Introduction

When it comes to prescription appetite suppressants, two medications often make the list: Zepbound, a modern GLP-1 + GIP injectable, and Qsymia, a long-standing combo pill approved for weight loss.

But they’re very different in how they work, how much weight you can lose, and how your body responds.

In this blog, we’ll compare Zepbound vs Qsymia so you can understand which might be the better option for your weight loss journey.

Quick Comparison

Feature	Zepbound	Qsymia
FDA Approved For	Obesity (2023)	Obesity (2012)
Medication Type	Weekly injectable	Daily oral pill
Active Ingredients	Tirzepatide (GLP-1 + GIP agonist)	Phentermine + Topiramate
Avg. Weight Loss	15–22.5% of body weight	6–11% of body weight

Zepbound is hormone-based. Qsymia is a stimulant + anticonvulsant combo that works through the central nervous system.

How They Work

Zepbound (tirzepatide)

• Mimics GLP-1 and GIP hormones
• Suppresses appetite
• Improves insulin sensitivity
• Slows digestion
• Supports long-term fat burning

Qsymia (phentermine/topiramate)

• Phentermine: Stimulates the CNS to reduce hunger
• Topiramate: Reduces cravings and may increase satiety
• Together, they blunt appetite and alter brain chemistry

Qsymia affects neurotransmitters, while Zepbound mimics natural gut hormones.

Weight Loss Effectiveness

Medication	Avg. Weight Loss	Study Reference
Zepbound	Up to 22.5%	SURMOUNT-1
Qsymia	6–11%	EQUIP & CONQUER Trials

Zepbound offers more than double the weight loss on average.

Side Effects

Side Effect	Zepbound	Qsymia
Nausea	Common	Common
Constipation	Sometimes	Sometimes
Insomnia	Rare	Due to phentermine
Tingling (paresthesia)	Rare	Reported with topiramate
Mood/Anxiety Changes	Rare	Possible

Qsymia can affect mental alertness, mood, or sleep. Zepbound’s side effects are mostly GI-related and temporary.

Dosing & Convenience

Zepbound

• Once-weekly injection
• Simple, prefilled pen
• Less daily planning

Qsymia

• Daily oral pill
• Requires slow titration
• Multiple strengths

Cost and Coverage

Factor	Zepbound	Qsymia
Retail Price	~$1,060/month	~$200/month (with coupon)
Insurance Coverage	With BMI criteria	Some plans; often limited
Savings Card	Zepbound Card	Qsymia Savings

Qsymia is more affordable, but less likely to be covered for severe obesity or metabolic conditions.

Who Should Choose Zepbound?

Best for:

• People needing 20+ pounds of weight loss
• Patients with insulin resistance, PCOS, or prediabetes
• Those looking for hormone-based, long-term treatment
• Individuals who prefer once-weekly injections

Who Might Choose Qsymia?

Consider Qsymia if:

• You prefer an oral medication
• You’ve responded well to stimulants in the past
• You’re looking for a more budget-friendly option
• You want a non-injection pathway

Can You Combine Them?

Not typically recommended.

Both suppress appetite, but combining a stimulant with a GLP-1 can increase side effects and doesn’t necessarily improve results. Only consider with medical supervision.

Final Thoughts

Both Zepbound and Qsymia are FDA-approved and effective for weight loss—but they work differently and suit different patients.

Zepbound = strongest weight loss results, metabolic effects, once-weekly
Qsymia = cheaper, oral option with moderate results but stimulant-related effects

Visit our Weight Loss Medication Comparison Hub for downloadable guides, savings links, and telehealth access.