GLP-1 vs Other Weight Loss Meds: Phentermine, Contrave, Saxenda & Qsymia (2026)
GLP-1 medications vs phentermine, Contrave, Saxenda, Qsymia, and metformin. Compare effectiveness, cost, side effects, and best choice for 2026.
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Quick answer:
GLP-1 medications (Wegovy, Zepbound) are the most effective weight loss medications available in 2026, producing 15 to 22.5% weight loss. They outperform phentermine (5 to 10%), Contrave (5 to 8%), Saxenda (8%), and Qsymia (8 to 10%). GLP-1s also have the best safety profile for long-term use. Compounded GLP-1s start at $99/month, making them cost-competitive with older medications.
Complete weight loss medication comparison (2026)
| Medication | Type | Avg weight loss | Cost/month | Duration | FDA-approved? |
|---|---|---|---|---|---|
| Zepbound (tirzepatide) | GLP-1/GIP agonist | 20 to 22.5% | $299 to $1,300 | Long-term | Yes (weight loss) |
| Wegovy (semaglutide) | GLP-1 agonist | 14 to 15% | $149 to $1,350 | Long-term | Yes (weight loss) |
| Ozempic (semaglutide) | GLP-1 agonist | 10 to 12% | $900 to $1,100 | Long-term | Yes (diabetes) |
| Mounjaro (tirzepatide) | GLP-1/GIP agonist | 20 to 22.5% | $1,000 to $1,200 | Long-term | Yes (diabetes) |
| Saxenda (liraglutide) | GLP-1 agonist | 8% | $1,000 to $1,300 | Long-term | Yes (weight loss) |
| Contrave (bupropion/naltrexone) | Antidepressant/opioid antagonist | 5 to 8% | $99 to $300 | Long-term | Yes |
| Qsymia (phentermine/topiramate) | Stimulant/anticonvulsant | 8 to 10% | $150 to $300 | Long-term | Yes |
| Phentermine | Stimulant | 5 to 10% | $15 to $50 | 12 weeks max | Yes (short-term) |
| Compounded semaglutide | GLP-1 agonist | 10 to 15% | $99 to $179 | Long-term | No (compounded) |
| Compounded tirzepatide | GLP-1/GIP agonist | 15 to 22% | $179 to $399 | Long-term | No (compounded) |
GLP-1 vs Phentermine
Phentermine is the oldest and cheapest weight loss medication, but it has significant limitations compared to GLP-1s:
| Feature | GLP-1 (Wegovy/Zepbound) | Phentermine |
|---|---|---|
| Weight loss | 15 to 22% | 5 to 10% |
| Duration of use | Long-term (years) | 12 weeks max |
| Mechanism | Hormone mimic (appetite + digestion) | Stimulant (suppresses appetite) |
| Side effects | Nausea, GI (manageable) | Jitteriness, heart rate, BP increase |
| Cardiovascular safety | Proven CV benefit | CV risk — not safe for heart patients |
| Cost | $99 to $1,300/month | $15 to $50/month |
| Rebound weight gain | Moderate (if stopped without plan) | High (almost universal) |
See our detailed GLP-1 vs Phentermine guide.
GLP-1 vs Contrave
Contrave combines bupropion (an antidepressant) with naltrexone (an opioid antagonist). It works on the brain's reward center to reduce cravings.
- Weight loss: 5 to 8% (GLP-1s: 15 to 22%)
- Cost: $99 to $300/month (GLP-1s: $99 to $1,300/month)
- Best for: Patients with emotional/binge eating patterns
- Drawback: Much less effective than GLP-1s; may increase blood pressure
GLP-1 vs Saxenda
Saxenda (liraglutide) was the first GLP-1 approved for weight loss, but it has been largely superseded by Wegovy and Zepbound:
| Feature | Wegovy/Zepbound | Saxenda |
|---|---|---|
| Weight loss | 15 to 22% | 8% |
| Injection frequency | Weekly | Daily |
| Cost | $99 to $1,350/month | $1,000 to $1,300/month |
| Side effects | Moderate (titration helps) | Moderate (daily injections = more side effect days) |
See our Saxenda vs Wegovy comparison.
GLP-1 vs Qsymia
Qsymia combines phentermine with topiramate. It's more effective than phentermine alone but still falls short of GLP-1s:
- Weight loss: 8 to 10% (GLP-1s: 15 to 22%)
- Cost: $150 to $300/month
- Best for: Patients who can't access GLP-1s
- Drawback: Birth defect risk (topiramate), cognitive side effects
Which medication is right for you?
| Your situation | Recommended | Why |
|---|---|---|
| BMI 30+, want maximum results | Zepbound (tirzepatide) | 20 to 22% weight loss, highest efficacy |
| BMI 27-30, moderate weight loss | Wegovy or compounded semaglutide | 15% weight loss, affordable at $99/month |
| Budget under $50/month | Phentermine (short-term only) | Cheapest option, 12-week course |
| Emotional/binge eating | Contrave or GLP-1 | GLP-1s reduce food noise; Contrave targets cravings |
| Heart condition | GLP-1 (Wegovy) | Proven cardiovascular safety; avoid phentermine |
| Type 2 diabetes | Ozempic or Mounjaro | FDA-approved for diabetes + weight loss |
| Prefer daily pill over injection | Wegovy pill or Rybelsus | Oral semaglutide from $149/month |
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"I tried everything — keto, intermittent fasting, gym memberships. Nothing worked long-term. GLP-1 changed everything. I lost 47 pounds in 8 months and finally feel like myself again. The online process was so easy — I had my prescription in 2 days."
Jessica M., 38
Texas
-47 lbs
in 8 months
Compounded semaglutide
"At 52, my doctor said I was heading toward diabetes. I started tirzepatide through a telehealth program and lost 62 pounds. My A1C is back to normal, my blood pressure dropped, and I'm off two medications. Wish I'd done this years ago."
David R., 52
Florida
-62 lbs
in 11 months
Tirzepatide (Zepbound)
"I was skeptical about doing this online, but the whole process was professional and easy. My provider answered all my questions, and the medication arrived in 4 days. I've lost 38 pounds and finally have energy to play with my kids again."
Aisha K., 34
California
-38 lbs
in 6 months
Compounded semaglutide
Results vary. These testimonials reflect individual experiences and are not typical. Weight loss depends on diet, activity, and adherence to medication.
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