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Auto-generated transcript of @drdavidalfery's video. Quoted here for educational fact-check commentary; original creator retains all rights to the video content.
- 0:00Which is a more effective drug for losing weight to zepatide or semaglutide if you like this real then comment on it repost
- 0:08Give me a follow if you want me to comment back follow me
- 0:13So I'm going to tell you about a study that was published yesterday in the New England Journal of Medicine
- 0:18Now the New England Journal is the most prestigious medical journal in the world. They get the most
- 0:24Important studies this study was actually of the results were announced a couple of months ago by Lily
- 0:31But now it's published in a peer reviewed journal
- 0:35And the study was called
- 0:38Terzepatide is compared with semaglutide for the treatment of obesity
- 0:42It is the first and only head-to-head trial of
- 0:46Terzepatide versus semaglutide in treating obesity. What was the study?
- 0:51751 participants they all had obesity and
- 0:58Did not have diabetes that it lasted for 72 weeks
- 1:02The participants were randomized to either getting Terzepatide the dose was 10 or 15 milligrams the max that a participant would tolerate
- 1:13Versus semaglutide the dose being 1.7 or 2.4 milligrams again the maximum dose that was tolerated
- 1:21What were the results? Well after that 72 week period the Terzepatide group lost an average of 50 pounds the semaglutide
- 1:3033 pounds that
- 1:32translated to about 20 percent of the body weight of the
- 1:35Terzepatide participants and
- 1:39Third or 14 percent of the semaglutide participants in terms of how much did their waistline shrink?
- 1:47Terzepatide 7 inches semaglutide
- 1:505 inches and finally how did they tolerate these drugs?
- 1:54Well the majority of the participants had side effects mainly the GI side effects
- 2:00but
- 2:02Most of them could continue in the study 6% of the Terzepatide folks dropped out 8% of the semaglutide dropped out
- 2:10So at the end of the day the first head-to-head study of these two drugs against each other
- 2:16Showing the Terzepatide clearly a better drug in terms of effectiveness of losing weight
- 2:22Now people will ask well who paid for that study? Well of course Lily paid for the study
- 2:27Lily knew what the results were gonna be other studies have showed that it's a better drug
- 2:32Although they weren't head-to-head trials and so Lily paid for the study
- 2:36You will not find any major study like this of hundreds and hundreds of participants that is not paid for
- 2:45by our
- 2:46So-called big pharma the reason is they cost tens of millions of dollars
- 2:52Nobody's gonna do that study where they don't think the results are gonna be in their best interest. So
- 2:59what you really rely on then is despite who pays for it that the
- 3:07reviewers of the article will say did it follow the
- 3:11Criteria that we need for valid studies. Is it prospective? Is it randomized? Is it double-blind and so forth?
- 3:18And it obviously was all of those things. So where do we stand now in terms of
- 3:25affording these drugs? Let's say you don't have insurance. Well
- 3:29About six months ago Lily came out with this direct-to-consumer program called Lily Direct
- 3:35Your doctor writes a prescription sends it to Lily Direct and then they send you vials right to your house
- 3:42About two months ago
- 3:44Novonortus came out with their direct programs called Novocare where your doctor sends in a prescription and then you get
- 3:52In this case you get pre-filled syringes sent to your house when Novonortus did that
- 3:58They undercut the price of Lily a little bit and they said you know what doesn't matter
- 4:04What dose you get it's going to be four hundred ninety nine bucks a month Lily responded to that by
- 4:10Lowering the price of their vials. So depending upon the
- 4:14the
- 4:15Dose that you get in a vial you're gonna pay a little bit more a little bit less than
- 4:20The Novonortus for ninety nine a month
- 4:24So these are heavily discounted from the list prices which are greatly inflated still very expensive
- 4:32So what's happening on the compounding front?
