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What this guide covers
Vad GLP-1 är. Hur de verkar i kroppen. För vem de är godkända. De fyra läkemedlen på marknaden. Förklarat utan hype. This is patient education, not a substitute for the prescriber who knows your case. Generic names sit next to brand names throughout: semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro, Zepbound).
Frequently asked questions
What is a GLP-1, in plain English?
GLP-1 stands for glucagon-like peptide-1. It's a hormone your gut already makes after you eat. It tells your pancreas to release insulin, tells your brain you're full, and slows how fast your stomach empties. The drugs in this class (semaglutide, tirzepatide, liraglutide) are lab-made versions that hang around in the body much longer than the natural hormone. Tirzepatide also activates a second gut hormone called GIP, which is why it's often described as a dual agonist.
Who are GLP-1s approved for?
It depends on the specific drug. Ozempic and Mounjaro are FDA-approved for adults with type 2 diabetes. Wegovy and Zepbound are approved for chronic weight management in adults with a BMI of 30 or higher, or 27 or higher with at least one weight-related condition (like hypertension or sleep apnea). Wegovy also has approvals for adolescents 12+ who meet the BMI criteria, and for reducing cardiovascular risk in adults with established heart disease and obesity. Your prescriber checks the specific label against your situation.
What's the difference between brand and generic?
There isn't a true generic version of semaglutide or tirzepatide yet. The patents are active. What exists is compounded semaglutide, which is made by a compounding pharmacy rather than Novo Nordisk. Compounded versions were widely available during the FDA-declared drug shortage; as shortages resolve, the picture keeps shifting. Compounded is not FDA-approved the same way brand-name is, and the FDA has publicly flagged concerns about salt forms, dosing errors, and quality control at some compounders.
Does it work if I don't change my diet?
It works, but it works better with food changes that support it. The STEP-1 trial paired semaglutide 2.4mg with lifestyle counseling and reported roughly 15% average body-weight loss at 68 weeks. Drug-only results exist but are less well-studied. What tends to happen: the drug shrinks appetite, and if you eat mostly ultra-processed food with whatever appetite is left, you'll lose weight but also lose muscle and feel worse. Most dietitians working with GLP-1 patients focus on protein first, vegetables next, everything else after that.
What happens when I stop?
The STEP-1 extension trial followed participants who stopped semaglutide after 68 weeks. On average, they regained about two-thirds of the weight they'd lost within the next year. Appetite returned, gastric emptying normalized, and the metabolic effects of the drug faded. This is the honest thing nobody wants to hear: the drug treats the condition while you're on it. Maintenance protocols and gradual tapers are being studied but there's no established off-ramp that prevents regain for most people.
Are GLP-1s safe long term?
The longest human data on semaglutide comes from the SUSTAIN and STEP trials, now stretching past 5 years for some participants. No new safety signals have emerged in that window for the approved populations. The known risks per the FDA label include pancreatitis, gallbladder disease, kidney injury from dehydration, and a boxed warning about thyroid C-cell tumors (based on rodent studies; no confirmed human cases at therapeutic doses). 10-20 year data doesn't exist yet for any drug in this class.
How much do they cost?
Without insurance, list prices in early 2026 run roughly $1,000-$1,400 per month for the brand-name drugs. Coverage is the big variable, Ozempic and Mounjaro are often covered for diabetes; Wegovy and Zepbound are inconsistently covered for obesity. Manufacturer savings cards exist (the Zepbound and Wegovy cards can drop out-of-pocket significantly with commercial insurance). Compounded versions run much less but come with the caveats above. Costs change month to month, and the manufacturer sites are the most reliable source.
Sources
Related reading
Mounjaro vs Ozempic vs Wegovy vs Zepbound: A Calm Comparison
The four big GLP-1 drugs compared on mechanism, efficacy, side effects, and cost. What the trials actually showed, side by side.
12 Questions to Ask Your Doctor Before Starting a GLP-1
Prep for your first GLP-1 appointment: 12 questions worth asking, why each matters, and what a good answer looks like.
Semaglutide vs Tirzepatide: How Ozempic, Wegovy, Mounjaro, and Zepbound Compare
Two different molecules, two different receptor targets, and one head-to-head trial. What the SURPASS-2, STEP-1, and SURMOUNT-1 data show on weight, blood sugar, side effects, dosing, and cost, in plain language.