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Semaglutide (Wegovy, Ozempic) is the second most effective at 10-15% average weight loss

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Zepbound: For adults with obesity (BMI 30) or who are overweight (BMI 27) with at least one weight-related health condition like high blood pressure or high cholesterol

There also seems to be a class effect for long-acting GLP-1RAs with regard to improving cardiovascular outcomes, and it seems likely that this class of agents confers benefits by mechanisms that are different from both pioglitazone and SGLT2 inhibitors

Insurance coverage depends on your individual plan and diagnosis