Introduction

When exploring prescription options for weight loss, many patients compare Zepbound, a weekly injectable, with Qsymia, a daily oral pill. While both are FDA-approved for weight management, they work very differently and deliver different results.

In this blog, we’ll break down Zepbound vs Qsymia to help you understand how each works, their pros and cons, and how to decide which is right for your weight loss journey.

Quick Overview

Feature	Zepbound	Qsymia
Type	Injectable GLP-1 + GIP agonist	Oral pill (phentermine + topiramate)
FDA Approval	Weight loss (2023)	Weight loss (2012)
Frequency	Once weekly injection	Daily oral tablet
Avg. Weight Loss	15–22.5% of body weight	6–11% of body weight
Control Schedule	Not a controlled substance	Schedule IV (controlled)

How They Work

Zepbound (tirzepatide)

• Mimics gut hormones GLP-1 and GIP
• Reduces appetite
• Slows gastric emptying
• Improves insulin sensitivity

Qsymia (phentermine + topiramate)

• Phentermine: stimulant that suppresses appetite
• Topiramate: anticonvulsant that may reduce hunger and cravings
• Works via central nervous system, not hormones

Zepbound focuses on hormonal reset and metabolic balance, while Qsymia stimulates the brain’s appetite control center.

Weight Loss Results

Medication	Avg. Weight Loss	Study Duration	Source
Zepbound	15–22.5%	72 weeks	SURMOUNT-1 Trial
Qsymia	6–11%	56–108 weeks	CONQUER Study

Zepbound results in nearly double the weight loss compared to Qsymia in clinical trials.

Side Effects Comparison

Symptom	Zepbound	Qsymia
Nausea	Common (early on)	Rare
Constipation	Sometimes	Sometimes
Insomnia	Not common	Common (due to phentermine)
Tingling/numbness	Not associated	Reported with topiramate
Anxiety or jitteriness	No	Possible with phentermine

Qsymia’s stimulant effects may not be tolerated well by those with heart issues, anxiety, or insomnia.

Cost & Insurance

Medication	Retail Cost (U.S.)	Savings Card Options	Insurance Coverage
Zepbound	~$1,060/month	Zepbound Savings Card	With prior auth
Qsymia	~$150–$200/month	Qsymia Savings Card	Often covered

Qsymia is more affordable, especially for those without insurance, but Zepbound offers more dramatic weight loss.

Who Should Consider Zepbound?

Ideal for:

• People who want significant long-term fat loss
• Those with insulin resistance, PCOS, or metabolic syndrome
• Individuals who prefer once-weekly dosing
• Patients who want a non-stimulant option

Who Should Consider Qsymia?

Ideal for:

• People who are stimulant-tolerant and want a pill
• Mild to moderate weight loss goals
• Those who don’t qualify for GLP-1 coverage
• Budget-conscious patients without insurance

Not suitable for:

• Those with cardiovascular issues
• Pregnant women or those trying to conceive
• Patients sensitive to stimulants or topiramate

Related: Top Weight Loss Medications for Emotional Eaters

Final Thoughts

Zepbound and Qsymia are both effective weight loss medications—but they’re built for different kinds of patients.

Zepbound = hormonal, injectable, long-term weight loss powerhouse
Qsymia = stimulant-based pill that’s affordable and effective for moderate goals
Always consult your provider to determine which option fits your lifestyle, health history, and insurance situation

Visit our Weight Loss Drug Comparison Center for downloadable charts, savings links, and doctor Q&A.