Mounjaro alternatives: Your complete guide to weight loss options in 2025

Jump to: What are Wegovy and Mounjaro? | How these medications work | Clinical trials vs real-world results | Side effect comparison | Who might prefer each option? | Frequently asked questions | Take home message

Wegovy (semaglutide) is currently the best alternative to Mounjaro, with clinical trials showing 13.7% average weight loss compared to Mounjaro’s 20.2%.

Still, Second Nature’s research shows Wegovy can achieve 19.1% weight loss when combined with proper support.

Other alternatives include Saxenda (liraglutide) with 5-10% average weight loss, Orlistat with 2-3%, and non-medication approaches like behavioural programmes, which show 5-7% average weight loss when delivered effectively.

While Mounjaro (tirzepatide) offers the highest average weight loss in clinical trials, its recent price increases and limited availability make alternatives worth considering, especially when combined with comprehensive support.

There is no tablet version of Mounjaro available in the UK. All current weight loss medications that work through the GLP-1 pathway require injections.

Second Nature will be relaunching its Wegovy programme soon. Click here to join our waiting list.

Alternative	Type	Average Weight Loss	Side Effect Profile	NHS Availability
Wegovy	Weekly GLP-1 injection	13.7% in trials, 19.1% with Second Nature	Mild-moderate digestive issues, ~4% discontinuation rate	Limited specialist services
Saxenda	Daily GLP-1 injection	5-10%	Similar to Wegovy but potentially more pronounced	Limited specialist services
Orlistat	Oral medication	2-3%	Digestive issues, different mechanisms	Available via GP or OTC (Alli)
Behavioural programme	Non-medication	5-7%	No medication side effects	Available via NHS referral

Wegovy (semaglutide): The leading Mounjaro alternative

Wegovy contains semaglutide, a GLP-1 receptor agonist that works by mimicking a hormone produced in your gut after eating. It’s currently the most effective alternative to Mounjaro available in the UK.

Effectiveness compared to Mounjaro

The landmark SURMOUNT-5 trial directly compared these medications and found:

• Mounjaro produced 20.2% average weight loss
• Wegovy produced 13.7% average weight loss
• The 6.5% difference was statistically significant

However, Second Nature’s published research shows that people using Wegovy with comprehensive support achieve significantly better results, averaging 19.1% weight loss at 12 months, nearly matching Mounjaro’s effectiveness.

This research demonstrates that with proper support, the real-world gap between these medications can be much smaller than clinical trials suggest.

Safety profile

Wegovy has a slightly better discontinuation rate due to side effects compared to Mounjaro (~4% vs 6-8.5%), suggesting it may be marginally better tolerated by some individuals.

The common side effects include:

• Nausea (40-45%)
• Diarrhoea (25-30%)
• Constipation (20-25%)
• Vomiting (20-25%)

These side effects typically occur during dose escalation and often improve with time. Many can be managed with dietary adjustments and proper hydration.

Saxenda (liraglutide): The daily GLP-1 option

Saxenda contains liraglutide, an earlier-generation GLP-1 receptor agonist that works through a similar mechanism to Wegovy but requires daily rather than weekly injections.

Effectiveness

Clinical trials show Saxenda produces an average weight loss of 5-10% after one year, making it less effective than both Mounjaro and Wegovy but still a viable option.

The SCALE Obesity and Prediabetes trial found:

• 8.0% average weight loss with Saxenda vs 2.6% with placebo
• 63.2% of participants lost at least 5% of their body weight
• 33.1% lost at least 10% of their body weight

While it doesn’t lead to as much weight loss as newer options, these results still represent clinically meaningful weight loss that can improve health markers.

Safety considerations

Saxenda has a similar side effect profile to Wegovy, with digestive issues being the most common:

• Nausea (40-50%)
• Constipation (20-25%)
• Diarrhoea (15-20%)
• Vomiting (15-20%)

The daily injection requirement can mean more consistent hormone levels but also potentially more persistent side effects compared to weekly options.

Orlistat: The non-hormonal option

Orlistat works through an entirely different mechanism than GLP-1 medications, blocking fat absorption in the gut rather than affecting appetite or metabolism.

Effectiveness

Orlistat typically produces modest weight loss of 2-3% beyond diet and exercise alone:

• Clinical trials show an average weight loss of 2.9% more than placebo
• Results are significantly less dramatic than GLP-1 medications
• Works best when combined with a reduced-calorie, lower-fat diet

While these results are modest, Orlistat has the longest safety record of any prescription weight-loss medication currently available in the UK.

