Introduction

Ozempic and Zepbound are two of the most talked-about weight loss medications today. Both are weekly injections. Both can help with weight loss and insulin resistance. But there’s a big legal and clinical distinction between them: Zepbound is FDA-approved for weight loss, while Ozempic is not.

 

So should you take Ozempic off-label, or stick with an on-label medication like Zepbound? In this guide, we’ll break down the differences, pros and cons of each, and what it means for insurance, safety, and long-term success.

 

What Does “Off-Label” Mean?

Off-label use means a medication is prescribed for something outside of its FDA-approved use. Doctors are legally allowed to prescribe off-label if they believe it’s medically appropriate—but it may affect:

• Insurance coverage
  

• Pharmacy fulfillment
  

• Legal protections for providers
  

• Patient education and expectations
  

FDA Approval Breakdown

Medication	FDA-Approved For	FDA-Approved For Weight Loss?
Zepbound	Chronic weight management	Yes (since 2023)
Ozempic	Type 2 diabetes	No (off-label for weight loss)

Wegovy is the weight loss–specific version of semaglutide, the same active ingredient as Ozempic.

 

Zepbound vs Ozempic: Quick Comparison

Feature	Zepbound	Ozempic
Active Ingredient	Tirzepatide	Semaglutide
Hormones Targeted	GLP-1 + GIP	GLP-1 only
FDA Weight Loss Approval	Yes	No
Average Weight Loss	Up to 22.5%	~10–15%
Coverage for Obesity	Growing	Often denied (off-label)

Learn more: Zepbound vs Wegovy – Which Is Better?

Why Some People Still Take Ozempic for Weight Loss

It’s widely available
Some insurance plans cover it for diabetes or prediabetes
It may be cheaper than Wegovy or Zepbound (in some cases)
Doctors familiar with semaglutide may prefer prescribing it

 

However, because it’s off-label for weight loss, coverage is not guaranteed, and pharmacies may refuse to fill prescriptions not backed by a diabetes diagnosis.

 

Zepbound: Why It’s the Preferred On-Label Option

FDA-approved specifically for chronic weight management
Dual hormone targeting = more powerful appetite and fat control
Easier to justify for insurance coverage with obesity diagnosis
Eligible for Zepbound Savings Card: Apply here

Backed by clinical trials like SURMOUNT-1 showing superior weight loss vs other medications.

Insurance Coverage Differences

Situation	Zepbound	Ozempic
Covered for weight loss	Sometimes	Rarely
Covered for diabetes	Not applicable	Often
Requires prior authorization	Likely	For diabetes
Can use with obesity diagnosis	Yes	Not officially

See: Is Zepbound Covered by Insurance in 2025?

Final Thoughts

Ozempic and Zepbound can both help with weight loss—but Zepbound is the only one FDA-approved for it. That means easier insurance approval, stronger trial data, and fewer roadblocks.

Choose Zepbound if you’re seeking a weight loss–specific treatment with full FDA backing
Consider Ozempic only if it’s the only covered option and you understand the off-label implications
Always discuss risks, costs, and long-term planning with your provider

Need help deciding? Visit our GLP-1 Match Tool to compare your eligibility, insurance coverage, and out-of-pocket costs for Zepbound, Ozempic, Wegovy, and more.