Contrave and Wegovy stand out as two popular prescription choices for adults seeking help with long-term weight management. Contrave works by targeting brain pathways to reduce cravings and emotional eating, while Wegovy mimics a gut hormone to promote fullness and slow digestion. Both require lifestyle changes like diet and exercise to deliver their full potential.
Many people face tough decisions when choosing between an oral pill taken daily and a weekly injection. Wegovy often produces more substantial weight reduction in studies, yet Contrave appeals to those who prefer convenience without needles or who respond well to craving control. Individual health profiles, preferences, and budgets guide the best selection.
Neither medication offers a magic solution on its own. Success comes from pairing them with sustainable habits under medical guidance. This comparison explores key differences to help clarify which might align better with personal goals and circumstances.
What Is Contrave and How Does It Work
Contrave combines naltrexone and bupropion in an extended-release tablet. Naltrexone blocks opioid receptors to lessen the pleasure from high-calorie foods, while bupropion boosts dopamine and norepinephrine to curb appetite. Together they address reward-driven and hunger signals in the brain.
This central nervous system approach helps many reduce impulsive snacking and feel satisfied sooner. It suits those whose weight challenges involve strong food cravings or stress eating. Effects develop gradually over weeks with proper titration.
Approved for adults with BMI 30+ or 27+ with weight-related conditions like hypertension or diabetes. A doctor evaluates suitability, considering mood history and other factors.
What Is Wegovy and How Does It Work
Wegovy contains semaglutide, a GLP-1 receptor agonist given as a weekly subcutaneous injection. It mimics the natural hormone GLP-1 to increase insulin release, slow gastric emptying, and signal fullness to the brain. This leads to reduced calorie intake naturally.
Users often experience prolonged satiety after meals and fewer hunger pangs between them. The once-weekly dosing fits busy schedules well. It also offers cardiovascular risk reduction in eligible adults.
Prescribed for similar BMI criteria as Contrave, plus certain children in some cases. Starting low and escalating doses minimizes initial discomfort. Regular monitoring tracks progress and tolerability.
Contrave vs Wegovy | Head-to-Head Comparison
Wegovy typically delivers greater average weight loss in clinical trials and real-world data. STEP trials show around 15% body weight reduction over 68 weeks, while Contrave studies report 5-9% over 56 weeks, with some adherent groups reaching 9.5%. Wegovy often helps more people achieve 10-20% loss.
Both support meaningful health improvements like better blood pressure or glucose control when weight drops. Contrave may shine for emotional or reward-based eating patterns. Wegovy excels in appetite suppression via hormonal pathways.
No direct head-to-head trials exist, so comparisons draw from separate studies. Response varies widely based on adherence, starting weight, and lifestyle. A provider helps weigh personal fit.
Average Weight Loss Data
| Medication | Average % Weight Loss | Study Duration | Key Notes |
|---|---|---|---|
| Contrave | 5-9% (up to 9.5% in adherent users) | 56 weeks | 5.4-8.1% in major trials; higher with strong adherence |
| Wegovy | ~15% | 68 weeks | STEP trials; sustained ~15% at 2 years in follow-ups |
Dosing and Administration Differences
Contrave starts with one tablet daily in week one, building to two tablets twice daily (32 mg naltrexone/360 mg bupropion) by week four. Take with food to ease stomach upset. Oral convenience avoids needles.
Wegovy begins at 0.25 mg weekly, escalating every four weeks to 2.4 mg maintenance. Self-inject under the skin in abdomen, thigh, or arm. Rotate sites and store refrigerated.
Both need gradual increases for tolerance. Contrave suits pill preferrers; Wegovy offers fewer doses per month. Providers teach proper technique and monitor adjustments.
Side Effects Profile Comparison
Common issues overlap with nausea, headache, and constipation appearing frequently in both. Contrave often adds insomnia, dry mouth, dizziness, or anxiety due to bupropion. These may improve over time.