- 4:34Well all of the major telemarketers and
- 4:38Compounders in America that have continued to sell compounded to zip-a-tide have been sued by Lily
- 4:45That is surely gonna happen with
- 4:48Novonortus as well in terms of compounding a lot of the
- 4:52Compounders have now quit because of that although I know that some of them are continuing to sell it
- 4:58I guess they're trying to run out the clock on this and get
- 5:01As many months of sales as they possibly can I have to think at the end of the day that
- 5:07The pharmaceutical companies are going to win because the FDA has the weight of the federal government behind them and
- 5:15The combined market cap of novo and Lily is a trillion dollars and I think they're gonna win these legal battles. So
- 5:25That's where we stand and being able to get this what about sales
- 5:30via insurance companies well about a month ago
- 5:34Novonortus announces a deal with CVS Caremark now CVS Caremark is one of the biggest
- 5:42pharmacy benefit managers middlemen in America in terms of drug dispensing and
- 5:50Involved in many many drug plans their
- 5:52Prefer GLP one will be
- 5:58Semaglu-tide now what that means is that's the drug that'll be on formulary if you had a prescription written to you
- 6:05And the drug is not covered by your insurance company. You know that it's prohibitively expensive
- 6:12so
- 6:13What this really means is that they have one-upped Lily in terms of availability
- 6:19But Lily has got a better drug. So what's gonna happen down the road? I think the fights are gonna continue. I think that the
- 6:28Legal challenges will continue but most importantly I think that Lily and
- 6:34Novonortus are going head to head with these two drugs
- 6:38And I really see prices coming down over time that Novonortus especially since this new study has come out
- 6:45They're gonna have to drop their prices semaglu-tide try to lure people there and say hey may not be quite as good a drug
- 6:52But we're cheaper and then Lily's gonna have to meet that so we'll see up the other big news today was that
- 6:59you know Trump and his administration have announced that
- 7:03We're done with paying more for drugs here than we did other countries pay now whether that means that the drug
- 7:11Prices are gonna come down in America or they're gonna have to be raised in other countries via tariffs or some other mechanism
- 7:19We really don't know but
- 7:22Stay tuned for that. That's gonna be a heck of a battle
- 7:25So I hope this has been useful to you who am I that I'm interested in this kind of stuff
- 7:29Well if you follow me, you know, I do reels on things that interest me and GOP one is certainly one of them
- 7:36I'm a retired cardiac anesthesiologist
- 7:38When I retired I wrote a book about my experiences in medicine. It's called saving grace
- 7:43When patients teach their doctors about life death and the balance in between it's the only book like it
- 7:49That's ever been written. It's the only book that ever shows the inside
- 7:53workings of the operating room the ICU the pain clinic and so forth from the perspective of the people that put you to sleep
- 8:00Bring you closer to death and you'll ever come and then bring you back again believe you can't believe what those surgeons say
- 8:08the stories in it are very dramatic very patient oriented and written from the perspective of a doc who realized it was a
- 8:16Privilege to take care of patients and I think as a result, that's why the ratings have been so high
- 8:21It is in the top one percent of rated books on Amazon that have at least a hundred ratings
- 8:29Everages 4.8. I defy you to find any buck any book on any subject that has a rating of
- 8:364.8 or higher if you want to get an extra
- 8:41Audible or written though, you know what I sound like go to saving grace book calm
- 8:46And it's available on all the usual platforms on Amazon, but for now
- 8:52big news in terms of the study
- 8:55Confirming what most of us really already knew
- 8:59Which is that turzepatide a more effective drug in terms of losing weight than is
- 9:05Semagluetide although both are quite effective
- 9:08Be interesting to see what happens to these drugs when red true tide comes along next year from Lily that is an even more powerful drug
Tirzepatide vs. semaglutide head-to-head: what the trial actually shows
Quick answer
SURMOUNT-5 (Jastreboff et al., 2025, NEJM) is the first randomized, double-blind, head-to-head trial comparing tirzepatide (10-15 mg weekly) to semaglutide 2.4 mg weekly in 751 adults with obesity and without type 2 diabetes over 72 weeks. Tirzepatide produced approximately 20% mean body weight loss versus approximately 14% for semaglutide, a statistically significant difference driven by tirzepatide's dual GIP and GLP-1 receptor agonism. Clinical decisions should account for formulary access, tolerability, and individual patient factors beyond trial-level averages.
