Semaglutide vs Liraglutide
It is the shot behind Ozempic and Wegovy, used for diabetes and weight loss. Trials in tens of thousands of people show 12 to 15% weight loss and fewer heart attacks. It is a daily injection for type 2 diabetes and for weight loss. Large trials of 9,340 and 3,731 people showed fewer heart problems and about 8% weight loss.
Both sit at grade A: strong human evidence. Both are FDA approved.
Evidence
AStrong human evidence
AStrong human evidence
Human studies cited
Animal or cell studies cited
Why the grade
Semaglutide has one of the largest trial programs of any peptide: the STEP trials in obesity (STEP 1, 1,961 adults), the SUSTAIN trials in type 2 diabetes, SELECT (17,604 adults with cardiovascular disease and obesity, the largest), FLOW in kidney disease, and systematic reviews pooling tens of thousands of participants. Weight loss, glucose lowering and reductions in heart attack, stroke and kidney outcomes are all shown in randomized placebo-controlled trials. A 2026 meta-analysis of 10 placebo-controlled obesity trials (7,131 adults) puts the pooled weight loss at 12.3 percent over placebo. A 2026 pooled analysis of seven placebo-controlled trials (38,412 adults) finds 17 percent fewer cardiovascular deaths. What remains open is what happens over decades and how to stop without regaining.
Both uses rest on large randomized placebo-controlled trials: LEADER (9,340 patients with type 2 diabetes, cardiovascular outcomes) and the SCALE obesity trial (3,731 adults, 56 weeks of weight loss). Multiple other phase 3 trials sit behind the labels. What the citations do not cover is how liraglutide compares with the newer weekly GLP-1 drugs, which outperform it on weight.
FDA
FDA approved
Semaglutide is FDA-approved as Ozempic (weekly injection, type 2 diabetes, 2017; with later indications to reduce cardiovascular events and, since January 2025, kidney disease progression in type 2 diabetes), Rybelsus (daily tablet, type 2 diabetes, 2019), and Wegovy (weekly injection, chronic weight management, 2021; cardiovascular risk reduction in obesity, 2024; MASH with liver fibrosis, 2025; an oral Wegovy tablet, December 2025). Compounded semaglutide is not FDA-approved.
FDA approved
Approved. Liraglutide is sold as Victoza (approved 2010) for type 2 diabetes in adults and children aged 10 and older and to reduce major cardiovascular events in adults with type 2 diabetes and heart disease, and as Saxenda (approved 2014) for chronic weight management in adults and adolescents aged 12 and older. Generic liraglutide for both indications has been approved since December 2024 and August 2025.
Sold for
Semaglutide is the GLP-1 injection behind Ozempic and Wegovy, the most talked-about weight loss drug of the decade.
Liraglutide was the first daily GLP-1 drug to be approved for weight loss and is now marketed as the cheaper generic alternative to semaglutide for people who want a GLP-1 but cannot get or afford the newer ones.
Studies say
Randomized trials in tens of thousands of people show 12 to 15 percent weight loss, roughly a 1 to 2 point HbA1c reduction, a 20 percent cut in major cardiovascular events, 17 percent fewer cardiovascular deaths in pooled trials and slower kidney decline, with gastrointestinal side effects and weight regain after stopping as the main caveats.
Trials in nearly 10,000 diabetic patients and 3,700 adults with obesity showed fewer heart events and about 8 percent body weight loss respectively, which earns an A for both approved uses.
Class
GLP-1 receptor agonist
GLP-1 receptor agonist
Route
Several routes
Injection