Semaglutide vs. Tirzepatide vs. Contrave: Which Weight-Loss Medication May Be Right for You?

Jul 14
6 min read

Written by Illumé Med Spa & Wellness · Medically reviewed by Kelcey DunWorth FNP

· Updated July 2026

If you have been searching for medical weight loss in Lee's Summit or Kansas City, you have probably encountered three common options: semaglutide, tirzepatide, and Contrave.

All three can support long-term weight management, but they are not interchangeable. Semaglutide and tirzepatide are generally administered as once-weekly injections, while Contrave is an oral medication. They work through different pathways, have different safety considerations, and may produce different levels of weight loss.

The quick answer

In a head-to-head clinical trial, tirzepatide produced greater average weight loss than semaglutide over 72 weeks. That does not automatically make tirzepatide the right medication for every patient. Semaglutide remains an effective, well-studied option, while Contrave may be considered for certain people who prefer an oral treatment or are not appropriate candidates for GLP-1–based medications.

The right choice depends on your medical history, current medications, weight-loss goals, side-effect tolerance, insurance or budget considerations, and how your body responds to treatment.

Semaglutide, Tirzepatide and Contrave at a Glance

Medication	How It’s Taken	How It Works	Key Considerations
Semaglutide	Once-weekly injection	GLP-1 receptor agonist	GI side effects; thyroid and pregnancy cautions
Tirzepatide	Once-weekly injection	Dual GIP + GLP-1 agonist	Most weight loss in a head-to-head trial; similar GI, thyroid and pregnancy cautions
Contrave	Oral tablets, twice daily	Naltrexone + bupropion (not a GLP-1)	Avoid with chronic opioid use, seizures, uncontrolled blood pressure or eating disorders

At a glance only — the full detail for each medication is below.

Important FDA-approval distinction: Wegovy is an FDA-approved semaglutide product for chronic weight management, Zepbound is an FDA-approved tirzepatide product for chronic weight management, and Contrave is FDA-approved as an oral weight-management medication. Compounded semaglutide and compounded tirzepatide are not FDA-approved products.

What Is Semaglutide?

Semaglutide is a GLP-1 receptor agonist. It acts similarly to a hormone your body naturally releases after eating and can help reduce calorie intake by influencing appetite and feelings of fullness.

Wegovy, a brand-name medication containing semaglutide, is FDA-approved for long-term weight reduction and maintenance in eligible patients when used alongside nutrition and physical-activity changes. It is typically administered once weekly, and the dosage is gradually increased to help the body adjust.

Semaglutide may be considered for someone who:

Wants a well-established weekly injectable option
Struggles with persistent hunger, portions or “food noise”
Has been unable to achieve sufficient results through lifestyle changes alone
Is comfortable with gradual dose adjustments and ongoing medical follow-up

Common side effects can include nausea, vomiting, diarrhea, constipation and abdominal discomfort. A provider should also review pregnancy plans, gastrointestinal history and any personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2.

What Is Tirzepatide?

Tirzepatide works through two hormone receptors: GIP and GLP-1. Zepbound, the FDA-approved tirzepatide product for chronic weight management, is administered as a once-weekly injection.

Because it activates two pathways, tirzepatide may provide stronger appetite and food-intake regulation for some patients. In a 2025 head-to-head clinical trial, adults receiving tirzepatide experienced greater average weight loss than those receiving semaglutide over 72 weeks.

Tirzepatide may be considered for someone who:

Is seeking a weekly injectable treatment
Has a larger amount of weight to lose
Has not reached the desired response with another approach
Is comfortable with provider-guided titration and regular monitoring

Tirzepatide can cause nausea, diarrhea, vomiting, constipation, abdominal discomfort and other gastrointestinal symptoms. It also carries important pregnancy, thyroid and medical-history considerations that should be reviewed before treatment. Greater average weight loss does not mean tirzepatide will automatically be the safest, most affordable or most tolerable option for every person.

What Is Contrave?

Contrave is a prescription oral medication containing naltrexone and bupropion. It is not a GLP-1 medication and does not work like semaglutide or tirzepatide.

It may be valuable for certain patients who prefer an oral option, are uncomfortable with injections or need a treatment that approaches appetite and craving-related eating differently.

