Mounjaro alternatives at a glance
| Alternative |
Type |
Average weight loss |
How it’s taken |
UK availability |
| Wegovy 2.4 mg |
GLP-1 receptor agonist |
13.7% in trials; 19.1% with Second Nature support1,3 |
Weekly injection |
Private and limited NHS |
| Wegovy 7.2 mg |
GLP-1 receptor agonist (higher dose) |
20.7% in the STEP UP trial2 |
Weekly injection |
Private (MHRA approved January 2026) |
| Wegovy pill |
GLP-1 receptor agonist (oral) |
13.6% in the OASIS 4 trial9 |
Daily tablet (empty stomach) |
Private (MHRA approved June 2026) |
| Saxenda |
GLP-1 receptor agonist |
5-10%4 |
Daily injection |
Private and limited NHS |
| Orlistat |
Lipase inhibitor |
2-3% beyond diet alone5 |
Oral tablet (up to 3 times daily) |
GP prescription or OTC (Alli) |
| Behavioural programme |
Non-medication |
5-7% |
N/A |
NHS referral or private |
For comparison, Mounjaro (tirzepatide) produces an average weight loss of around 20.2% in a trial that compared it directly with Wegovy 2.4 mg.1
Wegovy (semaglutide 2.4 mg)
Wegovy contains semaglutide, a GLP-1 receptor agonist that mimics a hormone your gut produces after eating. It reduces appetite and slows digestion, helping you eat less without constant hunger.
It’s the most widely prescribed alternative to Mounjaro in the UK, with a longer track record and more extensive safety data.
How it compares to Mounjaro
The SURMOUNT-5 trial compared these two medications directly1:
- Mounjaro produced 20.2% average weight loss
- Wegovy 2.4 mg produced 13.7% average weight loss
- The 6.5 percentage point difference was statistically significant
Those are clinical trial results in which participants receive medication without comprehensive behavioural support. In practice, the weight loss you can achieve with either medication can be similar.
Second Nature’s published research in JMIR Formative Research found that people using Wegovy 2.4 mg with dietitian-led coaching and a structured behaviour change programme achieved an average weight loss of 19.1% at 12 months.3 That’s within one percentage point of Mounjaro’s trial results.
These results suggest that when Wegovy is combined with dietitian-led coaching and structured habit change, the real-world gap between Wegovy and Mounjaro is much smaller than clinical trials suggest.
Side effects
Wegovy has a slightly lower discontinuation rate due to side effects than Mounjaro (roughly 4% vs 6-8.5%), meaning fewer people stop treatment because of tolerability issues.1
The most common side effects include:
- Nausea (40-45%)
- Diarrhoea (25-30%)
- Constipation (20-25%)
- Vomiting (20-25%)
These typically occur during dose escalation and improve over time. Second Nature’s research found that 69% of participants reported no side effects by month 12.3
Wegovy 7.2 mg
In January 2026, the MHRA approved a higher dose of Wegovy, 7.2mg, for adults with obesity (BMI 30 or above).6
The Phase 3b STEP UP trial tested the 7.2mg dose in 1,407 adults with obesity and found2:
- 20.7% average weight loss at 72 weeks (compared to 17.5% with the 2.4mg dose)
- 33.2% of participants lost 25% or more of their body weight
- 90.7% achieved at least 5% weight loss
This puts Wegovy 7.2 mg roughly on par with Mounjaro’s clinical trial results.
Who’s it for?
The 7.2 mg dose isn’t a starting dose. It’s intended for people who have already been taking Wegovy 2.4 mg for at least four weeks, and either haven’t reached their weight-loss goals or have hit a plateau.
The 7.2 mg dose is now available through private providers. NHS availability will depend on a NICE health technology assessment, which typically takes 6-9 months after regulatory approval.
