Weight-loss jabs 2026: Cost, comparison and risks of Wegovy, Mounjaro and Ozempic

Wegovy and Mounjaro are the two most-used jabs approved for weight loss, and out of pocket they cost you roughly 172 to 482 euros per four weeks.^{[1, 7, 34]} Where you land in that range depends on the drug and the dose. Statutory health insurance (GKV) pays none of it when the goal is weight loss.^{[3, 4]} The Wegovy prices below are pharmacy retail prices as of October 2026, while the figures for the other drugs date from March 2026. So check the current price with your pharmacy.^{[1, 7, 34, 35]} The overview lines up the five drugs people compare most, and the price of every single Wegovy dose follows further down.

All of these drugs are prescription-only in Germany, so for weight loss you pay for them yourself, on a private prescription at a pharmacy.^{[11, 13, 30]} Shopping around does not help much, because prescription-only drugs have a fixed pharmacy price under the drug price ordinance (Arzneimittelpreisverordnung, AMPreisV). That fixed price applies on a private prescription and at German online pharmacies too, and small differences between sources usually come from price changes over time.^[30] It also gives you a simple test: pens offered without a prescription, or far below the fixed price, are a red flag. Falsified Ozempic pens have already turned up in Germany.^[40]

Wegovy as a pen and as a pill

Wegovy (semaglutide) as a pen gets more expensive as the dose rises, from 172.73 euros for the starting doses to 277.60 euros for the 2.4 mg maintenance dose. Each pen lasts four weeks.^{[1, 2, 7]} The high 7.2 mg dose comes as a pack of four single-dose pens for 383.80 euros, which also lasts four weeks (as of October 2026).^[34]

The Wegovy pill (oral semaglutide) has been sold in German pharmacies since 1 September 2026. You take it once a day, following strict intake rules, instead of injecting once a week. That does not make it cheaper, though, because the starting packs of 30 tablets cost 172.73 euros, the same as the starting pens.^[7] The 25 mg maintenance dose was missing at launch and now costs 277.60 euros for 30 tablets (as of October 2026), as much as the 2.4 mg pen. Because a pack of tablets lasts 30 days and a pen 28 days, the pill comes out slightly cheaper over a year on maintenance.^{[7, 35]} Single strengths can still run short, as that 25 mg pill showed, so ask your pharmacy before you count on one.^{[7, 35]}

The table lists every Wegovy dose with its pack price, pen and pill side by side.

Mounjaro, Nevolat and Ozempic

Mounjaro (tirzepatide) also rises in price with the dose. Four weeks cost about 206 euros on the 2.5 mg starting dose and about 375 euros on a typical maintenance dose. The highest dose comes to about 482 euros.^[1] One Mounjaro pen (KwikPen) holds four weekly doses, so it lasts four weeks, and pens come singly or in packs of three.^[13] The pharmacy guide we use works out these costs from 3-pen packs (as of March 2026), so ask your pharmacy for the current price of your pack size.^[1]

If price matters most, Nevolat (liraglutide) is the cheapest of the weight-loss jabs. The generic from Zentiva has been in pharmacies since December 2025. It costs about 79 euros to start and about 129 euros a month on maintenance, against about 285 euros a month for the original brand, Saxenda.^{[1, 31]} The trade-off is that you inject liraglutide every day, and in a direct comparison it led to less than half the weight loss of semaglutide.^[43]

Ozempic (semaglutide) is listed at around 104 to 200 euros a month, but it is approved only for type 2 diabetes.^{[1, 4]} Using it to lose weight is therefore off-label (outside the approval), and the section on the differences explains why that low price is no shortcut.