Contrave is gradually increased over several weeks, and its usual maintenance regimen involves tablets taken in the morning and evening. It is therefore more involved than simply taking one pill once a day.

Contrave may be considered for someone who:

Strongly prefers an oral medication
Is not an appropriate candidate for a GLP-1–based treatment
Experiences persistent cravings or reward-driven eating
Wants to explore a different medication and pricing structure

Contrave is not appropriate for everyone. It should not be used by people with uncontrolled hypertension, seizure disorders, chronic opioid use, certain eating disorders, or those taking other bupropion-containing medications. It also carries warnings related to mood and suicidal thoughts or behaviors, particularly in younger patients. A complete medication review is especially important because the naltrexone component can interfere with opioid pain medications.

Which Medication Leads to the Most Weight Loss?

On average, tirzepatide has produced greater weight reduction than semaglutide in direct clinical comparison, while Contrave generally produces more modest average weight loss in its individual clinical trials. However, results from different studies should not be treated as guarantees for an individual patient. The medication with the highest average result is not necessarily the medication you will tolerate best or remain consistent with long term.

Your provider should also consider:

Your current medications
Blood pressure and cardiovascular history
History of pancreatitis, gallbladder problems or gastrointestinal symptoms
Personal or family thyroid-cancer history
Mental-health and seizure history
Opioid pain-medication use
Pregnancy plans
Previous weight-loss treatments
Insurance coverage and realistic long-term affordability

Why Medical Supervision Makes a Difference

Getting access to medication is only one part of successful medical weight loss. A complete program should also help determine whether you are losing primarily body fat or sacrificing too much lean muscle. It should address protein intake, strength training, hydration, side effects, dosage changes and what happens after you reach your initial goal.

At Illumé Med Spa & Wellness, your program may include:

A personalized consultation and medical-history review
Lab review or testing when clinically appropriate
Provider-guided medication selection and dosage adjustments
InBody body-composition scans to measure body fat and lean mass
Protein and strength recommendations designed to protect muscle
Ongoing progress and side-effect monitoring
A personalized maintenance strategy rather than an abrupt ending

The scale only shows total weight. InBody tracking allows our providers and patients to see whether weight changes are coming from body fat, lean tissue or water — information that can lead to better decisions throughout treatment.

Frequently Asked Questions

Is Contrave a GLP-1 medication?

No. Contrave contains naltrexone and bupropion and works differently from GLP-1–based medications such as semaglutide and tirzepatide.

Is tirzepatide better than semaglutide?

Tirzepatide produced greater average weight loss in a direct clinical trial, but “better” depends on your medical history, side effects, medication access, goals and personal response.

Which option is best if I do not want injections?

Contrave is an oral option. However, preference for a pill is only one factor. Your provider must also evaluate blood pressure, seizure history, opioid use, mental-health history and possible medication interactions.

Will I lose muscle while taking weight-loss medication?

Some lean-mass loss can occur during any significant weight-loss process. Adequate protein, resistance training, appropriate calorie intake and body-composition monitoring can help protect lean tissue.

Do I need laboratory testing before starting?

Testing should be individualized. Depending on your health history and symptoms, your provider may recommend reviewing blood sugar, kidney and liver function, thyroid markers or other relevant laboratory results.

What happens when I reach my goal?

Reaching your goal weight should begin the maintenance phase — not end your care. Your provider may adjust your medication, nutrition plan, activity goals and monitoring schedule based on your progress and risk of regain.

Medical Weight Loss in Lee's Summit and Kansas City

Illumé Med Spa & Wellness provides personalized medical weight-loss care in Lee's Summit for patients throughout Kansas City, Blue Springs, Independence, Raymore, Pleasant Hill, Greenwood, Overland Park and surrounding communities.

Instead of choosing a medication based solely on social-media trends, our providers review your health history, goals, body composition and previous experiences to determine whether semaglutide, tirzepatide, Contrave or another approach may be appropriate.

Ready to compare your options? Schedule a private medical weight-loss consultation with Illumé Med Spa & Wellness, or call or text 816-214-5260.

Prescription treatment requires an evaluation by a licensed medical provider. Not every patient is a candidate. This article is educational and does not replace individualized medical advice. Individual results vary.