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Key deciding factors for initiation of oral or subcutaneous semaglutide included: patient preference (fear of injection)

Decision factors: Weight loss goals: Want maximum weight loss and can tolerate side effects: Tirzepatide (Zepbound) shows ~4% greater weight loss than semaglutide on average Want proven cardiovascular benefits: Semaglutide has demonstrated 20% reduction in major cardiovascular events in the SELECT trial Want to try oral option: Oral semaglutide (Rybelsus) for diabetes, though weight loss is less than injectable Side effect sensitivity: Some people tolerate one better than the other