Side effects at the higher dose
The safety profile at 7.2 mg was consistent with that at 2.4 mg. Gastrointestinal side effects were slightly more common (71% vs 61%) and mostly mild to moderate during dose escalation. Only 3.3% discontinued due to gastrointestinal side effects.2
One notable difference: dysaesthesia (unusual skin sensations such as tingling or numbness) was reported in 22.9% of participants on 7.2 mg, compared to 6% on 2.4 mg.2
Wegovy pill (oral semaglutide 25 mg)
The Wegovy pill contains the same drug as the Wegovy injection, semaglutide, in a daily tablet rather than a weekly injection.
The MHRA approved it on 11 June 2026, the first GLP-1 weight-loss tablet licensed in the UK.10
It reached private providers, including Second Nature, in July 2026.
Effectiveness
In the OASIS 4 trial, participants taking the 25 mg tablet lost an average of 13.6% of their body weight over 64 weeks.9
That’s broadly the same as the 2.4 mg injection, and less than the 7.2 mg dose or Mounjaro.
The tablet has to survive stomach acid and cross the gut wall, so it requires a much higher dose than the injection to deliver a comparable amount of semaglutide into the bloodstream.
How it’s taken
The main difference from the injection is the daily routine. The tablet is taken first thing in the morning on an empty stomach, with a sip of water, followed by a 30-minute wait before food, drink, or other tablets.10
Eating or drinking too soon reduces the amount of the dose absorbed, which makes the timing of the dose more important than with the injection.
The dose starts at 1.5 mg and increases in steps to 25 mg, with at least a month at each level.
Availability
The Wegovy pill is available privately, including by pre-order through Second Nature if you’re eligible.
It isn’t yet available on the NHS. NHS access would follow a separate NICE appraisal, which is unlikely before 2027.
For a fuller comparison of the tablet and the injection, see our Wegovy pill guide.
Saxenda (liraglutide): the daily GLP-1 option
Saxenda contains liraglutide, an earlier-generation GLP-1 receptor agonist. It works through a mechanism similar to Wegovy but requires daily injections rather than weekly injections.
Effectiveness
The SCALE Obesity and Prediabetes trial found4:
- 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%
These results are meaningful but significantly lower than both Mounjaro and Wegovy. Saxenda may still be appropriate if you’ve tried newer GLP-1 medications and experienced side effects, or if your prescriber recommends it based on your medical history.
Side effects
Saxenda’s side effect profile is similar to other GLP-1 medications:
- Nausea (40-50%)
- Constipation (20-25%)
- Diarrhoea (15-20%)
- Vomiting (15-20%)
The daily injection schedule means more consistent hormone levels, but some people find the daily routine less convenient than weekly alternatives.
The brand Saxenda has been discontinued by Novo Nordisk, but generic liraglutide is still available in the UK under the brand name Nevolat, which is manufactured by the pharmaceutical company Zentiva.
Orlistat
Orlistat works through a completely different mechanism than Mounjaro, Wegovy, and Saxenda.
Rather than mimicking hormones that help us feel fuller for longer, it blocks roughly one-third of the fat you eat from being absorbed.5
Effectiveness
Orlistat typically produces modest weight loss of 2-3% beyond that achieved with diet and exercise alone.5
Results are significantly lower than those of GLP-1 medications, but it has the longest safety record of any prescription weight-loss medication currently available in the UK.
It works best when combined with a lower-fat diet. Higher-fat meals will noticeably increase side effects.
Side effects
Orlistat’s side effects are directly related to its fat-blocking mechanism and quite different from GLP-1 medications:
- Oily spotting or discharge
- Urgent bowel movements
- Fatty or oily stools
- Increased bowel movements
These effects decrease as you adapt your diet to include less fat, but they can be socially inconvenient in the early stages.
Availability
Orlistat is the most accessible weight-loss medication in the UK. You can get the full 120 mg dose on prescription from your GP, or buy the lower-dose 60 mg version (sold as Alli) over the counter at pharmacies.
Non-medication approaches
Medications aren’t the only option for weight loss, and they’re not always necessary.
Structured behavioural programmes can produce meaningful results, and the habits you build through them are essential for maintaining long-term weight loss, whether you’re taking medication or not.
Evidence-based behavioural programmes
NHS-commissioned research shows that structured digital behavioural programmes produce an average weight loss of 5-7% at 12 months.7 That’s enough to produce clinically meaningful improvements in blood pressure and blood sugar.