What a year costs

The pack price is not the whole bill, because stopping usually brings most of the weight back, so in practice the jab is a long-term therapy.^[23] Since a Wegovy pen pack and a single Mounjaro pen each last four weeks, a year takes 13 four-week supplies. On Wegovy that comes to about 3,600 euros a year on 2.4 mg and about 5,000 euros on 7.2 mg (as of October 2026).^{[7, 34]} A typical Mounjaro maintenance dose adds up to about 4,900 euros a year, based on March 2026 prices.^{[1, 13]} The daily jabs (Nevolat, Saxenda) and the pill are priced per month or per 30 days, so budget them per month instead.^{[1, 7, 31]}

Why statutory insurance pays nothing

Statutory insurance leaves you with that whole bill because German law has excluded weight-loss medicines since 2004. They count as lifestyle drugs under Section 34 (1) sentences 7 and 8 of SGB V, the German Social Code, Book Five.^{[3, 4]} For Wegovy, the body that decides what statutory insurance covers, the Federal Joint Committee (G-BA), made this formal on 21 March 2024. It added Wegovy to Annex II of its medicines directive, the list of excluded lifestyle drugs.^{[4, 32]} That listing took effect on 15 June 2024, and this date is behind claims online that insurance will pay from 15 June 2026. It marks the formal exclusion, not a reimbursement start, so there is no date from which the GKV pays for the weight-loss jab for weight regulation.^{[4, 32]}

The exclusion holds whatever your BMI (body mass index, your weight relative to your height). Calls for special rules at least for people with a BMI over 30 reached the G-BA. It saw no room to make one, because the law excludes weight-loss drugs across the board.^{[3, 4]} The courts see it the same way. On 28 April 2026 the Lower Saxony-Bremen state social court (LSG Niedersachsen-Bremen, L 16 KR 161/26 B ER) ruled on a 24-year-old woman with a hormonal disorder and obesity. In urgent proceedings, it turned down her claim to Mounjaro. The law, the court said, leaves no room for case-by-case exceptions.^[6]

Politics has not changed that so far, although the new G-BA chair has floated coverage for severe obesity. The head of the AOK federal association counters with the cost. By that estimate, treating everyone insured with a BMI of 30 or more would come to about 45 billion euros a year, and treating everyone from a BMI of 35 about 14 billion. As of late August 2026 there was no bill, so insurance still pays nothing.^[5]

The one exception is treatment for type 2 diabetes. Ozempic and Rybelsus (semaglutide for type 2 diabetes) remain reimbursable for people with diabetes, because the lifestyle exclusion applies only when the approved use is weight regulation.^{[4, 5]}

Private insurance and Beihilfe

The Section 34 exclusion is a rule for statutory insurance, but that does not mean everyone else is covered.^[3] Federal Beihilfe, the government's share of civil servants' medical bills, also refuses drugs listed in Annex II, such as Wegovy, when they are used for weight loss. It makes exceptions only when such a drug treats a different illness.^[41] With private health insurance it depends on your contract, so ask your insurer in writing before you pay.

Whichever of these drugs you end up paying for, the three brand names hold only two active ingredients: Ozempic and Wegovy both contain semaglutide, and Mounjaro contains tirzepatide.^{[10, 12, 20]} What separates them is the mechanism, the approval and the dosing.

Semaglutide (in Ozempic and Wegovy) acts only on the receptor for GLP-1, a natural gut hormone released after eating, and mimics it.^[8] Like the hormone, it slows gastric emptying, boosts the feeling of fullness and dampens appetite.^[11] Tirzepatide (in Mounjaro) also acts on a second receptor, for GIP, another gut hormone that influences metabolism.^{[8, 13]} That double action is the usual explanation for why tirzepatide tends to act more strongly on weight and blood sugar.^{[13, 9]} In people with type 2 diabetes, for example, a separate trial found that tirzepatide lowered long-term blood sugar (HbA1c) more than semaglutide 1 mg.^[17]

