Best GLP-1 for weight loss in Canada: every option ranked by evidence

The best GLP-1 for weight loss, ranked

The best GLP-1 for weight loss is the one with strong human trial results that you can actually get in Canada, and right now that is tirzepatide. We ranked eight GLP-1 drugs on two things first: how much weight people lost in the main trial, and whether Health Canada has authorized the drug for weight. Price and how you take it break ties.

Here is the short list, best first:

1. Tirzepatide (Zepbound). The most weight loss of any drug you can buy here. Weekly shot.
2. Semaglutide injection (Wegovy). A little less loss, a longer record and the widest set of Canadian labels. Weekly shot.
3. Liraglutide (Saxenda). Authorized and proven, but about half the loss of the top two. Daily shot.
4. Oral semaglutide (Wegovy pill, Rybelsus). Strong pill results, but the weight-loss dose is not sold in Canada.
5. Orforglipron (Foundayo in the US). A daily pill with no food rules. Under Health Canada review.
6. CagriSema. Semaglutide plus an amylin drug in one weekly shot. Under Health Canada review.
7. Retatrutide. The biggest trial result so far, but not approved anywhere or under review in Canada.
8. Survodutide. Phase 3 results are in, but they trail the others, and no filing is public.

The first three are the real choice today. Number four is a near miss, and the last four are worth knowing about so you can judge the news as it comes.

How we ranked the GLP-1 drugs

We read the trial papers for each drug and took the weight-loss figure the journal reports for the highest dose. Where a drug company’s press release gives a bigger number, we use the journal’s.

Most of these results count everyone who started the trial, including people who stopped the drug. That is the cautious way to measure, and it gives smaller numbers than you will see in some ads.

Next came Canadian status. We looked up each drug in Health Canada’s product and approval databases on 2026-11-12^3,4, and on its public list of new drugs under review⁵. A drug with great results but no Canadian approval ranks below one you can fill at a pharmacy this week.

One honest limit: most of these numbers come from different trials, with different people, lengths and placebo groups. Comparing them side by side is useful, but it is not as strong as a trial that tests two drugs against each other.

The top two have one head-to-head obesity trial, and we cover it below. Our grading method explains each step in more detail.

What is a GLP-1, and how does it help weight loss?

GLP-1 stands for glucagon-like peptide-1. It is a hormone that cells in your gut lining send out after a meal⁶. For weight, three of its jobs count.

It nudges the pancreas to put out more insulin and less glucagon when blood sugar climbs. It holds food in the stomach longer, so a meal empties out more slowly. And it signals the brain to cut back on eating⁶.

The catch is that your own GLP-1 is broken down within a few minutes⁶. GLP-1 agonists for weight loss, the drugs ranked here, are built to last far longer. That is how a single shot of semaglutide or tirzepatide can cover a whole week^13,2.

So how does a GLP-1 work for weight loss? Mostly through appetite. The drug does not melt fat.

People eat less, and the weight follows⁶. Tirzepatide goes one step further by targeting the receptor for GIP, a second gut hormone, as well¹. The ranking below shows how much each version of the idea delivers.

GLP-1 drugs for weight loss compared side by side

The table below shows every GLP-1 drug on this page, with its best trial result, time to full effect, how you take it, Canadian cash price and Health Canada status. Tap a column to sort it.

Weight-loss peptides compared on trial results, time to effect, how you take them, Canadian price, Health Canada status and evidence grade

