I've been on BOTH — Ozempic for 8 months, then Mounjaro for 10 months. Here's my totally subjective experience comparison: | Factor | Semaglutide (my experience) | Tirzepatide (my experience) | |--------|---------------------------|---------------------------| | Appetite suppression | Strong, felt like "food doesn't exist" | Moderate, felt like "food exists but I'm not interested" | | Energy levels | Lower than baseline | Similar to baseline | | Nausea | Moderate, injection day + 1 | Mild, injection day only | | Constipation | Significant | Mild | | Weight loss rate | ~1 lb/week | ~1.4 lbs/week | | Food noise reduction | 8/10 | 9/10 | | Mood effects | Slight increase in anxiety | Neutral | | Injection experience | Fine | Fine (slightly larger volume) | Tirz has been better FOR ME overall but I know people where the reverse is true. It's genuinely individual.

One thing missing from most decision frameworks: the COMPOUNDING angle. As of early 2026, the compounding landscape differs significantly between the two: - Compounded semaglutide: Still widely available from 503B pharmacies ($150-300/mo) - Compounded tirzepatide: Much more restricted following the FDA shortage list update ($300-500/mo where available, and getting harder to find) For cash-pay patients without insurance coverage, this can be the deciding factor. Brand-for-brand they're similar in cost, but the compounded market tilts heavily toward semaglutide right now. If your decision is partly financial, this matters. 💰

This thread has become exactly what I hoped — a balanced, evidence-informed discussion without tribal "my drug is better" energy. My updated decision factors for anyone reading this later: 1. Efficacy → Tirz edge (but both excellent) 2. CV outcomes data → Sema edge (SELECT trial) 3. Mechanism breadth → Tirz edge (dual agonist) 4. Track record → Sema edge (more years of data) 5. Oral option → Sema only 6. Dosing granularity → Tirz edge 7. Cost (brand) → Similar 8. Cost (compounded) → Sema edge 9. Supply reliability → Currently similar, varies by dose 10. Prescriber familiarity → Sema edge (for now) There's no universal right answer. The right answer is whichever one your doctor recommends based on YOUR clinical profile, YOU can access and afford, and YOU can tolerate. Everything else is noise. Thank you all for a fantastic discussion. Saving this thread. 📌