Video review standard
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Evidence signal
Source-backed review
Regulatory reality
Compounded Semaglutide access requires the right clinical path
Safety screen
Viral claims can miss contraindications, dose escalation, medication interactions, and quality-control risks.
This page currently connects to 10 source-backed evidence items through visible references or structured citation data.
PubMed evidence trail
Research sources used to frame this page
For Tirzepatide vs. semaglutide head-to-head: what the trial actually shows, FormBlends checks the page topic against primary trials, systematic reviews, guidelines, and current PubMed-indexed literature where available. These citations are context, not medical advice, proof of eligibility, or a claim that every study applies to every patient.
Once-Weekly Semaglutide in Adults with Overweight or Obesity
Primary STEP 1 trial source for semaglutide weight-management efficacy and adverse-event context.
PubMed
Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance
Used for maintenance, discontinuation, and weight-regain discussions after semaglutide response.
PubMed
Tirzepatide Once Weekly for the Treatment of Obesity
Primary SURMOUNT-1 trial source for tirzepatide weight-loss ranges and tolerability.
PubMed
Continued Treatment With Tirzepatide for Maintenance of Weight Reduction
Used for continuation, stopping, and maintenance questions after initial weight loss.
PubMed
Provider decision path
Use local research to choose a safer review path
Direct answer
Compounded Semaglutide is best used to compare access, oversight, pricing, pharmacy quality, and patient support before starting care.
Evidence check
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Safety check
Provider quality, pharmacy source, prescribing model, and follow-up support can matter as much as the medication name.
Next step
When you are ready, the get-started flow can collect the details needed for a prescription review instead of leaving you to guess.
Claim path
Keep researching this semaglutide video claims cluster
Best for searchers comparing social semaglutide claims with GLP-1 eligibility, outcomes, and safety context.
Page-specific review note
What this exact clip is really saying
This FormBlends review is specific to "Tirzepatide vs. semaglutide head-to-head: what the trial actually shows" from Dr. David Alfery. We read the clip as a GLP-1 social video fact-checks claim about Compounded Semaglutide, then separate the useful signal from what a short social video cannot prove. The page-specific claim focus is: SURMOUNT-5 (Jastreboff et al.
The reason this review is not generic is the source wording and the canonical claim label "glp1 the first head to head trial of semaglutide versus tirzepati." In this clip, the useful excerpt is: "Which is a more effective drug for losing weight to zepatide or semaglutide if you like this real then comment on it repost Give me a follow if you want me to comment back follow me So I'm going to tell you about a study that was published..." That wording changes the review because it points to Compounded Semaglutide safety, access, evidence, and fit, not a one-size-fits-all protocol.
The source trail for this page is checked against Once-Weekly Semaglutide in Adults with Overweight or Obesity (2021), Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance (2021), and Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight (2022), plus the creator's own wording. Compounded Semaglutide still needs an eligibility review, medication-interaction screen, access check, and quality-control review before anyone treats a social clip as medical advice.
Claim verdict
The useful answer behind this video
This page is built to answer the specific claim behind the clip, then separate what is useful from what still needs clinical context. That makes the URL more than a repost: it gives Google, readers, and AI retrieval systems a concise verdict with source and safety boundaries.
Claim being checked
SURMOUNT-5 (Jastreboff et al.
FormBlends verdict
Compounded Semaglutide safety, access, evidence, and fit
Evidence strength
Source-backed review with clinical or regulatory citations.
Patient-safe next step
Compare the claim with the Compounded Semaglutide guide, safety notes, access rules, and a licensed-provider review.
What to do with this video
Use the clip as a claim to verify, not a treatment plan
What it helps with
- SURMOUNT-5 (Jastreboff et al., 2025, NEJM) is the first randomized, double-blind, head-to-head trial comparing tirzepatide (10-15 mg weekly) to semaglutide 2.4 mg weekly in 751 adults with obesity and without type 2 diabetes over 72 weeks. Tirzepatide produced approximately 20% mean body weight loss versus approximately 14% for semaglutide, a statistically significant difference driven by tirzepatide's dual GIP and GLP-1 receptor agonism. Clinical decisions should account for formulary access, tolerability, and individual patient factors beyond trial-level averages.