Peptide	Weight loss	Time to full effect	How you take it	Cost per month	Health Canada	Grade
TirzepatideZepbound, Mounjaro	−20.9%SURMOUNT-1 · 72 wk · n=2,539	~17 moFull dose after 20 weeks	EasyWeekly pen	$314–742Cash, before insurance	Approved (Zepbound)	A
Semaglutide injectionWegovy, Ozempic, Sevmia, Apo-Semaglutide	−14.9%STEP 1 · 68 wk · n=1,961	~16 moFull dose after 16 weeks	EasyWeekly pen	$380–507Cash, before insurance	Approved	A
Wegovy pilloral semaglutide 25 mg, US only	−13.6%OASIS 4 · 64 wk · n=307	~15 moFull dose after about 3 months	Some rulesDaily tablet	US$149–299Wegovy pill, US price. Not sold in Canada	Not approved here	A
Rybelsusoral semaglutide, diabetes doses	−5.3%ACHIEVE-3 · 52 wk · n=425	~12 moWeight measured at 52 weeks	Some rulesDaily tablet	$235–339Cash, before insurance	Diabetes only	C
LiraglutideSaxenda	−8.0%SCALE Obesity and Prediabetes · 56 wk · n=3,731	~13 moCheck progress at 12 weeks	Some rulesDaily pen	$395–524Cash, before insurance	Approved	A
Foundayoorforglipron, US only	−11.2%ATTAIN-1 · 72 wk · n=3,127	~17 moDose steps every 30 days	EasyDaily tablet	From US$149Foundayo, US price. Not sold in Canada	Under review	A
RetatrutideGIP, GLP-1 and glucagon receptor agonist	−25.0%TRIUMPH-1 · 80 wk · n=2,339	~18 mo17.5% lost by week 24 (phase 2)	No product yetWeekly injection	Not soldNot approved in Canada	Not approved	B
CagriSema (cagrilintide + semaglutide)Amylin analogue plus GLP-1 receptor agonist	−20.4%REDEFINE 1 · 68 wk · n=3,417	~16 mo68-week trial	No product yetWeekly injection	Not soldNot approved in Canada	Under review	B
SurvodutideGlucagon and GLP-1 receptor agonist	−13.0%SYNCHRONIZE-1 · 76 wk · n=725	~18 mo76-week trial	No product yetWeekly injection	Not soldNot approved in Canada	Not approved	B

Best result = average weight loss at the highest dose in each drug's own main trial, so rows from different trials are not a head-to-head test. Cash prices in CAD before insurance; US prices in US dollars are shown only for drugs not sold here.How we grade

“Best result” is the average weight loss at the top dose in each drug’s main trial. Prices are cash prices in Canadian dollars before insurance. Drugs that are not sold in Canada show no price, because there is no legal one to quote.

1. Tirzepatide (Zepbound): the best GLP-1 for weight loss in Canada

Tirzepatide is the strongest weight-loss drug you can legally buy in Canada. It acts on two gut-hormone receptors, GIP and GLP-1, where the older drugs act on GLP-1 alone. You inject it once a week with a KwikPen.

The evidence. SURMOUNT-1 followed 2,539 adults without diabetes for 72 weeks. Average weight loss was 15.0% on 5 mg, 19.5% on 10 mg and 20.9% on 15 mg, against 3.1% on placebo.

On the top dose, 57% of people lost at least a fifth of their body weight, against 3% on placebo¹. In SURMOUNT-5, which tested the two drugs head to head in obesity, tirzepatide beat semaglutide by about 20% to 14%⁷. Our tirzepatide against semaglutide comparison walks through that trial in full, and our Zepbound vs Wegovy page sets the two Canadian weight brands side by side.

Canadian status. Health Canada issued a Notice of Compliance for Zepbound on 2025-05-13⁴, and Lilly made it available on 2025-07-09⁸. Its monograph allows it for long-term weight control in adults whose BMI is at least 30, or from 27 up to 30 when a weight-related health problem is present.

A June 2026 update added sleep apnea (moderate or severe) for adults living with obesity^2,9. It has no label for anyone under 18². Mounjaro holds the same drug, but in Canada it is a type 2 diabetes brand¹⁰.

Price. A 4-week pen runs about $314 to $418 at the 2.5 and 5 mg strengths, $439 to $581 at 7.5 and 10 mg, and $563 to $742 at 12.5 and 15 mg, before insurance.

All Zepbound prices in our data are estimated, not audited¹¹. For the cost at each dose, Lilly’s savings card and who might get coverage, read our Zepbound Canada guide.

• Best for: adults who want the most weight loss from a drug they can get today, and adults with obesity and sleep apnea.
• Biggest downside: the price climbs as the dose goes up, and the top doses are the most expensive pens on this list.

