Zepbound vs Contrave: Hormonal vs Non-Hormonal Weight Loss

Zepbound vs Contrave: Hormonal vs Non-Hormonal Weight Loss

Introduction


Not all prescription weight loss medications work the same way. While Zepbound uses hormone-based action to suppress appetite and improve metabolism, Contrave takes a non-hormonal approach—targeting the brain’s reward system.


In this post, we compare Zepbound vs Contrave, so you can understand how each works, how much weight you can expect to lose, and which might be a better fit for your lifestyle and goals.


Fast Facts: Zepbound vs Contrave


Feature

Zepbound

Contrave

Type

Hormonal (GLP-1 + GIP)

Non-hormonal (bupropion + naltrexone)

FDA Approved For

Weight loss (2023)

Weight loss (2014)

Method of Use

Weekly injection

Daily oral pills (2x/day)

Avg. Weight Loss

15–22.5% of body weight

5–10% of body weight

Appetite Suppression

✅ Yes

✅ Yes

Craving Control

✅ Yes

✅ Strong (targets reward center)

How They Work


Zepbound (tirzepatide)

  • Mimics GLP-1 and GIP hormones

  • Slows digestion, increases satiety, lowers blood sugar

  • Reduces appetite and improves insulin sensitivity

  • Weekly injection

Contrave (naltrexone/bupropion)

  • Combines an antidepressant + addiction treatment med

  • Reduces cravings by acting on the hypothalamus and reward center

  • Helps with emotional eating and food addiction

  • Taken as two pills twice a day

Weight Loss Results


Medication

Average Weight Loss

Duration

Source

Zepbound

15–22.5% of body weight

72 weeks

SURMOUNT-1

Contrave

5–10% of body weight

56 weeks

COR-I & COR-II Trials

💡 Zepbound consistently delivers more weight loss than Contrave in clinical trials.


Side Effects Comparison


Symptom

Zepbound

Contrave

Nausea

✅ Common (early on)

✅ Possible

Constipation

✅ Mild

✅ Mild

Headache

⚠️ Rare

✅ Common

Insomnia

❌ Rare

✅ Possible (from bupropion)

Mood Changes

❌ Not typical

⚠️ Possible (monitor closely)

⚠️ Contrave contains bupropion, which may increase the risk of seizures in some people and may not be ideal for those with anxiety or depression.


Cost & Insurance


Medication

U.S. Retail Price

Discount Options

Insurance Coverage

Zepbound

~$1,060/month

Savings Card

✅ With prior authorization

Contrave

~$99–$130/month

ContraveDirect Program

✅ Often covered

💡 Contrave is less expensive out-of-pocket, especially without insurance.


Who Should Consider Zepbound?


✅ Best for people who:

  • Have significant weight to lose (30+ lbs)

  • Prefer once-weekly dosing

  • Struggle with insulin resistance, PCOS, or metabolic syndrome

  • Want a hormonal, appetite-resetting approach

Who Should Consider Contrave?


✅ Best for people who:

  • Struggle with food cravings or binge eating

  • Prefer oral medications over injections

  • Have mild to moderate weight loss goals

  • Have emotional eating patterns

⚠️ Not recommended for those with:

  • History of seizures

  • Uncontrolled high blood pressure

  • Current opioid use

  • History of eating disorders (bulimia/anorexia)

📌 Related: Contrave vs Qsymia – Which Oral Medication Works Best?


Final Thoughts


Zepbound and Contrave work in very different ways. Zepbound is ideal for those looking for powerful, long-term weight loss with a weekly injection. Contrave may work better for individuals struggling with cravings or food addiction who prefer a daily pill.


✔️ Zepbound = stronger weight loss, better for insulin resistance
 ✔️ Contrave = good for emotional eating, more affordable
 ✔️ Choose based on your biology, behavior, and medication preference


📌 Visit our Weight Loss Medication Comparison Hub for in-depth guides, tools, and doctor Q&A.