GLP-1 alone. In addition, side effects are often slightly better tolerated, allowing people to stay on an effective dose for longer.

Is Saxenda still relevant?

Saxenda (liraglutide) was the first GLP-1 for weight management and is therefore the oldest generation. The daily injection is a practical disadvantage compared with weekly alternatives, and weight loss is lower on average. Saxenda can be an option if other GLP-1s are unavailable or poorly tolerated — but for most people, doctors nowadays choose semaglutide or tirzepatide.

Can I switch between GLP-1 medications?

Yes, in consultation with your doctor. Switching can make sense in case of insufficient effect, poor tolerance of side effects, or availability problems. Important: the transition takes place with an intermediate tapering schedule or a direct switch according to medical protocol. Do not experiment yourself — doses between medications are not comparable one-to-one.

Is GLP-1 reimbursed by health insurance?

For type 2 diabetes, often yes. For pure weight management (without diabetes), reimbursement in the Netherlands is very limited and depends on BMI, comorbidity and specific policy conditions. For most people who lose weight through a clinic: own costs. Check your policy or call your health insurer to be sure.

Which has the fewest side effects?

Nausea is the most common side effect with all GLP-1s and depends strongly on titration speed. In studies, tirzepatide (Mounjaro) is on average slightly better tolerated than high-dose semaglutide (Wegovy). Saxenda's daily injection irritates more quickly. But individual variation is large — what works for you cannot be predicted from figures alone.

GLP-1 comparison: Ozempic, Wegovy, Mounjaro and Saxenda

An educational overview of the four GLP-1 medications prescribed in the Netherlands — differences in mechanism, dosing, effectiveness, price, side effects and reimbursement.

Updated 28 May 2026 · Educational information, not prescribing advice

Disclaimer: this page is intended as educational information. Which medication is suitable for you is a medical decision made by a BIG-registered doctor based on your individual situation. This page does not promote any specific prescription medicine — all four are registered medicines that may only be prescribed by a doctor.

Overview in a table

Feature	Ozempic	Wegovy	Mounjaro	Saxenda
Active ingredient	Semaglutide	Semaglutide (higher dose)	Tirzepatide	Liraglutide
Indication	Type 2 diabetes (off-label for weight loss)	Registered for weight management (BMI ≥30, or ≥27 with risk factors)	Type 2 diabetes and weight management	Weight management (older-generation GLP-1)
Mechanism of action	GLP-1 receptor agonist (single receptor)	GLP-1 receptor agonist (same action as Ozempic, higher dose)	Dual agonist: acts on the GLP-1 and the GIP receptor	GLP-1 receptor agonist (older variant with shorter action)
Dosing schedule	Inject once weekly — titration from 0.25 mg to 1.0 mg	Once weekly — titration from 0.25 mg to 2.4 mg	Once weekly — titration from 2.5 mg to 15 mg	Inject once daily — titration from 0.6 mg to 3.0 mg
Weight loss (average)	Average 10-15% of body weight in 12 months	Average 14-17% of body weight in 16 months	Average 18-22% of body weight in 16 months	Average 5-8% of body weight in 12 months
Side effects (typical)	Nausea, constipation, fatigue, sometimes headache	Comparable to Ozempic, on average slightly stronger due to the higher dose	Nausea, fatigue; often slightly better tolerated than Wegovy	Nausea, fatigue; daily injection is a practical disadvantage
Price (without reimbursement)	€80-150 per month (without reimbursement)	€200-300 per month (without reimbursement)	€250-400 per month (without reimbursement)	€250-400 per month
Reimbursement NL	Often reimbursed for type 2 diabetes; usually not for weight loss	Very limited reimbursement in NL; usually paid out of pocket	Limited; sometimes for severe diabetes cases	Very limited

Ozempic

Active ingredient: Semaglutide

Indication: Type 2 diabetes (off-label for weight loss)
Mechanism: GLP-1 receptor agonist (single receptor)
Dosing schedule: Inject once weekly — titration from 0.25 mg to 1.0 mg
Effectiveness: Average 10-15% of body weight in 12 months
Typical side effects: Nausea, constipation, fatigue, sometimes headache
Price: €80-150 per month (without reimbursement)

Wegovy

Active ingredient: Semaglutide (higher dose)

Indication: Registered for weight management (BMI ≥30, or ≥27 with risk factors)
Mechanism: GLP-1 receptor agonist (same action as Ozempic, higher dose)
Dosing schedule: Once weekly — titration from 0.25 mg to 2.4 mg
Effectiveness: Average 14-17% of body weight in 16 months
Typical side effects: Comparable to Ozempic, on average slightly stronger due to the higher dose
Price: €200-300 per month (without reimbursement)

Mounjaro

Active ingredient: Tirzepatide

Indication: Type 2 diabetes and weight management
Mechanism: Dual agonist: acts on the GLP-1 and the GIP receptor
Dosing schedule: Once weekly — titration from 2.5 mg to 15 mg
Effectiveness: Average 18-22% of body weight in 16 months
Typical side effects: Nausea, fatigue; often slightly better tolerated than Wegovy
Price: €250-400 per month (without reimbursement)

Saxenda

Active ingredient: Liraglutide

Indication: Weight management (older-generation GLP-1)
Mechanism: GLP-1 receptor agonist (older variant with shorter action)
Dosing schedule: Inject once daily — titration from 0.6 mg to 3.0 mg
Effectiveness: Average 5-8% of body weight in 12 months
Typical side effects: Nausea, fatigue; daily injection is a practical disadvantage
Price: €250-400 per month

How do you choose the right medication?

There is no "best" medication in an absolute sense — what works best depends on your BMI, health status, tolerance for side effects, budget and any reimbursement situation. A few rules of thumb that doctors use:

High BMI, no diabetes: tirzepatide (Mounjaro) or high-dose semaglutide (Wegovy) give the strongest weight loss on average.
Type 2 diabetes with excess weight: Ozempic or Mounjaro treat both at once; often eligible for partial reimbursement.
Poor tolerance for nausea: Mounjaro is often slightly better tolerated in studies. Titrating more slowly always helps.
Limited budget: Ozempic (lower dose) is usually cheaper than Wegovy or Mounjaro. With reimbursement for type 2 diabetes, that difference can be considerable.
Contraindications (e.g. MEN2, thyroid history): all four GLP-1s are advised against. Other approaches (bariatric surgery, intensive lifestyle) come into view.

Which medication suits you?

Our BIG-registered doctor discusses which medication is the most appropriate for your situation, both medically and financially. No one-size-fits-all.

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