Verdict: the first drug to raise with your doctor when losing the most weight matters and the price fits your budget.

2. Semaglutide injection (Wegovy): the long-track-record pick

Semaglutide is the GLP-1 most people have heard of, and for good reason. It has the longest record of the weekly drugs and the widest set of Canadian labels. You inject it once a week.

The evidence. STEP 1 followed 1,961 adults without diabetes for 68 weeks.

People on 2.4 mg lost 14.9% of their body weight on average, against 2.4% on placebo, and 86.4% lost at least 5%¹². With intensive behaviour therapy added in STEP 3, the average rose to 16.0%, against 5.7% on placebo with the same therapy¹³.

Canadian status. Wegovy has been authorized since 2021-11-23⁴. Its monograph covers chronic weight management in adults and in teens 12 to under 18 who meet set limits.

It is also approved to cut heart-attack risk in people who already have heart disease, and for a fatty-liver disease called MASH (on a conditional basis)¹³. Per the monograph, people begin on 0.25 mg weekly and move up one step each month until they hit 2.4 mg, the maintenance dose, at week 16¹³.

Generic semaglutide is arriving, with a catch. Sevmia, the first generic with a weight label, got its Notice of Compliance on 2026-06-29 but is not on the market yet^3,4.

The generics you can buy, such as Apo-Semaglutide, copy Ozempic and are labelled for type 2 diabetes, so using one for weight is off-label³. See Wegovy vs Ozempic for what separates the weight brand from the diabetes brand.

Price. A Wegovy pen with 4 weekly doses costs about $380 to $507 before insurance, at any strength.

The drug price was audited in August 2026 at five chains¹¹. Diabetes-labelled Apo-Semaglutide is about $92 to $123 a pen on the same basis¹¹.

• Best for: adults with heart disease, teens who qualify, and anyone who wants the most studied weekly option.
• Biggest downside: about 6.5 points less weight loss than tirzepatide in the head-to-head trial⁷.

Verdict: a strong first choice, and the better one if heart risk is part of your picture.

3. Liraglutide (Saxenda): the older daily option

Saxenda has been authorized for weight in Canada since 2015, longer than any other drug on this list⁴. It works the same way as semaglutide, but it is shorter-acting, so you inject it every day¹⁴.

The evidence. The SCALE trial followed 3,731 adults without diabetes for 56 weeks.

They lost 8.4 kg on average against 2.8 kg on placebo¹⁵, or 8.0% of body weight against 2.6%¹⁴. About 63% lost at least 5%, against 27% on placebo¹⁵.

Canadian status. Saxenda is meant for adults whose BMI is at least 30, or at least 27 alongside a weight-related health problem, and who have already tried a weight program without enough success. It also covers teens 12 to under 18 who meet set limits¹⁴.

The monograph has a stopping rule: if you have not lost at least 5% after 12 weeks on the full 3.0 mg dose, you stop¹⁴. No generic liraglutide is authorized yet, though 10 generic filings are under review¹⁶.

Price. Five pens, enough for 30 daily doses, cost about $395 to $524 before insurance. That figure is estimated, not audited¹¹.

• Best for: people whose drug plan covers Saxenda but not the newer drugs, and teens who qualify.
• Biggest downside: a daily shot for roughly half the weight loss of the weekly drugs, at a similar price.

Verdict: it works, but most people will do better on Zepbound or Wegovy if they can get them.

4. Oral semaglutide: the GLP-1 pill that is not here for weight yet

Oral semaglutide is the same drug as Wegovy in a daily tablet. In its own trial the 25 mg Wegovy pill came close to the shot’s result, but Canadians cannot fill a prescription for it.

The evidence. OASIS 4 followed 307 adults without diabetes for 64 weeks.

The 25 mg pill led to 13.6% weight loss on average, against 2.2% on placebo. Stomach and bowel side effects were common: 74.0% against 42.2%¹⁷.

Canadian status. The US FDA approved the Wegovy pill for weight management on 2025-12-22¹⁸. In Canada there is no drug number or Notice of Compliance for it^3,4.

