The best weight loss medications in 2026, ranked by trial results

The best weight loss medication, going by the results on FDA labels, is Zepbound: people on its 15 mg dose lost 20.9% of their body weight on average over 72 weeks. Wegovy HD and the 2.4 mg Wegovy shot come next, then three pills: the Wegovy pill, Foundayo and Qsymia. The older drugs, liraglutide, Contrave, orlistat and phentermine, produce less.

This page ranks the drugs themselves, not the programs that prescribe them. Every figure comes from the drug’s own label, read on November 6, 2026, at the highest approved dose, from that drug’s main placebo-controlled trial. The trials enrolled different people over different lengths of time, so read the ranking as a guide, not a head-to-head result, and make the choice with a licensed clinician.

FDA-approved weight loss medications, ranked

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Every drug was tested alongside a reduced-calorie diet and more physical activity, and its label says to use it that way. Ozempic and Mounjaro aren’t on the list: they are approved for type 2 diabetes, so prescribing them for weight loss alone is off-label.

The warnings come first

• Boxed warning for thyroid C-cell tumors: Zepbound, Wegovy (shot and pill), Foundayo and liraglutide. The warning comes from thyroid C-cell tumors seen in rodents with GLP-1 drugs, and these medications aren’t for anyone with a personal or family history of medullary thyroid carcinoma or with MEN 2. Their labels also warn about pancreatitis, gallbladder problems and dehydration from stomach side effects.
• Boxed warning for suicidal thoughts and behaviors: Contrave, because it contains bupropion.
• Schedule IV controlled substances: Qsymia and phentermine. Qsymia can cause harm to an unborn baby, so its label calls for a negative pregnancy test before starting and monthly while on it, and it is sold through a restricted safety program (REMS).
• Short-term use only: phentermine is labeled as “a short-term adjunct (a few weeks).” Its label says the extra weight loss over placebo in trials was “only a fraction of a pound a week.”

The shots: Zepbound, Wegovy and liraglutide

Zepbound is a weekly tirzepatide injection that acts on two hormone receptors, GIP and GLP-1. In SURMOUNT-1, people lost 15.0% at 5 mg, 19.5% at 10 mg and 20.9% at 15 mg over 72 weeks. It is also approved for moderate to severe obstructive sleep apnea in adults with obesity. Its most common side effects are stomach-related: nausea, diarrhea, vomiting and constipation.

Wegovy is a weekly semaglutide injection. At 2.4 mg, people lost 14.9% over 68 weeks against 2.4% on placebo. The higher Wegovy HD dose, 7.2 mg, produced 18.8% over 72 weeks against 3.9%, and 15.5% for the 2.4 mg group in the same trial. Wegovy is also approved to lower the risk of heart attack, stroke and cardiovascular death in adults with heart disease and obesity or overweight. Our Wegovy vs Zepbound guide compares the two in detail.

Liraglutide is an older GLP-1 taken by injection every day. Saxenda, the brand, produced 7.4% weight loss over 56 weeks against 3.0% on placebo, and a generic from Teva launched on August 28, 2025, the first generic GLP-1 for weight loss. See Saxenda and liraglutide.

The pills: Wegovy pill, Foundayo, Qsymia, Contrave and orlistat

• Wegovy pill: a daily semaglutide tablet. At 25 mg, people lost 13.6% over 64 weeks against 2.4% on placebo. You take it on an empty stomach in the morning with up to 4 ounces of water, then wait at least 30 minutes before eating, drinking or taking other medicines.
• Foundayo: Lilly’s daily GLP-1 tablet, approved in 2026. At 17.2 mg, people without diabetes lost 11.1% over 72 weeks against 2.1% on placebo. Its label says to take it once a day “with or without food.” Our guide to Foundayo vs the Wegovy pill compares the two.
• Qsymia: phentermine plus topiramate in one morning capsule. At the top dose, adults with obesity lost 10.9% over 56 weeks against 1.6%, and adults with weight-related conditions 9.8% against 1.2%. The most common side effects include tingling, dizziness, altered taste, insomnia, constipation and dry mouth.
• Contrave: naltrexone plus bupropion, reaching two tablets twice a day by week 4. In COR-I, people lost 5.4% over 56 weeks against 1.3%. Our Contrave guide covers who it suits.
• Orlistat: an intestinal lipase inhibitor, taken with each main meal that contains fat. On the Xenical label, people lost about 3 percentage points more than placebo after a year. Alli, a 60 mg version, is sold without a prescription for overweight adults on a reduced-calorie, low-fat diet.

Phentermine is a stimulant appetite suppressant approved for a few weeks of use. Our phentermine guide covers the controlled-substance rules.

What each medication costs without insurance

These are the makers’ own self-pay prices, read on November 6, 2026. An online program that prescribes them usually adds its own fee.

Foundayo’s 2.5 mg and 5.5 mg prices are temporarily reduced through December 31, 2026. With commercial insurance that covers them, Novo’s and Lilly’s savings offers can bring Wegovy, the Zepbound single-dose pen or Foundayo to as little as $25 a month; Zepbound vials aren’t part of Lilly’s savings card. Eligible Medicare Part D enrollees pay $50 a month through the Medicare GLP-1 Bridge from July 1, 2026 to December 31, 2027, which covers Foundayo, Wegovy injection and tablets, Wegovy HD and the Zepbound KwikPen. Our Wegovy cost and Zepbound cost guides go dose by dose.

Who can be prescribed them

The GLP-1 drugs on this list are approved for adults with obesity, or with overweight and at least one weight-related condition such as high blood pressure. In their trials that meant a BMI of 30 or more, or 27 or more with such a condition. Wegovy and Saxenda are also approved for some children 12 and older. Phentermine’s label uses the same thresholds. Check your number with our BMI calculator, then talk to a clinician about your history.

Compounded versions are not on this list

Compounded semaglutide and compounded tirzepatide are sold by many online programs, but they aren’t ranked here because none has an FDA label or label trial results. Compounded semaglutide is not Wegovy, compounded tirzepatide is not Zepbound, and neither is a generic of those drugs. A compounding pharmacy prepares them, they aren’t FDA-approved, and the FDA does not review compounded drugs “for safety, effectiveness or quality prior to marketing” (FDA).

At the programs we rank, compounded semaglutide runs $75.58 to $299 a month and compounded tirzepatide $85.58 to $399, taking each program’s lowest ongoing price with medication and any required membership, as of November 2026. Our compounded GLP-1 page explains the rules, and our semaglutide cost guide puts the compounded and brand prices side by side.

Getting a prescription online

Every drug here except Alli needs a prescription. Online programs review your health history, prescribe if a clinician decides it’s right for you, and fill the prescription through a pharmacy, sometimes at the maker’s self-pay price plus a program fee. For Qsymia and phentermine, a temporary DEA rule lets clinicians prescribe by telemedicine without an in-person visit through December 31, 2026.

To compare programs by our published score, see our brand-name GLP-1 rankings, our GLP-1 pill rankings or the full GLP-1 provider rankings.

The bottom line

By label results, Zepbound produces the most weight loss of the approved medications, followed by Wegovy HD and Wegovy. The Wegovy pill is the most effective pill, Foundayo is the pill with no food rules, and Qsymia and Contrave have the lowest manufacturer self-pay prices. Each carries its own warnings, so the best one for you depends on your health history, your coverage and whether you’d rather take a shot or a pill. Talk it through with a licensed clinician, and start comparing on our weight-loss hub.