- SURMOUNT-5 (Jastreboff et al., 2025, NEJM) is the first randomized head-to-head trial of tirzepatide vs. semaglutide 2.4 mg for obesity, with 751 participants over 72 weeks.
- Tirzepatide produced roughly 20% mean body weight loss versus roughly 14% for semaglutide, a statistically significant difference across the 72-week period.
What it may miss
- It may not cover eligibility, contraindications, medication interactions, lab history, or dose escalation.
- Compounded Semaglutide decisions still need source quality, legal access, and provider oversight checks.
- Social video captions rarely show the full evidence base behind a claim.
Best next step
Compare the claim against the Compounded Semaglutide guide, cost path, safety notes, and provider review before acting.
Review Compounded SemaglutideWhat You'll Learn
- SURMOUNT-5 (Jastreboff et al., 2025, NEJM) is the first randomized head-to-head trial of tirzepatide vs. semaglutide 2.4 mg for obesity, with 751 participants over 72 weeks.
- Tirzepatide produced roughly 20% mean body weight loss versus roughly 14% for semaglutide, a statistically significant difference across the 72-week period.
- The semaglutide dose used was 2.4 mg weekly (Wegovy), not the lower 1 mg dose used in Ozempic for diabetes management. These are not interchangeable.
- Despite tirzepatide's superior trial results, formulary decisions like CVS Caremark preferring semaglutide mean real-world access often favors the less effective drug for many insured patients.
- Compounded tirzepatide and semaglutide are not FDA-approved and have not been tested for bioequivalence with brand-name versions. They carry different and less well-characterized risk profiles.
- Industry funding does not automatically invalidate a trial, but a 2017 Cochrane review (Lundh et al.) found industry-funded drug studies are more likely to report favorable results. Independent replication matters.
- Both drugs carry primarily gastrointestinal side effects. Discontinuation rates in SURMOUNT-5 were low (6-8%), but individual tolerability varies and should guide prescribing decisions alongside efficacy data.
Our take · Written by FormBlends editorial team · Reviewed by FormBlends Medical Team · This is not a transcript. It is our independent review of the video above.
What did @drdavidalfery actually say?
The creator walked through the SURMOUNT-5 trial, published in the New England Journal of Medicine, which he called "the first and only head-to-head trial" of tirzepatide versus semaglutide for obesity. He reported that tirzepatide users lost an average of 50 pounds (about 20% body weight) compared to 33 pounds (about 14%) for semaglutide, over 72 weeks. He also noted waistline reductions of 7 inches versus 5 inches, and roughly similar dropout rates due to side effects (6% vs. 8%). He then pivoted to cost and compounding, noting Eli Lilly and Novo Nordisk direct-to-consumer programs, lawsuits against compounders, and CVS Caremark's decision to prefer semaglutide on formulary.
That is a lot of ground for one TikTok. Most of it holds up. Some of it needs context.
Does the science back this up?
On the trial results, yes, largely. The numbers he cited are consistent with what was published. The SURMOUNT-5 trial (Jastreboff et al., 2025, NEJM) randomized 751 adults with obesity and without diabetes to tirzepatide (10 or 15 mg) or semaglutide (1.7 or 2.4 mg) for 72 weeks.
- Tirzepatide group: mean body weight reduction of approximately 20.2% (roughly 22.8 kg, or about 50 lbs for an average participant weight)
- Semaglutide group: mean body weight reduction of approximately 13.7% (roughly 15.5 kg, or about 34 lbs)
- Waist circumference reductions: approximately 18.4 cm tirzepatide vs. 13.0 cm semaglutide, which translates loosely to about 7 vs. 5 inches
- Discontinuation due to adverse events: 6% tirzepatide, 8% semaglutide
His numbers are in the right ballpark. The percentage figures (20% vs. 14%) are accurate representations of the primary endpoint. The trial was prospective, randomized, double-blind, and active-controlled, which he correctly described.
What did they get wrong (or right)?
He got the trial data right. Where things get messier is his framing of industry funding and his comments on compounding.