Side effect differences

Orlistat’s side effects are quite different from GLP-1 medications and directly related to its fat-blocking mechanism:

• Oily spotting or discharge
• Urgent bowel movements
• Fatty or oily stools
• Increased bowel movements

These effects tend to be more noticeable after high-fat meals and decrease as patients adapt their diet to include less fat.

Non-medication approaches

While medications can be effective tools, comprehensive lifestyle changes remain the foundation of sustainable weight management.

Evidence-based behavioural programmes

Structured behavioural programmes like Second Nature focus on developing sustainable habits rather than quick fixes:

• NHS-commissioned research shows average weight loss of 5-7% at 12 months
• Higher engagement correlates with better outcomes
• Benefits extend beyond weight loss to overall health improvement
• Skills learned support long-term weight maintenance

The advantage of these approaches is that they address the root causes of weight gain, like emotional eating and our habits, rather than just offering a crash diet and a quick fix.

Combined approaches: The multiplier effect

Second Nature’s research demonstrates that combining medication with comprehensive behavioural support produces superior results:

• 19.1% average weight loss with Wegovy + Second Nature vs 13.7% with Wegovy alone in clinical trials
• 61% of participants achieved at least 15% weight loss
• 70% reported no side effects after 12 months with proper support

This ‘multiplier effect’ occurs because behavioural support helps patients:

• Manage side effects more effectively
• Make dietary changes that complement the medication’s effects
• Develop sustainable habits for long-term success
• Address emotional and psychological aspects of eating

NHS pathway vs private options

The NHS offers several tiers of weight management services:

• Tier 1: Self-help and commercial weight management services
• Tier 2: Community-based lifestyle interventions (like Second Nature)
• Tier 3: Specialist weight management services
• Tier 4: Bariatric surgery

Referral pathways vary by region, with access to higher tiers often requiring progression through lower tiers first.

Private options offer more immediate access but at a higher cost, with combined medication and support programmes typically providing the best value for sustainable results.

Frequently asked questions

What is the best alternative to Mounjaro?

Wegovy (semaglutide) is currently the most effective alternative to Mounjaro, especially when combined with comprehensive support. Second Nature’s research shows that with proper support, Wegovy can achieve 19.1% weight loss, approaching Mounjaro’s 20.2% in clinical trials.

Which weight loss injection has the least side effects?

Among the major weight loss injections, Wegovy has a slightly lower discontinuation rate due to side effects (~4%) compared to Mounjaro (6-8.5%). However, individual responses vary significantly, and proper support can help manage side effects with any medication.

Which is better, Ozempic or Mounjaro?

Mounjaro shows greater average weight loss than Ozempic in clinical trials (20.2% vs 12-15%). However, Ozempic contains the same active ingredient as Wegovy (semaglutide) and may be more affordable and accessible for some patients, particularly those with diabetes where it’s often covered by insurance.

Which is safer, Wegovy or Mounjaro?

Both medications have similar safety profiles, but Wegovy has a slightly lower discontinuation rate due to side effects and a longer track record since approval. Long-term safety data continues to evolve for both medications, with ongoing monitoring by regulatory authorities.

Is there a natural version of Mounjaro?

No, there is no natural supplement that replicates Mounjaro’s dual GLP-1/GIP action or effectiveness.

While some dietary approaches may modestly increase natural GLP-1 production, these effects are minimal compared to medication.

Is there a tablet version of Mounjaro?

There is currently no tablet version of tirzepatide (Mounjaro) available in the UK. All current formulations require weekly injection.

While some oral GLP-1 medications exist in other markets, none are currently approved for weight management in the UK. All UK-approved GLP-1 weight loss medications require injection, whether daily (Saxenda) or weekly (Wegovy, Mounjaro).

How do I know which option is right for me?

The best approach depends on several factors:

• Your weight loss goals and health status
• Previous weight loss attempts
• Budget considerations
• Tolerance for potential side effects
• Preference for medication vs non-medication approaches
• Access to NHS vs private healthcare

A healthcare professional can help you evaluate these factors to determine the most appropriate option for your specific situation.

Take home message

While Mounjaro shows the highest average weight loss in clinical trials, effective alternatives exist, particularly when combined with comprehensive support.

Wegovy stands out as the leading alternative, with Second Nature’s research demonstrating that proper support can enhance its effectiveness to nearly match Mounjaro’s results (19.1% vs 20.2% weight loss).

The ‘best’ option depends on your individual circumstances, including health status, budget, and access to healthcare.

What matters most for long-term success is not just which medication you choose, but the support system and habit changes you develop alongside it.

Second Nature’s approach focuses on building sustainable lifestyle changes that enhance medication effectiveness and help maintain results long-term, addressing the root causes of weight gain rather than making dramatic changes in the short term that don’t last.