The brand names also tell you the approval, which is the difference that matters in everyday life. Semaglutide is called Ozempic for diabetes and Wegovy for obesity, while tirzepatide is sold in the EU as Mounjaro for both. In case American headlines throw you, tirzepatide for weight loss is sold in the US as Zepbound.^{[10, 12, 29]} Wegovy and Mounjaro are approved in the EU for weight management, but Ozempic is approved only for type 2 diabetes, so any use for weight loss is off-label.^{[1, 4]} Off-label does not automatically mean dangerous, but there is no approved dosing or monitoring plan for weight loss. In 2023 that demand also added to shortages for people with diabetes.^[39] Supply has since stabilized, and in March 2026 the shortage advisory board at the BfArM, Germany's drug regulator, lifted its advice to reserve Ozempic for type 2 diabetes.^[39]

Both approved drugs are stepped up slowly (titration) so your gut can adapt. Wegovy as a pen is raised over 16 weeks, with one injection under the skin once a week^{[10, 11]}:

• Weeks 1 to 4: 0.25 mg
• Weeks 5 to 8: 0.5 mg
• Weeks 9 to 12: 1.0 mg
• Weeks 13 to 16: 1.7 mg
• From week 17: 2.4 mg, the standard maintenance dose

Above that maintenance dose, the EU has also allowed a higher 7.2 mg dose since February 2026. It is meant for adults who started with a BMI of 30 or more, after at least four weeks on 2.4 mg. It comes in its own single-dose pens and is now in German pharmacies (see the cost section). In the trials, abnormal skin sensations such as tingling or burning (dysesthesia) were much more common on 7.2 mg than on placebo, though mostly mild to moderate. If 7.2 mg brings no extra weight loss, the label says to go back to 2.4 mg.^[11]

The Wegovy pill starts at 1.5 mg a day and steps up every four weeks through 4 and 9 mg to the 25 mg maintenance dose.^[7] You take it on an empty stomach after at least 8 hours without food, so in practice right after waking up. Swallow it whole with a sip of water (at most half a glass, 120 ml), then wait at least 30 minutes before eating, drinking or taking other medicines. Take only one tablet a day, because two smaller tablets do not replace a higher dose. The pill is approved for adults only.^{[7, 11]}

Mounjaro starts at 2.5 mg once a week and goes up to 5 mg after four weeks. Your doctor raises it further only if needed, in 2.5 mg steps with at least four weeks on each dose. The maintenance dose is 5, 10 or 15 mg, depending on how well it works and how well you tolerate it. The maximum is 15 mg once a week.^[13]

Reaching the Wegovy maintenance dose therefore takes four months, and on Mounjaro each further step adds at least four weeks. Since the low doses are the cheaper ones, the first months cost less than the later ones.^{[1, 7, 11, 13]}

In a direct trial, Mounjaro led to more weight loss than Wegovy at the doses tested. SURMOUNT-5 compared the two in 751 adults without diabetes. Over 72 weeks, people on tirzepatide lost 20.2 percent of their weight on average. On semaglutide (Wegovy) they lost 13.7 percent, a gap of about 6.5 percentage points.^[9] The trial was open-label (everyone knew which drug they got) and compared the highest tolerated doses: tirzepatide 10 or 15 mg against semaglutide 1.7 or 2.4 mg. It did not include the newer 7.2 mg Wegovy dose or the pill, so it says nothing about how those compare with Mounjaro.^[9]

Like most figures in this section, those come from large randomized trials (RCTs, where chance decides who gets which treatment), most of them funded by the manufacturers.^{[9, 14]} Tirzepatide's main approval trial, SURMOUNT-1, tested it against placebo in adults without diabetes who had obesity, or overweight plus a weight-related complication.^[14] Over 72 weeks, weight loss grew with the dose, from 15.0 percent on 5 mg to 20.9 percent on 15 mg, against 3.1 percent on placebo.^{[14, 15]} On the top dose, more than half of the participants lost a fifth of their body weight or more.^{[14, 15]}

That 20.9 percent is not the highest figure you will read for tirzepatide, and the difference is no contradiction. The figures here count everyone who started the trial, whether or not they kept injecting. Manufacturers and the press often quote a more optimistic figure of up to about 22.5 percent. It estimates what would have happened if everyone had stayed on the drug for the whole trial.^[14] Both numbers are real, but they answer different questions, so compare like with like.

