Best GLP-1 for weight loss: how clinicians actually compare options

There is no single best GLP-1 for every adult

There is no single best GLP-1 for every adult. Head-to-head, SURMOUNT-5 found a higher average percent weight loss with tirzepatide than with semaglutide. Plenty of people still do better on semaglutide, cannot take a dual agonist, or should take nothing. A clinician weighs your history, not a ranking table. This page will not call Beema's compounded options the winner, and it will not run a Zepbound-versus-compounded price contest.

This article will not conclude that Beema compounded is the best. It will not frame compounded tirzepatide versus Zepbound as a value contest.

A map of trial-average effect sizes

Liraglutide 3.0 mg (SCALE): daily GLP-1, smaller mean losses than later weekly agents. Semaglutide 2.4 mg (STEP 1): about 14.9% at 68 weeks versus 2.4% placebo. Tirzepatide (SURMOUNT-1): dose-dependent means, about 20.9% at 15 mg at 72 weeks in that trial. SURMOUNT-5: 20.2% versus 13.7% tirzepatide versus semaglutide. Retatrutide Phase 2: about 24.2% at 12 mg at 48 weeks, investigational. Orforglipron ATTAIN-1: significant versus placebo, smaller means than STEP 1. CagriSema REDEFINE 1: about 20.4% versus 3.0% placebo, investigational combination.

Different durations and estimands apply. Treat the map as orientation, not a betting card.

Dimensions a clinician actually weighs

Diabetes versus no diabetes. Established cardiovascular disease (SELECT used semaglutide 2.4 mg). Injection willingness. Gastrointestinal budget. Pregnancy timing. Other medicines. What the pharmacy can fill this month. What the patient can pay in cash if insurance is not in play. Beema is cash-pay and does not run insurance math on this site.

• Efficacy averages from named trials
• Labeled indications and warnings
• Tolerability and adherence
• Legal availability of a specific product

Pipeline drugs are not secretly the current best

Retatrutide, CagriSema, and mazdutide (China-only approval) are not Beema offerings. Orforglipron is approved as Foundayo but is not a Beema offering. Ranking an unavailable drug as 'best' is how people buy research chemicals. Do not do that.

If you are in Beema's program, the choice set is smaller

Licensed providers may prescribe compounded semaglutide or compounded tirzepatide when legally available and clinically appropriate. Compounded semaglutide is not FDA-approved and is considered only when legally available and clinically appropriate. Compounded tirzepatide is not FDA-approved and is considered only when legally available and clinically appropriate. Within that pair, SURMOUNT-5-style averages may inform a conversation. They still do not force tirzepatide for every person, and they do not make compounding better than Zepbound.

Commercial details and plan selectors: compounded semaglutide and compounded tirzepatide. Program overview: medical weight-loss.

Take a list, not a brand winner, to your visit

Write your top constraint (needles, nausea history, heart disease, timeline). Ask the clinician how they would choose given that constraint. If you start Beema intake, put the same constraint on the questionnaire. Completing intake and any later payment do not guarantee a prescription.

Frequently asked questions

Sources

1. [1] Wilding JPH, et al. STEP 1 semaglutide 2.4 mg. N Engl J Med. 2021.
2. [2] Jastreboff AM, et al. SURMOUNT-1 tirzepatide. N Engl J Med. 2022.
3. [3] Aronne LJ, et al. SURMOUNT-5: tirzepatide compared with semaglutide. N Engl J Med. 2025.
4. [4] Pi-Sunyer X, et al. SCALE: liraglutide 3.0 mg. N Engl J Med. 2015.