Wegovy tends toward more gastrointestinal effects like vomiting, diarrhea, or abdominal pain, especially early on. Fatigue or heartburn occur too. Injection-site reactions remain mild for most.
Serious risks differ: Contrave carries a boxed warning for suicidal thoughts, particularly in those with mood concerns. Wegovy has one for potential thyroid tumors (seen in rodents). Report mood changes or severe symptoms promptly.
Cost and Accessibility Considerations
Without insurance, Contrave typically runs $99-199 monthly with manufacturer savings programs. Retail prices hover higher around $600-850, but coupons make it more attainable.
Wegovy lists around $1,300-1,350 monthly, though savings cards drop it to $199-349 for eligible patients in some programs. Coverage varies widely by plan.
Contrave often proves more affordable long-term for cash payers. Both face supply fluctuations at times. Check pharmacy options and assistance programs regularly.
Who Might Benefit More from Each
Contrave appeals to those avoiding injections, with pill convenience, or strong cravings/emotional eating. It may suit milder obesity cases or budget-conscious individuals.
Wegovy often fits those seeking maximum weight reduction, especially with higher starting BMI or cardiometabolic needs. Weekly dosing works for needle-tolerant users.
Neither suits everyone; contraindications include opioid use for Contrave or personal thyroid cancer history for Wegovy. Comprehensive evaluation determines appropriateness.
Lifestyle Integration Tips for Success
Focus on balanced, lower-calorie meals rich in protein, fiber, and vegetables to complement either medication. Smaller portions feel natural with reduced hunger.
Incorporate 150+ minutes of moderate activity weekly, mixing walking, strength training, or enjoyable movement. Consistency preserves muscle and boosts mood.
- Drink ample water to ease constipation or nausea.
- Prioritize sleep for hormone regulation.
- Track intake and progress in a simple journal.
- Seek support from dietitians or groups for accountability.
Build habits gradually to sustain changes beyond medication. Non-scale wins like energy gains keep motivation high.
Summary
Contrave and Wegovy both aid chronic weight management when combined with diet and exercise, yet Wegovy generally achieves higher average loss (around 15% vs 5-9% for Contrave). Contrave offers oral convenience and targets cravings effectively, while Wegovy provides stronger appetite control via weekly injections. Side effects overlap in gastrointestinal areas, but each has unique risks like mood concerns for Contrave or thyroid warnings for Wegovy.
Cost favors Contrave for many without robust insurance, though savings programs help both. Individual factors such as preferences, health history, and goals determine the better choice. Consult a healthcare provider for personalized advice and monitoring.
FAQ
Which causes more weight loss, Contrave or Wegovy?
Wegovy typically leads to greater average reduction, around 15% of body weight over 68 weeks in trials. Contrave averages 5-9%, with some reaching higher in adherent groups. Results depend on lifestyle adherence and personal response.
Is Contrave or Wegovy better for avoiding injections?
Contrave wins here as a twice-daily oral tablet. Wegovy requires weekly self-injections, which some find inconvenient. Many prefer Contrave for needle-free ease.
What are the main side effects differences?
Both cause nausea and headache commonly. Contrave more often brings insomnia, dry mouth, or mood changes. Wegovy tends toward vomiting, diarrhea, or abdominal issues early on.
How do costs compare without insurance?
Contrave generally costs less, often $99-199 monthly with savings offers. Wegovy lists higher at $1,300+, though discounts may lower it to $199-349 for eligible users. Prices vary by program and pharmacy.
Who should choose one over the other?
Choose Contrave for pill preference, craving control, or budget needs. Opt for Wegovy when seeking maximum loss or cardiovascular benefits. A doctor assesses contraindications like mood history or thyroid risks to guide selection.
Dr. Hamza is a medical content reviewer with over 12+ years of experience in healthcare research and patient education. He specializes in evidence-based health information, medications, and chronic conditions. His reviews are grounded in trusted medical sources and current clinical guidelines to ensure accuracy, transparency, and reliability. Content reviewed by Dr. Hamza is intended for educational purposes and is not a substitute for professional medical advice.