For Wegovy, the matching placebo trial is STEP-1, in which people on 2.4 mg lost 14.9 percent of their weight over 68 weeks against 2.4 percent on placebo.^[16] The Wegovy pill (25 mg a day) came close to that in its main trial, OASIS 4, with 13.6 percent over 64 weeks against 2.2 percent on placebo. About three in four people on the pill had gastrointestinal side effects, though.^[42] No trial has compared the pill directly with the jab or with Mounjaro, so the table lines up results from separate trials.^[42]

Read the table with that in mind: only the last row compares two drugs within one trial, while the first three each come from a separate placebo trial.

Every percentage in that table describes the trial period, under medical supervision and on top of diet and exercise. None of them shows what happens after stopping (covered under who the jab is for), and none shows what the weight loss costs you in side effects.

The side effects of the weight-loss jabs are mostly gastrointestinal, usually mild to moderate and mostly while the dose is still being stepped up.^[14] Next to them sit a few rarer but more serious risks, and the list at the end of this section says when to see a doctor straight away.

Gastrointestinal. Your gut takes most of the hit. This is what people on tirzepatide 5 / 10 / 15 mg reported in SURMOUNT-1^[14]:

• Nausea: 24.6 / 33.3 / 31.0 percent (placebo 9.5 percent)
• Diarrhea: 18.7 / 21.2 / 23.0 percent (placebo 7.3 percent)
• Constipation: 16.8 / 17.1 / 11.7 percent
• Vomiting: 8.3 / 10.7 / 12.2 percent
• Stopped because of side effects: 4.3 / 7.1 / 6.2 percent (placebo 2.6 percent)

Most complaints ease over time. Vomiting and diarrhea can dehydrate you, which in rare cases harms the kidneys, so drink enough and call your doctor if you cannot keep fluids down.^{[11, 13]}

Gallbladder. The gallbladder risk is real. Across all GLP-1 drugs, a meta-analysis of randomized trials found a higher risk of gallstones, gallbladder inflammation and other bile-duct trouble.^[18] In the weight-loss trials the risk was more than double that of the comparison groups, and it also rose with higher doses and longer use. Rapid weight loss makes gallstones more likely anyway, and these drugs add to that.^[18]

Pancreas (pancreatitis). For the pancreas, the signal is small and the data are mixed. A meta-analysis of randomized trials found a modest rise in pancreatitis (inflammation of the pancreas) across GLP-1 drugs. That rise was no longer significant, though, once the trials were split by the other medicines people were already taking.^[19] Pancreatic cancer showed no significant increase overall, though the data cannot rule one out, since follow-up in the trials averaged under a year.^[19] The labels are clear on what to do. If you get severe, persistent pain in the upper abdomen, sometimes spreading to the back, stop the jab and see a doctor straight away. If pancreatitis is confirmed, the drug must not be restarted, and if you have had pancreatitis before, the EU label asks for particular caution.^{[11, 13]}

Thyroid. In rodent studies, semaglutide and tirzepatide caused tumors of the thyroid's C-cells (hormone-making cells), more often at higher doses and with longer exposure.^{[20, 33]} For that reason the US labels rule the drugs out if you or close family have had medullary thyroid carcinoma (MTC), a thyroid cancer of those C-cells. The same applies to MEN-2, an inherited condition that causes tumors in hormone glands.^{[20, 33]} The EU labels that apply in Germany list no such contraindication, but if that history applies to you, talk to your doctor before starting.^{[11, 13]}

Whether the rodent finding carries over to humans is unclear, because the studies in people point in different directions. A large Scandinavian study of users found no clear rise in thyroid cancer.^[26] A French study comparing people with and without the cancer, by contrast, linked 1 to 3 years of use to more thyroid cancer, including MTC.^[27] Both looked mainly at people using older GLP-1 drugs for type 2 diabetes.^{[26, 27]} Taken together, there is no proof that the jab causes thyroid cancer, and no full all-clear either.

