Introduction

If you’re struggling with overeating, emotional cravings, or food addiction, you may be considering medications that help control your appetite. Two prescription options that often come up are Zepbound and Contrave.

While both target hunger, they work very differently—and one is significantly more powerful when it comes to weight loss. In this post, we compare Zepbound vs Contrave to help you choose the right medication for your goals.

Quick Overview

Feature	Zepbound	Contrave
FDA Approved For	Obesity (2023)	Obesity (2014)
Active Ingredients	Tirzepatide (GLP-1 + GIP agonist)	Bupropion + Naltrexone (combo med)
Dosing	Weekly injection	Twice-daily oral pill
Mechanism	Hormone-based (GLP-1 + GIP)	Appetite/craving regulation via brain
Avg. Weight Loss	15–22.5% of body weight	5–9% of body weight

Zepbound works on gut hormones and metabolism, while Contrave targets brain pathways related to cravings and reward.

How They Work

Zepbound (tirzepatide)

• Mimics GLP-1 + GIP hormones

• Reduces appetite
• Slows digestion
• Improves insulin sensitivity
• Boosts fat burning

Contrave (bupropion/naltrexone)

• Affects the hypothalamus and reward system in the brain
• Reduces hunger and food cravings
• Often used for emotional eating or addiction-like behaviors

Weight Loss Comparison

Medication	Avg. Weight Loss	Study Reference
Zepbound	Up to 22.5%	SURMOUNT-1 Trial
Contrave	5–9%	CONQUER Trial

Zepbound produces more than double the weight loss in most patients.

Dosing and Convenience

• Zepbound: Inject once a week using an auto-pen
• Contrave: Take two pills daily (one morning, one evening)
  • Requires titration over 4 weeks to reach full dose

Zepbound is more low maintenance, while Contrave requires daily consistency.

Side Effects

Side Effect	Zepbound	Contrave
Nausea	Common	Common
Constipation	Sometimes	Sometimes
Headache	Rare	Reported
Insomnia	Rare	Common (bupropion-related)
Anxiety or jitteriness	No	Possible

Contrave is not recommended for people with seizure risk or uncontrolled high blood pressure.

Cost and Insurance

Factor	Zepbound	Contrave
Insurance Coverage	With BMI criteria	Sometimes (less consistent)
Retail Cost	~$1,060/month	~$99–$150/month (with coupon)
Savings Program	Zepbound Card	Contrave Direct Savings

Contrave is much cheaper, but may not be as effective for those needing substantial weight loss.

Who Should Choose Zepbound?

Ideal for:

• Moderate to severe obesity (20+ lbs to lose)
• Insulin resistance or metabolic issues (e.g., PCOS, prediabetes)
• Those who prefer once-a-week dosing
• Patients needing maximum clinical results

Who Might Choose Contrave?

Consider if:

• You struggle with emotional eating or binge patterns
• You prefer an oral medication
• You’re early in your weight loss journey
• You’re not eligible or not ready for injectables

Can You Take Both Together?

Some physicians combine Zepbound and Contrave for patients with:

• Food addiction patterns + metabolic dysfunction
• Emotional cravings that persist on GLP-1s alone

Always consult your provider before combining therapies.

Final Thoughts

Zepbound and Contrave both reduce appetite—but Zepbound has stronger metabolic effects and is much more effective for total weight loss. Contrave, however, is affordable, oral, and helpful for controlling cravings.

Zepbound = more effective, newer, hormone-based, and once-weekly
Contrave = cheaper, oral option targeting brain-based cravings

Visit our GLP-1 Comparison Guide to download dosing charts, view cost breakdowns, and get matched with a licensed provider.