These programmes work by helping you change the eating habits and behaviours that led to weight gain in the first place.
Developing healthy habits to lose weight sustainably is crucial. Research shows that around two-thirds of people regain weight within a year of stopping GLP-1 medication without behaviour change support.8
Combining medication with behavioural support
Second Nature’s research shows that combining semaglutide with dietitian-led coaching produces better results than medication alone3:
- 19.1% average weight loss at 12 months (compared to 13.7% with medication alone in clinical trials)
- 77.7% of participants achieved at least 10% weight loss
- 69% reported no side effects by month 12
These results suggest that behavioural support helps in two ways: it improves weight-loss outcomes and helps people manage side effects more effectively, enabling them to stay on treatment for longer.
Choosing a provider for Mounjaro alternatives
If you’re considering switching from Mounjaro or starting on an alternative, the provider you choose matters as much as the medication.
UK providers broadly fall into two categories: prescription-only services (pharmacies and online prescribers that supply medication without ongoing support) and programme-based providers (services that combine medication with coaching, dietary guidance, and behaviour-change support).
Second Nature’s published research shows 19.1% weight loss with Wegovy plus structured support, compared to 13.7% with medication alone in clinical trials.3 If you’re comparing options, these are the key things to consider:
- Clinical credentials: who is prescribing and monitoring your medication? Are the support staff registered healthcare professionals?
- Published evidence: has the provider published their outcomes in a peer-reviewed journal, or are they citing internal data?
- Ongoing support: do they offer dietitian or nutritionist support, or just a prescription?
- Long-term plan: what happens when you want to come off medication? Do they have a plan for maintenance?
Second Nature provides registered dietitians and nutritionists alongside medication, a structured four-phase behaviour change programme, and peer-reviewed published outcomes in JMIR Formative Research.3
We’ve put together detailed comparisons of how we differ from other UK providers:
What’s on the horizon
The weight-loss medication landscape is changing quickly. Several new treatments are in development that may become available in the UK within the next one to two years.
Retatrutide (triple-agonist)
Retatrutide is a next-generation injection from Eli Lilly that targets three hormone receptors (GLP-1, GIP, and glucagon) rather than the two that Mounjaro targets.
In May 2026, Eli Lilly reported the first Phase 3 results (TRIUMPH-1), with an average weight loss of 28.3% at 80 weeks on the highest dose, the highest reported for any obesity medication to date.
Eli Lilly is expected to file for approval before the end of 2026, so UK availability is unlikely before 2027.
You can read more in our guide to retatrutide.
Orforglipron (Foundayo)
Orforglipron is a second-daily GLP-1 pill from Eli Lilly, now branded as Foundayo. Unlike the Wegovy pill, it’s a small-molecule drug that can be taken at any time of day, with or without food.
The FDA approved Foundayo in April 2026. In its main trial (ATTAIN-1), participants lost an average of 11.1% of their body weight.
It isn’t yet licensed in the UK. An MHRA decision would be the next step before it becomes available here.
Frequently asked questions
What is the best alternative to Mounjaro?
Wegovy (semaglutide) is currently the most effective alternative. At the standard 2.4 mg dose, clinical trials show 13.7% average weight loss.
The newer 7.2mg dose (approved in the UK in January 2026) achieves 20.7%, roughly matching Mounjaro’s clinical trial results.1,2
Second Nature’s research shows Wegovy 2.4 mg with dietitian-led coaching achieves 19.1% weight loss at 12 months.3
Can I switch from Mounjaro to Wegovy?
Yes. You’ll need to wait at least 7 days between your last Mounjaro dose and your first Wegovy dose, and a prescriber should assess whether the switch is appropriate for you.
Is Wegovy 7.2mg as effective as Mounjaro?
The data suggest they’re comparable. Wegovy 7.2 mg achieved an average weight loss of 20.7% in the STEP UP trial, compared with 20.2% in the SURMOUNT-5 trial for Mounjaro, compared with Wegovy 2.4 mg.1,2
These were different trials with different populations, so direct comparison has limitations, but the results are in the same range.
