Semaglutide vs. tirzepatide: I've been on both.
- I started on semaglutide, lost about 40 pounds, and felt sick a lot of the time.
- I switched to tirzepatide. Weight came off slower, but I felt better and stayed more consistent.
- If cost is the deciding factor, semaglutide is usually cheaper. If it isn't, I lean tirzepatide for how I felt. Your doctor gets the final say.
I get this question almost every day.
"Semaglutide or tirzepatide? Which one worked better for you? Do you regret switching?"
For a long time I dodged it, because the honest answer is messy. But I've been on both. I'm three years into this, more than 75 pounds down, and still going. So here's what it actually looked like for me, the good parts and the not so cute parts.
One thing before we start: I'm not a doctor, and this isn't a recommendation. It's one woman's real experience. Your provider knows your body, your history, and your insurance. Take this to them as a conversation starter, not a decision.
How I got started
When I walked into a weight loss clinic for the first time, I didn't even know what a GLP-1 was. I went in asking about a completely different program I'd heard about. They told me about semaglutide instead.
I started on a compounded version that dissolved under my tongue. No needles, just a little something every morning. I lost about 7 pounds that first month. Then I went home and spent days on TikTok trying to figure out what I'd just started putting in my body.
That's honestly why I started sharing online. There weren't many regular women talking about what this was really like, and I wanted to document it for me and for whoever needed it. Three years later, here we are.
By month two I'd moved to weekly injections. By month six, I was down about 40 pounds.
My honest time on semaglutide
I felt bad. Not dramatic, call-in-sick bad. Just steadily, routinely bad.
- Sulfur burps. If you know, you know.
- Stomach issues. The kind that make you plan your day around a bathroom.
- Exhaustion. The bone-tired kind, even on days I slept.
And because of that, I was inconsistent. Vacation coming up? I'd skip my shot. Period starting? Skip. Anything on the calendar I didn't want to feel sick for? Skip.
I never made it very far up in dose. Every time I tried to go up, it knocked me flat. And I teach sixth grade. I have a room full of kids in front of me all day. I can't run out mid-lesson. I can't put my head on my desk when I'm wiped out. Side effects that someone else might be able to push through just weren't an option for my life.
By fall, I'd stalled. I took a few weeks off for a trip, came back, restarted at the lowest dose, and the weight loss had stopped. I was frustrated and done feeling awful.
Why I switched
I'd love to tell you it was a carefully researched decision. It wasn't, totally. Everyone was suddenly talking about tirzepatide, and my ADHD brain needed to try it. That's the honest version.
But I also had real reasons. I'd stalled. The side effects weren't worth it anymore. And I wanted to know if something would feel different.
I was already working with a telehealth provider, so I asked if I could switch. They said yes and moved me over. I'd been on semaglutide for about nine months, lost roughly 40 pounds, and then stopped losing for those last few months because I kept skipping doses.
If you're thinking about switching, that's exactly the conversation to have with your provider. They can walk you through timing, dosing, and what to expect. Don't DIY it.
What tirzepatide actually felt like
The side effects were less. Not gone, but less. Where semaglutide had me miserable, tirzepatide felt manageable. And because I felt better, I took it more consistently.
Here's the part people don't expect: my weight loss was slower. I went from around 215 to 199 in about five months. Hitting onederland felt huge, but that pace was slower than my early semaglutide months.
Here's how I make sense of that. On semaglutide, a lot of foods I loved made me sick, so I just didn't eat them. That probably helped the scale, but it was a miserable way to live. On tirzepatide, I could eat more normally. That meant I had more freedom, and also more responsibility, because the medication wasn't making less helpful choices feel terrible anymore.
So did semaglutide "work better"? Maybe, for the number. But I also felt awful, and I was leaning on extra supplements just to get through my days. Feeling like a person again counts for a lot.
What I've learned three years in
I haven't been perfect. I took months off at one point, and the scale went back up about 20 pounds before I got back on track. I've had dose increases that made for a rough couple of days, a headache, tired, a little queasy. But nothing close to what my early months felt like. If you want the full story of what going up in dose was like for me, I wrote about why I didn't keep increasing my dose.
A few things I'd tell a friend:
- Consistency beats speed. The medication you can actually stay on will do more for you than the "stronger" one you keep skipping.
- Side effects are worth a call. If you feel bad all the time, tell your provider. There may be options, like adjusting dose or timing.
- Your pace is your pace. Comparing your month three to someone else's month three will make you feel crazy. If that's you, read the weight loss timeline nobody is showing you.
- Food still matters. The medication turns down the noise. It doesn't plan your dinners. That's why I built Picky Girl HQ.
So which one is better?
Honestly? I can't tell you. And I've lived both.
What I can tell you is how I think about it now:
If cost is the biggest factor, semaglutide has usually been the more affordable option out of pocket. Prices and coverage change a lot, so check what's true for you right now.
If cost isn't the deciding factor, I lean tirzepatide, not because it "works better," but because for me the side effects were easier to live with. That meant I showed up more consistently, and consistency is everything with this.
Both can work. Both have helped a lot of women. The best one for you is the one you can actually stay on, with a provider who listens when you tell them how you feel.
I don't regret switching. I also can't prove it was the "right" call. After three years, I'm okay sitting in that, because I feel so much better than I did at 277 pounds, and I'm still going.
If you're just getting started and want the rest of what I wish I'd known, read what I'd do differently if I started today and grab my free GLP-1 Roadmap.
Want to talk this through with women who get it?
- Daily threads where you can ask "has anyone switched?" and get real answers.
- Sunday weigh-ins with me, the real numbers, every week.
- Picky Girl HQ and the GLP-1 Hub included with yearly.
Yearly members also get Picky Girl HQ and the GLP-1 Hub included.
Tell me: which one are you on, and how's it going? Come tell me over on Girl Code Daily.
Quick note: I'm not a doctor. This is my personal experience, not medical advice. Talk to your provider about anything related to your medication, your dose, or your health.
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