Novo Nordisk told Global News in December 2025 that it had applied to Health Canada¹⁹. The semaglutide pill you can get here, Rybelsus, is authorized for type 2 diabetes only, at lower doses²⁰. It must be taken on an empty stomach with no more than 120 mL of water, at least 30 minutes before food, drink or other pills²⁰.

Price. Rybelsus runs about $235 to $339 for 28 tablets, estimated¹¹. There is no Canadian price for the weight-loss pill because it is not sold here.

For reference, Americans paying cash through Novo’s NovoCare programme are charged US$149 to US$299 a month, depending on the dose²¹. That is a US price in US dollars, and the Wegovy pill is not sold in Canada.

• Best for: people with type 2 diabetes who would rather swallow a pill than inject (as Rybelsus), and people who are happy to wait.
• Biggest downside: no weight-loss version in Canada yet, and the daily empty-stomach routine.

Verdict: worth watching. When the weight-loss pill reaches Canada, it will be a real option for people who avoid needles.

What is coming next: four GLP-1 drugs in the pipeline

None of these four is sold legally in Canada today. We list them in order of how close each one looks to a Canadian decision, not by trial results alone.

5. Orforglipron (Foundayo in the US)

Orforglipron is a daily GLP-1 pill, but it is a small chemical molecule, not a peptide²². The US FDA approved it as Foundayo on 2026-04-01²³. Its US label has no food or water rules, which makes it easier to take than oral semaglutide²⁴.

In ATTAIN-1, 3,127 adults without diabetes took it for 72 weeks. They lost 7.5%, 8.4% and 11.2% on the three doses, against 2.1% on placebo. Between 5.3% and 10.3% stopped because of side effects, against 2.7% on placebo²².

It has also beaten the semaglutide pill head to head. In ACHIEVE-3, a 52-week trial in 1,698 adults with type 2 diabetes, people on the top orforglipron dose lost 9.2% of their weight against 5.3% on oral semaglutide 14 mg, the top Rybelsus dose in that trial²⁵. They also stopped more often for side effects, about 10% against 5%²⁶.

Health Canada accepted Lilly’s filing for review in January 2026⁵. We do not know when a decision will come.

In the US, Lilly sells Foundayo to cash payers from US$149 a month at the lowest dose²⁷. Treat that as a US reference point in US dollars only: Foundayo is not sold in Canada.

How does it compare with the Wegovy pill? In their own trials the Wegovy pill took off more weight, 13.6% over 64 weeks against Foundayo’s 11.2% over 72 weeks^17,22.

No trial has tested the two weight-loss doses against each other, and ACHIEVE-3 used lower semaglutide doses. Foundayo’s real edge is convenience: no empty-stomach rule.

Verdict: less weight loss than the shots and a little less than the Wegovy pill, but the easiest pill on this list. The one to watch if you want to avoid needles.

6. CagriSema

CagriSema pairs semaglutide with cagrilintide, a long-acting copy of the fullness hormone amylin, in one weekly shot²⁸. In REDEFINE 1, 3,417 adults without diabetes lost 20.4% over 68 weeks, against 3.0% on placebo. Stomach and bowel side effects were common, at 79.6% against 39.9%²⁸.

Novo Nordisk filed for US approval in December 2025²⁹. Health Canada accepted it for review in March 2026⁵. It is not approved anywhere yet.

Verdict: results close to tirzepatide’s, with a Canadian review under way. A likely future option, not a current one.

7. Retatrutide

Retatrutide acts on three hormone receptors: GIP, GLP-1 and glucagon. Its phase 3 trial, TRIUMPH-1, followed 2,339 adults with obesity and no diabetes for 80 weeks. They lost 17.6%, 23.7% and 25.0% on the three doses, against 3.9% on placebo³⁰.

That is the biggest result on this page. Heart rate rose on the drug in the earlier phase 2 trial³¹.

It has no approval in Canada or the US, and it is not on Health Canada’s list of drugs under review^3,5. Anything sold as retatrutide in Canada today is unauthorized, and Health Canada has seized it from sellers^32,33. Our page on vials sold as retatrutide and the law covers that.

Verdict: big trial results, but a drug you cannot get legally for now.

