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Cost Per Kilogram Lost: The Comparison That Matters

Medically reviewed Dr. Saad Mahmood MBBS, FCPS (Endocrinology)
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Comparing weight loss options by monthly price is misleading. Cost per kilogram lost reverses much of the ranking. Here is the arithmetic worked through.

Most people compare weight loss options by monthly price. That ranks the weakest drugs as the best value, which is the opposite of the truth.

The more useful measure is what you spend per kilogram actually lost. It changes the ranking substantially, and it exposes which options are genuinely cheap and which are just inexpensive.

Why monthly price misleads

A drug costing half as much per month is not half as good value if it produces a quarter of the result.

Dulaglutide is frequently among the cheaper GLP-1 imports here and produces roughly 3 kg. Tirzepatide is the most expensive and produced 20.9 percent average body weight reduction in SURMOUNT-1.

On a 90 kg person, 20.9 percent is roughly 19 kg. Against 3 kg, that is more than six times the result.

Unless tirzepatide costs more than six times as much per month, it is better value per kilogram despite the higher monthly figure.

How to do the calculation

Four steps.

One: take the monthly cost at your maintenance dose, not the starting dose. Add consultation, delivery and monitoring, which together typically add 20 to 40 percent.

Two: multiply by the course duration. Use the trial duration as your guide. SURMOUNT-1 ran 72 weeks, STEP 1 ran 68, SCALE ran 56.

Three: estimate the kilograms. Apply the trial percentage to your own starting weight.

Four: divide the total cost by the kilograms.

That figure is comparable across options in a way monthly price never is.

What the ranking looks like

Using average trial results on a 90 kg starting weight:

DrugAverage resultKilograms on 90 kgCourse length
Tirzepatide 15 mg20.9 percent~19 kg72 weeks
Semaglutide 2.4 mg14.9 percent~13 kg68 weeks
Orforglipronup to 12.4 percent~11 kg72 weeks
Qsymia 15/9210.5 percent~9 kg108 weeks
Liraglutide 3.0 mg8.4 kg~8 kg56 weeks
Contrave6.1 percent~5 kg56 weeks
Orlistat5.8 kg~6 kg4 years
Dulaglutide 1.5 mg~3 kg~3 kg40 weeks

Two things stand out.

Orlistat's 5.8 kg took four years. Spread across that duration, its cost per kilogram is less attractive than the low monthly price suggests, even though the monthly price is genuinely the lowest available locally.

Dulaglutide's 3 kg over 40 weeks makes it poor value per kilogram regardless of a lower monthly figure.

The supplement comparison

Applying the same logic to supplements is instructive.

SupplementPooled effect
Green tea extract1.78 kg
Glucomannan1.27 kg
L-carnitine1.21 kg
CLA1.08 kg
Garcinia0.88 kg
Berberine, fenugreekNo significant change

None reaches the 2.5 kg threshold researchers use for clinical significance. Berberine and fenugreek produced no significant weight change at all.

Spending anything on a product producing no significant weight change gives an undefined cost per kilogram. That is the honest arithmetic for several of the most heavily marketed supplements in Pakistan.

The number that ruins everything

An abandoned course has an effectively infinite cost per kilogram.

GLP-1 medication manages weight while you take it. Appetite returns after stopping and weight regain is common. If you spend six months of money and then stop, and the weight comes back, your cost per kilogram retained approaches infinity.

This is not a theoretical edge case in Pakistan. It is the normal pattern when supply depends on informal import that interrupts.

Which means the single largest factor in cost per kilogram is not the drug's price. It is whether you finish.

What that implies

If completion determines value, then the questions that matter change.

Not: which is cheapest per month?

But: which can I obtain continuously for the full duration, verify the authenticity of, and afford across the whole course?

A moderately effective option you complete beats a highly effective one you abandon at month four. That is not a compromise, it is arithmetic.

This is the reasoning behind locally registered alternatives in a market with no registered GLP-1 medication. When you compare against the best weight loss drops in Pakistan carrying registration, you are not comparing effect sizes with imported pharmaceuticals. METASLIMβ„’ is a physician-reviewed sublingual supplement, not a pharmaceutical GLP-1 receptor agonist, and SURMOUNT-1 or STEP 1 figures do not describe it.

What it changes is the completion variable. No cold chain to break, no import shipment to fail, and a physician review included rather than charged separately. Those are the factors that determine whether a course finishes.

Our monthly cost comparison sets the raw figures side by side, and hidden costs of weight loss programs covers what gets left out of quotes. If you are unsure which situation applies to you, check your eligibility in a few questions.

The summary

Monthly price ranks the weakest options as best value, which inverts the truth.

Cost per kilogram lost is the comparable measure. Calculate maintenance monthly cost plus overheads, multiply by course duration, divide by expected kilograms.

Stronger drugs cost more monthly and frequently less per kilogram.

Orlistat's low monthly price is offset by taking four years to produce 5.8 kg.

Several popular supplements produced no significant weight change, giving an undefined cost per kilogram.

Completion is the largest single factor, because an abandoned course returns almost nothing.

Find out what the program costs for an option built around finishing.

This article is for informational purposes only and does not constitute medical advice. Consult a qualified physician before starting any weight loss program, medication, or supplement.

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References & Sources

  1. Jastreboff AM et al. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1), NEJM 2022
  2. Torgerson JS et al. XENical in the prevention of Diabetes in Obese Subjects (XENDOS), Diabetes Care 2004

Frequently Asked Questions

Take your monthly cost at maintenance dose, add consultation, delivery and monitoring which typically add 20 to 40 percent, multiply by the course duration from the trial data, then divide by the kilograms you would expect based on the trial percentage applied to your starting weight.

Tirzepatide often does despite the highest monthly price, because it produced 20.9 percent average reduction, roughly 19 kg on a 90 kg person. That holds only if the full 72-week course is completed without supply interruption.

Its monthly price is the lowest with reliable local availability, but XENDOS recorded 5.8 kg over four years. Spread across that duration, cost per kilogram is less attractive than the monthly figure suggests, though it remains the most obtainable option in Pakistan.

It produces roughly 3 kg while requiring the same course duration, consultations, cold-chain delivery and supply risk as stronger options. Paying less per month for a fifth of the result gives a worse cost per kilogram, not a better one.

It approaches infinity. GLP-1 medication manages weight while taken, and regain after stopping is common. Money spent on a course abandoned partway returns almost nothing, which is why completion matters more than monthly price.

For several, it is undefined. Berberine and fenugreek produced no significant weight change in pooled trials, so any spending divides by zero. Green tea extract at 1.78 kg and garcinia at 0.88 kg both fall below the 2.5 kg clinical significance threshold.

Whether you can complete the course. A moderately effective option you finish beats a highly effective one you abandon at month four. In a market supplied by informal import, continuity of supply is the main determinant of value.

Written by

Ayesha Tariq

Medical Content Writer

Ayesha is a Karachi-based health writer specialising in metabolic health and evidence-based nutrition for South Asian readers.

Medically reviewed by

Dr. Saad Mahmood

MBBS, FCPS (Endocrinology)

Dr. Mahmood is a consultant endocrinologist with a decade of experience managing obesity and type 2 diabetes.

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