His defense of Eli Lilly funding the study is nuanced but fair. He correctly points out that industry-funded trials of this scale are essentially the only trials that exist, and that peer review serves as a structural check. That is an honest take, not spin. Researchers like Lundh et al. (2017, Cochrane) have documented that industry-funded trials do tend to produce more favorable results, but that does not automatically invalidate SURMOUNT-5's methodology.
His statement that compounders "are going to lose" is an opinion stated as near-certainty. The FDA's shortage designations and legal landscape are still evolving. He is probably right directionally, but presenting this as settled is an overreach.
One thing he glossed over: the semaglutide dose used in SURMOUNT-5 was 2.4 mg weekly (Wegovy), not the 1 mg dose used in Ozempic for diabetes. Viewers conflating the two could draw the wrong conclusions about their own medication.
What should you actually know?
SURMOUNT-5 is a real, well-designed trial and its results are meaningful. Tirzepatide, a dual GIP/GLP-1 agonist, consistently outperforms semaglutide, a GLP-1-only agonist, across multiple outcomes in people with obesity. That is not just one Lilly-funded study. Trials like SURMOUNT-1 (Jastreboff et al., 2022, NEJM) and STEP 1 (Wilding et al., 2021, NEJM) established the benchmarks for each drug individually, and SURMOUNT-5 is the first direct comparison.
But "better" in a clinical trial is not the same as "better for you." Insurance coverage, side effect profile, individual response, and cost all shape real-world outcomes. The CVS Caremark formulary decision the creator mentioned actually means millions of people with that pharmacy benefit will have easier access to semaglutide than tirzepatide, regardless of what SURMOUNT-5 showed. A drug you can afford and tolerate beats a drug you cannot access.
On compounding: the creator correctly described the legal pressure on compounders but stopped short of saying compounded GLP-1 products are not equivalent to brand-name drugs. They are not. Compounded tirzepatide and semaglutide are not FDA-approved, have not been tested for bioequivalence, and carry different risk profiles. Patients using compounded versions should discuss this directly with their prescriber.
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About the Creator
Dr. David Alfery · TikTok creator
65.7K views on this video
The first head-to-head trial of Semaglutide versus tirzepatide for losing weight has just been published. Which drug is better? ##semaglutide##tirzepatide##zepbound##wegovy##glp1##glp1 ##medicine##doctorsoftiktok##healthcare##obesity##weightliss
Frequently asked questions
Quick answers based on this video and our medical team review.
What does the video say about surmount-5 (jastreboff et al., 2025, nejm)?
SURMOUNT-5 (Jastreboff et al., 2025, NEJM) is the first randomized head-to-head trial of tirzepatide vs. semaglutide 2.4 mg for obesity, with 751 participants over 72 weeks.
What does the video say about tirzepatide produced roughly 20% mean body weight loss versus roughly?
Tirzepatide produced roughly 20% mean body weight loss versus roughly 14% for semaglutide, a statistically significant difference across the 72-week period.
What does the video say about the semaglutide dose used was 2.4 mg weekly (wegovy), not?
The semaglutide dose used was 2.4 mg weekly (Wegovy), not the lower 1 mg dose used in Ozempic for diabetes management. These are not interchangeable.
What does the video say about despite tirzepatide's superior trial results, formulary decisions like cvs caremark?
Despite tirzepatide's superior trial results, formulary decisions like CVS Caremark preferring semaglutide mean real-world access often favors the less effective drug for many insured patients.
What does the video say about compounded tirzepatide?
Compounded tirzepatide and semaglutide are not FDA-approved and have not been tested for bioequivalence with brand-name versions. They carry different and less well-characterized risk profiles.
What does the video say about industry funding does not automatically invalidate a trial,?
Industry funding does not automatically invalidate a trial, but a 2017 Cochrane review (Lundh et al.) found industry-funded drug studies are more likely to report favorable results. Independent replication matters.
Sources & references
Citations extracted from our medical team's review. Click any citation to search PubMed.
Read More on This Topic
Our written guides go deeper with dosing details, comparison tables, and medical-team reviewed protocols.
Not medical advice. This video was made by Dr. David Alfery, not by FormBlends. Our write-up above is an editorial review, not a medical recommendation. Talk to your doctor before making any decisions about medications or treatments.