8. Survodutide

Survodutide acts on the GLP-1 and glucagon receptors and is a weekly shot. In SYNCHRONIZE-1, 725 adults without diabetes lost 12.2% and 13.0% on its two doses over 76 weeks, against 5.4% on placebo.

That placebo loss is unusually large. Stomach and bowel side effects hit 80.9% to 89.7% of people, against 47.9% on placebo³⁴.

It is not approved anywhere and is not under Health Canada review^5,3.

Verdict: real phase 3 data, but so far it trails the drugs above on weight and side effects.

What happens when you stop a GLP-1

Most of the weight tends to come back. That matters when you choose, because the best GLP-1 for weight loss is one you can afford and tolerate for years, not months.

Two trials tested this directly. In SURMOUNT-4, the 670 adults who finished a 36-week lead-in on tirzepatide had lost 20.9% on average. Half then switched to a placebo without knowing it.

Over the next 52 weeks, the placebo group regained 14.0% while the group still on tirzepatide lost another 5.5%³⁵. STEP 4 did the same with semaglutide: after a 20-week run-in, people who switched to placebo regained 6.9% over 48 weeks, while those who stayed on it lost another 7.9%³⁶.

So budget for the long run. A drug that costs a bit less a month, or that your plan covers, may serve you better than the strongest one if it means you can stay on it.

Which GLP-1 is best for you?

Your health, budget and habits change the answer. Use these cases as a starting point for the talk with your doctor, not as a prescription.

• You want the most weight loss you can get now. Ask about Zepbound. It has the strongest trial results of the authorized drugs¹.
• Your heart is part of the story. If you already have heart disease, Wegovy is approved here to lower your odds of a non-fatal heart attack, as long as your BMI is 27 or higher¹³. Zepbound and Saxenda carry no such claim^2,14.
• You snore and stop breathing at night. If a sleep test shows moderate or severe apnea and you live with obesity, Zepbound is the GLP-1 approved here to treat it².
• You have type 2 diabetes. Your options widen to the diabetes brands, Mounjaro, Ozempic and Rybelsus, which a plan may cover. Our Mounjaro vs Ozempic guide compares the two shots.
• Your budget is tight. Compare the low-dose Zepbound pens with Wegovy, and check what your drug plan covers before you choose¹¹.
• You hate needles. For now there is no GLP-1 pill authorized for weight in Canada. Rybelsus is for diabetes. If you can wait, watch orforglipron and the Wegovy pill^5,19.
• You are under 18. Wegovy and Saxenda have labels for teens 12 and up who meet set limits. Zepbound does not^13,14,2.
• You are tempted to wait for retatrutide. That could take a while. It is not under review in Canada yet⁵.

Still torn? Our one-minute quiz matches you to options based on your goals, budget and comfort with needles. When you know which drug to ask about, our guide to getting a weight-loss injection in Canada covers prescriptions and pharmacies.

Side effects every GLP-1 shares

They all cause the same kind of side effects: nausea, diarrhea, constipation and vomiting, mostly while the dose is rising⁷. In SURMOUNT-1, nausea hit 24.6% to 29.0% of people on tirzepatide, against 8.5% on placebo². In STEP 1, 4.5% of people on semaglutide stopped because of stomach side effects, against 0.8% on placebo¹².

The Canadian monographs for Zepbound, Wegovy and Saxenda all carry a warning about thyroid C-cell tumours seen in rodents^2,13,14. Ask your prescriber what that means for you.

How this ranking was checked

We looked up each drug’s Canadian status in Health Canada’s two public drug databases on 2026-11-12^3,4. Trial figures are taken from the published papers. Prices come from a single Canadian dataset that flags each row as audited or estimated¹¹.

This ranking is a reading of published evidence; nobody here gave these drugs to anyone. A pharmacist has not reviewed the page yet, and the page says so until that review is done.

Want to see how GLP-1s stack up against the other peptides people ask about? Our rankings of every weight-loss peptide grade them all on the same evidence.

Nothing here is medical advice. Your doctor or pharmacist should help you decide whether to begin, change or come off any of these drugs.