The honest answer
If we had to rank purely on average weight loss, the order is Mounjaro > Wegovy ≈ Ozempic > Saxenda. But “best” isn't only about results — it's about what you can afford month after month, what your medical aid will (or won't) fund, what's in stock, how you tolerate it, and whether on-label use matters to you. We won't tell you one is right for you; that's a clinical decision.
Avoid counterfeits
All four, side by side
| Medicine | Avg. weight loss | Price / month | SA registration | Frequency |
|---|---|---|---|---|
| Mounjaro (tirzepatide) | ~21% (highest) | R3 500–R4 600 | Diabetes + weight mgmt | Once weekly |
| Wegovy (semaglutide) | ~15% | R1 900–R3 750 | Weight management | Once weekly |
| Ozempic (semaglutide) | ~15% (lower max dose) | R2 700–R3 300 | Diabetes (off-label) | Once weekly |
| Saxenda (liraglutide) | ~8% | R2 800–R4 800 | Weight management | Once daily |
Best for maximum results
Mounjaro (tirzepatide) — the largest average weight loss in trials and the winner of a head-to-head against semaglutide. It's also usually the priciest.
Best for budget
Wegovy became more competitive after the 2026 price cuts, and Ozempic at a lower dose can be manageable. Per-month cost still runs into thousands of Rand for all of them — see the price guide. Be wary of “cheap” unregistered options: read about compounded semaglutide first.
Best for medical-aid cover
None are reliably covered for weight loss, but Saxenda — the longest-registered for weight management — is the one most likely to attract partial funding on some plans. If you have type 2 diabetes, Ozempic may be covered under a chronic benefit. See medical-aid cover.
How to choose
- Check eligibility — try the BMI calculator and read am I eligible?
- Set a realistic monthly budget, including the hidden costs.
- Ask your medical aid what (if anything) they'll fund.
- Discuss the trade-offs with a registered provider, who can match a medicine to your health and goals.
Next step