How much does Wegovy cost compared to Mounjaro?
Prices vary by provider and dose. Since Mounjaro’s September 2025 price increase, Wegovy is generally cheaper at the 2.4 mg dose.
Wegovy 7.2 mg costs more than the 2.4mg dose (around £329 per month through some providers), which is closer to Mounjaro’s pricing. Check with your chosen provider for their current prices, as these change regularly.
Which weight-loss injection has the fewest side effects?
Among the major options, Wegovy 2.4 mg has a slightly lower discontinuation rate due to side effects compared to Mounjaro (roughly 4% vs 6-8.5%).1
Wegovy 7.2 mg has a discontinuation rate of about 3.3%, similar to the lower dose.2 Individual responses vary, and proper support can help manage side effects with any medication.
Can I get Mounjaro alternatives on the NHS?
Wegovy is available through some NHS specialist weight management services, but access is limited and varies by region. Orlistat is available on GP prescription.
Saxenda is available through specialist services in some areas. For most people, private providers offer faster access.
Is there a tablet version of Mounjaro?
There is no tablet version of tirzepatide (the drug in Mounjaro) available anywhere in the world.
There is now a tablet version of Wegovy, though. The MHRA approved the Wegovy pill (oral semaglutide 25 mg) in June 2026, and it became available privately in the UK in July 2026.10
Is there a natural version of Mounjaro?
No supplement or natural product replicates Mounjaro’s dual GLP-1/GIP action or produces comparable weight loss.
Some dietary approaches may modestly increase endogenous GLP-1 production, but the effects are minimal compared with medication.
What is the cheapest weight-loss injection in the UK?
Wegovy 2.4 mg is generally the cheapest weekly GLP-1 injection for weight loss in the UK since Mounjaro’s price increase. Saxenda requires daily injections, and the monthly cost varies by provider.
Orlistat (a tablet, not an injection) is the cheapest overall prescription weight-loss medication and is available over the counter at a lower dose.
What happens when I stop taking weight-loss medication?
Research shows that around two-thirds of people regain weight within a year of stopping GLP-1 medication if they haven’t made lasting lifestyle changes.8 This is why it’s important to combine weight-loss medications with lifestyle change support.
Take home message
Mounjaro produces the highest average weight loss in clinical trials, but effective alternatives exist, particularly since the approval of Wegovy 7.2 mg in January 2026.
Wegovy 7.2 mg now achieves results comparable to Mounjaro, with an average weight loss of around 20.7%.
Even at the standard 2.4mg dose, Second Nature’s published research shows that dietitian-led coaching and structured habit change can close the gap, with participants averaging 19.1% weight loss at 12 months.
Semaglutide is now available as a tablet too. The Wegovy pill produced an average weight loss of 13.6% in trials, broadly the same as the standard 2.4 mg injection, and it gives people who would rather not inject another way to take the same drug.
Research shows that around two-thirds of people regain weight within a year of stopping GLP-1 medication without lasting habit changes.8
Second Nature's Mounjaro and Wegovy programmes
Second Nature provides Mounjaro or Wegovy as part of our Mounjaro and Wegovy weight-loss programmes.
Why choose Second Nature over other medication providers, assuming you're eligible?
Because peace of mind matters.
We've had the privilege of working with the NHS for over eight years, helping people across the UK take meaningful steps toward a healthier, happier life.
Our programmes are designed to meet people where they are, whether that means support with weight loss through compassionate one-to-one health coaching, or access to the latest weight-loss medications (like Mounjaro and Wegovy) delivered alongside expert care from a multidisciplinary team of doctors, psychologists, dietitians, and personal trainers.
At the heart of everything we do is a simple belief: real, lasting change comes from building better habits, not relying on quick fixes. We're here to support that change every step of the way.
With over a decade of experience, thousands of lives changed, and a long-standing record of delivering programmes used by the NHS, we believe we're the UK's most trusted weight-loss programme.
We hope to offer you something invaluable: peace of mind, and the support you need to take that first step.