If you also take diabetes medicines. Together with insulin or a sulfonylurea (an older type of diabetes tablet that makes the pancreas release more insulin), the jab raises the risk of low blood sugar. Your doctor may therefore lower that dose, and you should check your glucose.^{[11, 13]}

Kidneys and liver. Wegovy is not recommended in severe kidney or liver impairment.^{[11, 13]}

Eyes. In people with type 2 diabetes, large observational studies (which watch patients rather than test the drug) link semaglutide to about twice the risk of NAION. That is a sudden loss of vision from poor blood flow to the optic nerve. It stays rare, at about one extra case for every 10,000 people treated for a year. If your vision suddenly drops, see an eye doctor straight away; if NAION is confirmed, semaglutide is stopped.^[11] If you already have diabetic eye disease (retinopathy), a rapid improvement in blood sugar can make it temporarily worse, so it needs close monitoring.^{[11, 13]}

Stomach and surgery. Semaglutide is not recommended if you have severe gastroparesis (a stomach that empties extremely slowly). Before any operation or sedation, tell your anesthetist about the jab, because food stays in the stomach longer.^{[11, 13]}

Muscle loss. Part of the weight you lose is lean mass, roughly a quarter to 40 percent in the main trials.^{[21, 24]} What helps against that is covered in the section on keeping muscle.

Ozempic face. Sunken cheeks and temples and looser skin come from the rapid weight loss itself. The fat pads in the face shrink while the skin's elasticity lags behind, which can happen with any fast weight loss. That explanation comes from dermatology explainers, not controlled trials, but it is considered plausible.^[22]

When to see a doctor straight away:

• Severe, persistent pain in the upper abdomen, sometimes spreading to the back^{[11, 13]}
• Vomiting or diarrhea that stops you keeping fluids down^{[11, 13]}
• A sudden loss of vision^[11]
• Anything that feels like gallbladder trouble, since these drugs raise the risk of gallstones and gallbladder inflammation^[18]

The weight-loss jab is approved as a medical therapy for obesity. The European Medicines Agency (EMA) approves Wegovy and Mounjaro for adults in one of two groups^{[10, 12]}:

• BMI 30 or higher (obesity)
• BMI 27 to under 30 (overweight) plus at least one weight-related condition, such as high blood pressure, a lipid disorder, sleep apnea, cardiovascular disease or prediabetes

In both groups the jab is an add-on to a calorie-reduced diet and more exercise, not a replacement for them.^{[10, 12]} To plan that deficit, our calorie calculator works out your daily needs and a target.

Beyond the adult groups, Wegovy is also approved from age 12 for teenagers with obesity who weigh more than 60 kg. If their BMI has not fallen by at least 5 percent after 12 weeks on 2.4 mg or the highest dose they tolerate, treatment should be stopped and reassessed. Mounjaro's weight-loss approval covers adults only, and so does the Wegovy pill.^{[11, 13]}

Minor, cosmetic weight loss is not what the jab is for. Someone with a normal BMI who wants to drop a few kilos falls outside the approval, and the balance of benefit and risk then shifts unfavorably.^{[10, 12]} For a few kilos, fiber is a gentler lever on fullness, though with much weaker evidence. Berberine, often called a natural Ozempic, is nowhere near the league of the prescription drugs.

Pregnancy is another clear no: both labels advise against use during pregnancy. If you plan one, they say to stop Wegovy at least 2 months ahead and Mounjaro at least 1 month ahead. If you can become pregnant, both recommend contraception during treatment. Wegovy should not be used while breastfeeding. For Mounjaro the label says breastfeeding can be considered, so decide that with your doctor.^{[11, 13]}

Stopping is the point that matters most for any cost plan, and it is uncomfortable. In the STEP-1 extension, people who stopped semaglutide regained about two thirds of the weight they had lost within a year. Their net loss shrank from 17.3 percent of their starting weight during treatment to 5.6 percent. That is an average from a follow-up of about 300 participants, in which the lifestyle program also ended.^[23] In practice the jab is therefore a long-term therapy, which is why the cost section budgets per year. Over that many years, it also matters what kind of weight you lose.

