Question 1

Wegovy vs Zepbound side effects — which is more tolerable?

Accepted Answer

Side effects of Wegovy (semaglutide) and Zepbound (tirzepatide) overlap heavily — nausea, constipation, diarrhea, fatigue, headache. SURMOUNT-1 vs SELECT discontinuation rates are within 1-2 percentage points. Patient reports on Reddit (r/Zepbound, r/WegovyWeightLoss) suggest qualitative differences: Wegovy users describe more "sulfur burps" (a semaglutide-specific finding) while Zepbound users report more fatigue at maintenance doses (10mg+). Tirzepatide users report less food noise but stronger weight-loss effect. If you have severe GI sensitivity, slower titration helps with either drug. If you have a history of pancreatitis, both drugs carry similar warnings.

Question 2

Does Wegovy cause hair loss?

Accepted Answer

Wegovy doesn't directly cause hair loss, but rapid weight loss (>1.5% body weight/month sustained) triggers telogen effluvium — a stress response that pushes more hair follicles into the resting/shedding phase. Onset: months 2-4. Peak: month 4-5. Resolution: month 6-8 with full regrowth. Mitigation: adequate protein (1.4g/kg body weight/day), iron + vitamin D supplementation if deficient, biotin (modest evidence), avoid harsh styling during shedding phase. If shedding persists past month 8 или is severe, check ferritin, vitamin D, thyroid — could be unrelated cause unmasked by weight loss.

Question 3

Does Wegovy make you tired?

Accepted Answer

Fatigue on Wegovy is common — 10-15% of users in STEP-1 trial. Mechanisms: (1) Reduced caloric intake (often -500 to -1000 kcal/day) during titration leaves body without usual energy supply. (2) GI side effects disrupt sleep. (3) Dehydration from reduced food/water intake. (4) Possibly direct GLP-1 effect on sleep architecture. Timing: peaks weeks 1-4, resolves by month 3 for most. Mitigation: adequate protein (1.4g/kg/day), iron + B12 + vitamin D check if persistent, electrolyte awareness (sodium loss), slower titration if severe. Persistent fatigue past month 3: rule out anemia, thyroid changes, sleep apnea.

Zepbound and constipation

When constipation appears

Why it happens

What to do

What the evidence says