Contrave vs Wegovy

These medications target weight loss through completely different pathways. Contrave reduces food cravings via the brain's reward system; Wegovy suppresses appetite via gut hormone mimicry. Here's how to choose.

	Contrave	Wegovy
Type	Oral tablet (twice daily)	Weekly injection
Mechanism	Opioid antagonist + antidepressant	GLP-1 receptor agonist
What it targets	Food cravings & reward eating	Appetite & satiety signals
Avg. weight loss	5–10%	15–17%
Monthly cost	~$300	$400–460
Duration	Long-term	Long-term
Nausea rate	~33% (resolves in 2–4 weeks)	~44% (resolves in 8–16 weeks)
Key advantage	Specifically targets emotional eating	Much higher weight loss
Key warning	Seizure risk, no opioids	GI side effects during escalation

The core difference

Wegovy produces significantly more weight loss (~15-17% vs ~5-10%) because GLP-1 receptor agonism is a more potent mechanism for weight reduction than Contrave's reward pathway modulation. For pure weight loss numbers, Wegovy wins decisively.

However, Contrave has a unique advantage: it specifically targets the reward and craving pathways that drive emotional and binge eating. If your weight challenge is primarily driven by "I can't stop eating chocolate/chips/fast food" rather than "I'm always hungry," Contrave addresses the root cause in a way Wegovy doesn't directly target.

Choose Contrave if:

Your weight is driven by emotional eating, binge eating, or specific food cravings
You strongly prefer tablets over injections
You have co-existing depression (bupropion is an antidepressant)
You want to spend ~$100/month less than Wegovy

Choose Wegovy if:

Maximum weight loss is your priority
Your eating pattern is more about constant hunger/large portions than specific cravings
You have cardiovascular disease or risk factors (SELECT trial benefits)
You may qualify for PBS pricing

Contrave vs Wegovy

The core difference

Choose Contrave if:

Choose Wegovy if:

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