A large part of the weight lost on GLP-1 drugs is not fat but lean mass, meaning muscle and other fat-free tissue. In the semaglutide trial STEP-1, up to about 40 percent of the loss was lean mass, and in the tirzepatide trial SURMOUNT-1 about a quarter.^{[21, 24]} Both figures come from DXA, a body scan that tells fat and lean mass apart. They come from secondary analyses of only those participants who had the scan, so read them as a rough range rather than exact values.^{[21, 24]}

That range sounds alarming until you look at the placebo group of SURMOUNT-1. It split its loss the same way, about three quarters fat and one quarter lean mass, and simply lost less of both.^[24] Any fast weight loss costs some lean mass, even a diet with no drug at all.^{[21, 24]} So the useful question is how to keep that loss small.

The standard advice from obesity and nutrition societies is strength training with progressive resistance (slowly adding load over time) plus enough protein.^[28] How well that works on GLP-1 drugs rests so far on small reports. One case series followed three people who lifted weights three to five times a week.^[21] Some of them kept their lean mass or even gained a little, but without a control group the report cannot show what the training itself achieved.^[21]

For the protein side, a 2025 advisory from US obesity and nutrition societies mentions about 1.2 to 1.6 g per kg of body weight a day while you lose weight. It calls these figures proposals and leaves open which body weight to use, because with a lot of body fat your actual weight can overstate the need.^[28] Timing, realistic amounts and what to watch in blood work are covered in the dedicated guide on keeping muscle on GLP-1. Since the drug takes lean mass along with fat, a reasonable thing to try is to start strength training and mind your protein in the week of the first injection.

The next generation of weight-loss drugs is already in large trials and so far works even more strongly than today's drugs did in their approval trials. Its best-known candidate is retatrutide, which acts on three hormone receptors at once: GIP and GLP-1, like tirzepatide, plus glucagon.^[25]

Its phase 2 trial, a mid-sized trial that tests doses, ran for 48 weeks. People on the highest dose of 12 mg lost 24.2 percent of their body weight on average, against 2.1 percent on placebo.^[25] Side effects were mostly gastrointestinal, as with the other drugs in this class, and heart rate rose with the dose and peaked at 24 weeks.^[25]

The larger phase 3 trials, the last stage before approval, have since shown a similar result over a longer period. In TRIUMPH-1, adults with obesity but without diabetes lost 25.0 percent of their body weight on average over 80 weeks on the 12 mg dose. On placebo they lost 3.9 percent, and both figures count everyone who started.^[36] People who also had type 2 diabetes lost less on the same dose in TRIUMPH-2, 18.8 percent against 5.1 percent on placebo.^[37] In that trial more people stopped because of side effects than on placebo, and low blood pressure and abnormal skin sensations (dysesthesia) were more common.^[37]

With those results in hand, Lilly, the maker of retatrutide, plans to file for US approval in early 2027.^[29] Lilly's weight-loss pill orforglipron is further along, since it is already sold in the US as Foundayo.^[29] On 15 October 2026 the EU medicines committee (CHMP) recommended approval for weight management and type 2 diabetes.^[38] The European Commission's decision is still pending, though, and as of October 2026 there is no German launch or price.^[38] The Wegovy pill, by contrast, has been on sale in Germany since September 2026, with prices in the cost section.^[7]

As of October 2026, neither new drug is approved in the EU or on sale in German pharmacies. Retatrutide is still an investigational drug that may not legally be sold, and orforglipron is waiting for the Commission's decision.^{[29, 38]} Anything offered online as either drug belongs to the grey market, which this guide does not cover. The falsified Ozempic pens found in Germany show what can end up in such packs.^[40]